In vitro validation of a new approach for quantitating regurgitations using proximal isovelocity surface area.

The present work has been designed to validate the calculation of the effective regurgitant orifice (ERO) area with the use of a new formula that takes into account the velocity profile (V(r) vs r) and that is insensitive to errors in the determination of the position of the orifice. Assuming a hemispheric model, ERO = 2 pi r(2). V(r)/V(o) (with V(o) = velocity at the orifice) and (V(o)/V(r))(0.5) = (2 pi/ERO)(0.5) r. Thus, the slope of the corresponding linear regression allows ERO to be calculated as: ERO = 2 pi/slope(2). This approach was tested in vitro in pulsatile conditions on circular, conical, and slit-like orifices. The calculated ERO was compared with the actual jet cross sectional area derived from the transverse velocity profile at the jet origin. For the purpose of comparison, the "classical" ERO was calculated for all the configurations, angulations, and threshold velocities. The relationship between (V(o)/V(r))(0.5) was linear (r > 0.98) over a wide range of velocities. The nonhemispheric components were found to modify the constant and not the slope. The mean variation of the calculated ERO was 6.5%. The correlation between the calculated and the actual ERO was very close (>0.97) with slope equal to 0.96. By comparison with the new method, the classical formula gave an underestimation of the ERO that dramatically increased when studying the flow closer to the orifice or in the case of error on the measurement of r. In conclusion, a method using velocity profiles instead of isolated values improves the accuracy of the proximal isovelocity surface area (PISA) method for measuring the ERO.

Fluid mechanics of regurgitant jets and calculation of the effective regurgitant orifice in free or complex configurations.

The velocity fields of turbulent jets can be described using a single formula which includes two empirical constants: k(core) determining the length of the central core and k(turb) the jet widening. Flow models simulating jet adhesion, confinement and noncircular orifices were studied using laser Doppler anemometer and the modifications of the constants were derived from series of velocity profiles. In circular free jets, k(core) was found equal to 4.1 with a variability of 1.4%. In complex configurations, its variability was equal to 15.2%. For k(turb), the value for free circular jets was of 45.2 with a variability of 6.0% and this variability in complex configurations was significantly higher (30. 1%, p=0.025). The correlation between the actual orifice size and the jet extension was poor (r=0.52). However, the almost constant value of k(core) allowed to define a new algorithm calculating the regurgitant orifice diameter with the use of outlines of the jet image (r=0.89). In conclusion, the fluid mechanics of regurgitant jets is modified in complex configurations but, due to the relative independency of the central core, velocity fields could be used to evaluate the dimensions of the effective regurgitant orifice.

In vitro flow mapping of regurgitant jets. Systematic description of free jet with laser Doppler velocimetry.

BACKGROUND: Color Doppler and magnetic resonance imaging give pictures of abnormal jets within which the respective contribution of fluid mechanics and image artifacts are difficult to establish because of current technical limitations of these modalities. We conducted the present study to provide numerical descriptions of the velocity fields within regurgitant free jets. METHODS AND RESULTS: Laser Doppler measurements were collected in rigid models with pulsatile flow conditions, giving several series of two-dimensional flow images. The data were studied with the use of two-dimensional or M-mode flow images as well as regular plots. Numerical descriptions validated in steady flow conditions were tested at the various times of the cycle. In these free jets, the momentum was conserved throughout the cycle. The transverse velocity profiles were approximately similar. A central laminar core was found at peak ejection and during the deceleration. Its length (l = 4.08 d-0.036 mm, r = .99) and its diameter (d) were proportional to the orifice diameter. At peak ejection, the velocity decay was hyperbolic, and the transverse velocity profiles were clearly gaussian. The different relations that were tested could be combined in a single formula describing the velocity field: V(x,y,t peak) = V(O,O,t peak).4.(d/x).10(-45(y/x)2) (r = .92). CONCLUSIONS: These in vitro measurements demonstrated the presence of a central laminar core and similar transverse velocity profiles in free turbulent jets. This allowed us to validate a series of numerical relations that can be combined to describe the velocity fields at peak ejection. On the other hand, further studies are needed to describe the various singularities often encountered in pathology.

Influence of pulsatility on the development of intracardiac jets: an in vitro laser Doppler study.

So far, it has been hypothesized that numerical data obtained in steady flow conditions apply to pulsatile flows. In order to study the modifications of the velocity fields due to pulsatility, jets were produced by 8 orifices (with a diameter "D" of 4.4 to 11.3 mm) included in a chamber of 50 mm. The velocity was measured using laser Doppler anemometry with a pulsatile flow ("pf") and compared to the values obtained in steady ("sf"): at maximum velocity, the longitudinal velocity profile is qualitatively similar to this observed in steady flow: it is made of a plateau followed by an hyperbolic velocity decay in the turbulent area. The length of the core ("Lpf") is strongly related to "D" (Lpf = 3.72 D + 5.49, r = .99) and the velocity decay depends on the ratio between the distance "x" from the orifice and "D" (V/Vo = 2.83D/x + 3.46, r = .85, where V is the velocity at "x" and Vo the initial velocity). During the acceleration and the deceleration, the laminar core is disturbed by turbulences. The comparison of "pf" data with "sf" data demonstrated similar diameters at the origin of the jets (Dpf = 0.96 Dsf + .12, r = .99), but significant (p less than .0001) differences both for "L" and "V/Vo": Lpf = .91Lsf + 6.58, r = .97, V/Vopf = .63 V/Vosf + .34, r = .76. Thus, pulsatility modifies velocity fields and the results obtained in steady flow conditions do not apply to pulsatile jets.

In vitro analysis of a model of intracardiac jet: analysis of the central core of axisymmetric jets.

In order to provide physical information supporting the clinical use of flow mapping, an in vitro model was designed to measure the velocity fields in a pulsatile hydraulic turbulent jet. We used a peak velocity ranging from 2.5 to 5.5 m.s-1, an orifice diameter ranging from 5.8 to 11.3 mm and confined the jet in a receiving tube whose diameter ranged from 16 to 30 mm, thus simulating a large variety of valvular leaks. In steady flow conditions, our results agreed with previously reported descriptions. Under pulsatile conditions, the same structure was found at peak velocity and during the beginning of the deceleration. Below a threshold velocity, the length of the central core was independent of the peak velocity and proportional to about six times the orifice diameter. Above the threshold velocity, this relationship was no longer true, the threshold value being related to the ratio of the orifice diameter to the diameter of the receiving tube.

Limitations of ultrasound imaging and image restoration.

The definition of medical ultrasound images is strongly limited by the need for low examination frequencies which is imposed by the high attenuation of acoustic waves in tissues. The filtering effect of imaging systems is described and quantified for echography, transmission tomography and reflection tomography. Improvement of image definition is demonstrated to be the result of a numerical restoration of the received echoes implemented, in the present case, by a simplified Kalman filter. The improvement in definition obtained is emphasized on simulated data and tissue images. The comparison between the results obtained from the three techniques shows that: if only echography provides a real-time acquisition of signals, tomographic methods lead to faster processing associated with a better signal-to-noise ratio on the reconstructed images, and reflection tomography offers the best definition.

Visualization of the parietal mass transfer by using immobilized peroxidase.

A new method is developed for direct visualization of the local mass transfer at solid liquid interfaces involving the chemiluminescent oxidation of luminol by H2O2 catalyzed by immobilized peroxidase. At low concentration of H2O2 (C less than 5 x 10(-5) M) this reaction is controlled by diffusion and it is possible to characterize the diffusion convection of H2O2 at each point of the tube as a function of the local hydrodynamic properties. These properties are characterized by pulsed Doppler ultrasound velocimetry. 1) The rate of light emission depends on Re1/3 for the laminar case and decreases when going downstream in accordance with the known theories of diffusion convection along tubes. 2)Downstream to a stenosis, a maximum of light appears which depends on the input Reynolds number in a manner similar to the reattachment point of the flow. This constitutes the first experimental confirmation of calculations on diffusion convection downstream to stenoses. These first experiments show the capacity of the method to detect the local properties of the parietal mass transfer phenomenon as a function of the geometry of the wall and the hydrodynamic properties of the flow.