Numerical study on the left ventricular flow after dilated cardiomyopathy

SUMMARY. The role of flow on the progression of left ventricular (LV) remodeling has been presumed, although measurements are still limited and the flow pattern inside of remodeling hearts has not been systematically evaluated in a clinical setting yet. The combination of 3D echocardiography with direct numerical simulations are here used to analyze the intraventricular fluid dynamics in healthy subjects and in dilated cardiomyopathy (DCM) patients. Quantitative global indicators of flow energetics and blood transit properties are defined, they summarize the qualitative fluid dynamics behaviors. The flow in DCM exhibited qualitative differences due to the weakness of the vortices forming in larger LV chambers, combined with significant volumetric differences; these reflect in flow properties like the vortex formation time, energy dissipation, and sub-volumes describing flow transit. Purely fluid dynamics indicators that are not influenced by volumetric measures are defined by proper normalization.