title: Comparative numerical study on left ventricular fluid dynamics after dilated cardiomyopathy.
abstract: BACKGROUND
  The role of flow on the progression of left ventricular (LV) remodeling has been presumed, although measurements are still limited and the intraventricular flow pattern in remodeling hearts has not been evaluated in a clinical setting. Comparative evaluation of intraventricular fluid dynamics is performed here between healthy subjects and dilated cardiomyopathy (DCM) patients.
  
  
  METHODS
  LV fluid dynamics is evaluated in 20 healthy young men and 8 DCM patients by combination of 3D echocardiography with direct numerical simulations of the equation governing blood motion. Results are analyzed in terms of quantitative global indicators of flow energetics and blood transit properties that are representative of the qualitative fluid dynamics behaviors.
  
  
  RESULTS
  The flow in DCM exhibited qualitative differences due to the weakness of the formed vortices in the large LV chamber. DCM and healthy subjects show significant volumetric differences; these also reflect inflow properties like the vortex formation time, energy dissipation, and sub-volumes describing flow transit. Proper normalization permitted to define purely fluid dynamics indicators that are not influenced by volumetric measures.
  
  
  CONCLUSIONS
  Cardiac fluid mechanics can be evaluated by a combination of imaging and numerical simulation. This pilot study on pathological changes in LV blood motion identified intraventricular flow indicators based on pure fluid mechanics that could potentially be integrated with existing indicators of cardiac mechanics in the evaluation of disease progression.
authors.affiliation: Department of Civil and Environmental Engineering, University of Florence, Italy. jmangual@dicea.unifi.it
authors.forename: Jan O
authors.initials: JO
authors.lastname: Mangual
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Kraigher-Krainer
authors.forename: Alessio
authors.initials: A
authors.lastname: De Luca
authors.forename: Loira
authors.initials: L
authors.lastname: Toncelli
authors.forename: Amil
authors.initials: A
authors.lastname: Shah
authors.forename: Scott
authors.initials: S
authors.lastname: Solomon
authors.forename: Giorgio
authors.initials: G
authors.lastname: Galanti
authors.forename: Federico
authors.initials: F
authors.lastname: Domenichini
authors.forename: Gianni
authors.initials: G
authors.lastname: Pedrizzetti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology*; D018056:Hemorheology; D006801:Humans; D057446:Hydrodynamics; D008297:Male; D008875:Middle Aged; D016276:Ventricular Function; D055815:Young Adult