Tetralogy of Fallot regurgitation energetics and kinetics: an intracardiac flow analysis of the right ventricle using computational fluid dynamics

Repaired Tetralogy of Fallot (rTOF) patients suffer from pulmonary regurgitation and may require pulmonary valve replacement (PVR). Cardiac magnetic resonance imaging (cMRI) guides therapy, but conventional measurements do not quantify the intracardiac flow effects from pulmonary regurgitation or PV...

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Bibliographic Details
Published in:The international journal of cardiovascular imaging 2024-04, Vol.40 (5), p.1135-1147
Main Authors: Loke, Yue-Hin, Yildiran, Ibrahim N., Capuano, Francesco, Balaras, Elias, Olivieri, Laura
Format: Article
Language:English
Subjects:
Axis movements
Cardiac Imaging
Cardiology
Computational fluid dynamics
Computer applications
Contours
Energy loss
Fluid dynamics
Fluid flow
Heart
Hydrodynamics
Imaging
Inflow
Kinetic energy
Magnetic resonance imaging
Medicine
Medicine & Public Health
Original Paper
Parameters
Radiology
Regurgitation
Tetralogy of Fallot
Ventricle
Vorticity
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Summary:Repaired Tetralogy of Fallot (rTOF) patients suffer from pulmonary regurgitation and may require pulmonary valve replacement (PVR). Cardiac magnetic resonance imaging (cMRI) guides therapy, but conventional measurements do not quantify the intracardiac flow effects from pulmonary regurgitation or PVR. This study investigates intracardiac flow parameters of the right ventricle (RV) of rTOF by computational fluid dynamics (CFD). cMRI of rTOF patients and controls were retrospectively included. Feature-tracking captured RV endocardial contours from long-axis/short-axis cine. Ventricular motion was reconstructed via diffeomorphic mapping, serving as domain boundary for CFD simulations. Vorticity (1/s), viscous energy loss (ELoss, mJ/L) and turbulent kinetic energy (TKE, mJ/L) were quantified in RV outflow tract (RVOT) and RV inflow. These parameters were normalized against total RV kinetic energy (KE) and RV inflow vorticity to derive dimensionless metrics. Vorticity contours by Q-criterion were qualitatively compared. rTOF patients (n = 15) had mean regurgitant fraction 38 ± 12% and RV size 162 ± 35 mL/m 2 . Compared to controls (n = 12), rTOF had increased RVOT vorticity (142.6 ± 75.6/s vs. 40.4 ± 11.8/s, p 
ISSN:1875-8312
1569-5794
1875-8312
1573-0743
DOI:10.1007/s10554-024-03084-0