On the Significance of Systolic Flow Waveform on Aortic Valve Energy Loss

Ann Biomed Eng. 2018 Dec;46(12):2102-2111. doi: 10.1007/s10439-018-2102-y. Epub 2018 Jul 20.

Abstract

This study aims to quantitatively and qualitatively assess energy dissipation in the aortic valve as a function of systolic aortic flow waveform representing pathologies where flow time-to-peak is delayed. A bioprosthetic valve was tested in the aortic position of a left-heart simulator under physiological pressure and flow conditions. The flow loop piston pump was programmed to generate three different flow waveforms each with a different peak time annotated as early peak (EP) with a rapid acceleration, mid peak (MP) and late peak (LP) with a rapid deceleration. Energy dissipation was calculated from flow and pressure measurements while sinus vorticity dynamics were evaluated using time-resolved planar particle image velocimetry. Average pressure gradients during systole are found 30.2 ± 0.19, 30.7 ± 0.25 and 32.9 ± 0.29 mmHg and average dissipation over systole is found 0.95 ± 0.026, 1.05 ± 0.034 and 1.25 ± 0.043 W for EP, MP and LP respectively. As systole's acceleration phase is slower, sinus vortices are more likely to form, necessitating more energy exchange from shear layers inducing more viscous dissipation. EP found in healthy individuals is superior in terms of reducing energy dissipation and increasing aortic valve efficiency. In the context of possible left ventricular dysfunction and aortic stenosis, this means that delayed time-to-peak in the aortic flow waveform seen is not compensatory.

Keywords: Aortic valve; Aortic valve efficiency; Energy dissipation; Fluid mechanics; Heart failure; Time to peak.

MeSH terms

  • Aortic Valve / physiology*
  • Blood Flow Velocity
  • Blood Pressure
  • Heart Valve Prosthesis
  • Rheology
  • Systole / physiology*