Computational evaluation of intraventricular pressure gradients based on a fluid-structure approach.

The dynamics of intraventricular blood flow, i.e. its rapid evolution, implies the rise of intraventricular pressure gradients (IPGs) characteristic of the inertia-driven events as experimentally observed by Pasipoularides (1987, 1990) and by Falsetti et al. (1986). The IPG time course is determined by the wall contraction which, in turn, depends on the load applied, namely the intraventricular pressure which is the sum of the aortic pressure (i.e., the systemic net response) and the IPG. Hence the IPGs account, at least in part, for the wall movement. These considerations suggest the necessity of a comprehensive analysis of the ventricular mechanics involving both ventricular wall mechanics and intraventricular fluid dynamics as each domain determines the boundary conditions of the other. This paper presents a computational approach to ventricular ejection mechanics based on a fluid-structure interaction calculation for the evaluation of the IPG time course. An axisymmetric model of the left ventricle is utilized. The intraventricular fluid is assumed to be Newtonian. The ventricle wall is thin and is composed of two sets of counter-rotating fibres which behave according to the modified version of Wong's sarcomere model proposed by Montevecchi and Pietrabissa and Pietrabissa et al. (1987, 1991). The full Navier-Stokes equations describing the fluid domain are solved using Galerkin's weighted residual approach in conjunction with finite element approximation (FIDAP). The wall displacement is solved using the multiplane quasi-Newton method proposed by Buzzi Ferraris and Tronconi (1985). The interaction procedure is performed by means of an external macro which compares the flow fields and the wall displacement and appropriately modifies the boundary conditions to reach the simultaneous and congruous convergence of the two problems. The results refer to a simulation of the ventricular ejection with a heart rate of 72 bpm. In this phase the ventricle ejects 61 cm3 (ejection fraction equal to 54 percent) and the ventricular pressure varies from 78 mmHg to 140 mmHg. The IPG show an oscillating behaviour with two major peaks at the beginning (11.09 mmHg) and at the end (4.32 mmHg) of the ejection phase, when the flow rate hardly changes, according to the experimental data. Furthermore the wall displacement, the wall stress and strain, the pressure and velocity fields are calculated and reported.