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在模拟循环回路中使用血泵支持观察不同心力衰竭阶段的心室内血流可视化。

Intraventricular flow visualization in different heart failure stages with blood pump support in a mock circulatory loop.

机构信息

State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Department of Adult Cardiac Surgery, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China.

出版信息

Int J Artif Organs. 2021 Oct;44(10):773-782. doi: 10.1177/03913988211021432. Epub 2021 Aug 12.

Abstract

The intraventricular blood flow changed by blood pump flow dynamics may correlate with thrombosis and ventricular suction. The flow velocity, distribution of streamlines, vorticity, and standard deviation of velocity inside a left ventricle failing to different extents throughout the cardiac cycle when supported by an axial blood pump were measured by particle image velocimetry (PIV) in this study. The results show slower and static flow velocities existed in the central region of the left ventricle near the mitral valve and aortic valve and that were not sensitive to left ventricular (LV) failure degree or LV pressure. Strong vorticity located near the inner LV wall around the LV apex and the blood pump inlet was not sensitive to LV failure degree or LV pressure. Higher standard deviation of the blood velocity at the blood pump inlet decreased with increasing LV failure degree, whereas the standard deviation of the velocity near the atrium increased with increasing intraventricular pressure. The experimental results demonstrated that the risk of thrombosis inside the failing left ventricle is not related to heart failure degree. The "washout" performance of the strong vorticity near the inner LV wall could reduce the thrombotic potential inside the left ventricle and was not related to heart failure degree. The vorticity near the aortic valve was sensitive to LV failure degree but not to LV pressure. We concluded that the risk of blood damage caused by adverse flow inside the left ventricle decreased with increasing LV pressure.

摘要

血流动力学改变导致的心室内部血流变化可能与血栓形成和心室抽吸有关。本研究采用粒子图像测速(PIV)技术测量了在轴向血流泵支持下,不同程度左心室衰竭时左心室内部的流速、流线分布、涡度和速度标准差。结果表明,左心室中部靠近二尖瓣和主动脉瓣的区域存在较慢且静态的血流速度,对左心室衰竭程度或左心室压力不敏感。在左心室心尖和血流泵入口附近的左心室内壁周围存在较强的涡度,对左心室衰竭程度或左心室压力不敏感。血流泵入口处的血流速度标准差随左心室衰竭程度的增加而降低,而心房附近的速度标准差随室内压力的增加而增加。实验结果表明,衰竭左心室内部的血栓形成风险与心力衰竭程度无关。左心室内壁附近强涡度的“冲刷”性能可降低左心室的血栓形成潜力,与心力衰竭程度无关。主动脉瓣附近的涡度对左心室衰竭程度敏感,但对左心室压力不敏感。我们得出结论,左心室内部不良流动引起的血液损伤风险随左心室压力的增加而降低。

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