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Asymmetric redirection of flow through the heart

Author

Listed:
  • Philip J. Kilner

    (Royal Brompton Hospital site of Imperial College of Science, Medicine and Technology)

  • Guang-Zhong Yang

    (Royal Brompton Hospital site of Imperial College of Science, Medicine and Technology
    Royal Brompton Hospital site of Imperial College of Science, Medicine and Technology)

  • A. John Wilkes

    (Flow Design Research Group, Emerson College)

  • Raad H. Mohiaddin

    (Royal Brompton Hospital site of Imperial College of Science, Medicine and Technology)

  • David N. Firmin

    (Royal Brompton Hospital site of Imperial College of Science, Medicine and Technology)

  • Magdi H. Yacoub

    (Royal Brompton Hospital site of Imperial College of Science, Medicine and Technology)

Abstract

Through cardiac looping during embryonic development1, paths of flow through the mature heart have direction changes and asymmetries whose topology and functional significance remain relatively unexplored. Here we show, using magnetic resonance velocity mapping2,3,4,5, the asymmetric redirection of streaming blood in atrial and ventricular cavities of the adult human heart, with sinuous, chirally asymmetric paths of flow through the whole. On the basis of mapped flow fields and drawings that illustrate spatial relations between flow paths, we propose that asymmetries and curvatures of the looped heart have potential fluidic and dynamic advantages. Patterns of atrial filling seem to be asymmetric in a manner that allows the momentum of inflowing streams to be redirected towards atrio-ventricular valves, and the change in direction at ventricular level is such that recoil away from ejected blood is in a direction that can enhance rather than inhibit ventriculo-atrial coupling6. Chiral asymmetry might help to minimize dissipative interaction between entering, recirculating and outflowing streams7. These factors might combine to allow a reciprocating, sling-like, ‘morphodynamic’ mode of action to come into effect when heart rate and output increase during exercise6.

Suggested Citation

  • Philip J. Kilner & Guang-Zhong Yang & A. John Wilkes & Raad H. Mohiaddin & David N. Firmin & Magdi H. Yacoub, 2000. "Asymmetric redirection of flow through the heart," Nature, Nature, vol. 404(6779), pages 759-761, April.
    • Handle: RePEc:nat:nature:v:404:y:2000:i:6779:d:10.1038_35008075
    DOI: 10.1038/35008075
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    Cited by:

    1. K. Cao & M. BukaČ & P. Sucosky, 2016. "Three-dimensional macro-scale assessment of regional and temporal wall shear stress characteristics on aortic valve leaflets," Computer Methods in Biomechanics and Biomedical Engineering, Taylor & Francis Journals, vol. 19(6), pages 603-613, April.
    2. Federico Domenichini & Gianni Pedrizzetti, 2011. "Intraventricular vortex flow changes in the infarcted left ventricle: numerical results in an idealised 3D shape," Computer Methods in Biomechanics and Biomedical Engineering, Taylor & Francis Journals, vol. 14(01), pages 95-101.
    3. Bee Ting Chan & Einly Lim & Chi Wei Ong & Noor Azuan Abu Osman, 2015. "Effect of spatial inlet velocity profiles on the vortex formation pattern in a dilated left ventricle," Computer Methods in Biomechanics and Biomedical Engineering, Taylor & Francis Journals, vol. 18(1), pages 90-96, January.

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