Numerical analysis for elucidation of nonlinear frictional characteristics of a deformed erythrocyte moving on a plate in medium subject to inclined centrifugal force.

Complex interactions between blood cells, plasma proteins, and glycocalyx in the endothelial surface layer are crucial in microcirculation. To obtain measurement data of such interactions, we have previously performed experiments using an inclined centrifuge microscope, which revealed that the nonlinear velocity-friction characteristics of erythrocytes moving on an endothelia-cultured glass plate in medium under inclined centrifugal force are much larger than those on plain or material-coated glass plates. The purpose of this study was to elucidate the nonlinear frictional characteristics of an erythrocyte on plain or material-coated glass plates as the basis to clarify the interaction between the erythrocyte and the endothelial cells. We propose a model in which steady motion of the cell is realized as an equilibrium state of the force and moment due to inclined centrifugal force and hydrodynamic flow force acting on the cell. Other electrochemical effects on the surfaces of the erythrocyte and the plate are ignored for the sake of simplicity. Numerical analysis was performed for a three-dimensional flow of a mixture of plasma and saline around a rigid erythrocyte model of an undeformed biconcave shape and a deformed shape with a concave top surface and a flat bottom surface. A variety of conditions for the concentration of plasma in a medium, the velocity of the cell, and the minimum gap width and the angle of attack of the cell from the plate, were examined to obtain the equilibrium states. A simple flat plate model based on the lubrication theory was also examined to elucidate the physical meaning of the model. The equilibrium angle of attack was obtained only for the deformed cell model and was represented as a power function of the minimum gap width. A simple flat plate model qualitatively explains the power function relation of the frictional characteristics, but it cannot explain the equilibrium relation, confirming the computational result that the deformation of the cell is necessary for the equilibrium. The frictional characteristics obtained from the present computation qualitatively agree with those of former experiments, showing the validity of the proposed model.

Optimization of strut placement in flow diverter stents for four different aneurysm configurations.

A modern technique for the treatment of cerebral aneurysms involves insertion of a flow diverter stent. Flow stagnation, produced by the fine mesh structure of the diverter, is thought to promote blood clotting in an aneurysm. However, apart from its effect on flow reduction, the insertion of the metal device poses the risk of occlusion of a parent artery. One strategy for avoiding the risk of arterial occlusion is the use of a device with a higher porosity. To aid the development of optimal stents in the view point of flow reduction maintaining a high porosity, we used lattice Boltzmann flow simulations and simulated annealing optimization to investigate the optimal placement of stent struts. We constructed four idealized aneurysm geometries that resulted in four different inflow characteristics and employed a stent model with 36 unconnected struts corresponding to the porosity of 80%. Assuming intracranial flow, steady flow simulation with Reynolds number of 200 was applied for each aneurysm. Optimization of strut position was performed to minimize the average velocity in an aneurysm while maintaining the porosity. As the results of optimization, we obtained nonuniformed structure as optimized stent for each aneurysm geometry. And all optimized stents were characterized by denser struts in the inflow area. The variety of inflow patterns that resulted from differing aneurysm geometries led to unique strut placements for each aneurysm type.

In vitro study of ultrasound radiation force-driven twinkling sign using PVA-H gel and glass beads tissue-mimicking phantom.

The twinkling sign observed in ultrasound coded-excitation imaging (e.g., GE B-Flow) has been reported in previous research as a potential phenomenon to detect micro calcification in soft tissue. However, the mechanism of the twinkling sign has not been clearly understood yet. We conducted an in vitro experiment to clarify the mechanism of the twinkling sign by measuring a soft tissue-mimicking phantom with ultrasonic and optical devices. A soft tissue-mimicking phantom was made of poly(vinyl alcohol) hydro (PVA-H) gel and 200-µm-diameter glass beads. We applied ultrasound to the phantom using medical ultrasound diagnostic equipment to observe the twinkling sign of glass beads. Optical imaging with a laser sheet and a high-speed camera was performed to capture the scatter lights of the glass beads with and without ultrasound radiation. The scatter lights from the glass beads were quantified and analyzed to evaluate their oscillations driven by the ultrasound radiation force. The twinkling sign from the glass beads embedded in the PVA-H gel soft tissue phantom was observed in ultrasound B-Flow color imaging. The intensity and oscillation of the scattered lights from the glass beads showed significant difference between the cases with and without ultrasound radiation. The results showed a close relationship between the occurrence of the twinkling sign and the variations of the scatter lights of glass beads, indicating that ultrasound radiation force-driven micro oscillation causes the twinkling sign of micro calcification in soft tissue.

Tracking of Blood Vessels Motion from 4D-flow MRI Data.

This paper presents a novel approach to track objects from 4D-flow MRI data. A salient feature of the proposed method is that it fully exploits the geometrical and dynamical nature of the information provided by this imaging modality. The underlying idea consists in formulating the tracking problem as a data assimilation problem, in which both position and velocity observations are extracted from the 4D-flow MRI data series. Optimal state estimation is then performed in a sequential fashion via Kalman filtering. The capabilities of the method are extensively assessed in a numerical study involving synthetic and clinical data.

Development of Ultrasound Phantom Made of Transparent Material: Feasibility of Optical Particle Image Velocimetry.

OBJECTIVE: The need for ultrasound flow phantoms to validate ultrasound systems requires the development of materials that can clearly visualize the flow inside for measurement purposes. METHODS: A transparent ultrasound flow phantom material composed of poly(vinyl alcohol) hydrogel (PVA-H) with dimethyl sulfoxide (DMSO) and water solution manufactured using the freezing method and mixed with quartz glass powder to exhibit scattering effects is proposed. To achieve transparency of the hydrogel phantom, the refractive index (RI) was changed to match that of the glass by modifying the PVA concentration and the ratio of DMSO to water in the solvent. The feasibility of optical particle image velocimetry (PIV) was verified by comparing an acrylic rectangular cross-section channel with a rigid wall. After the feasibility tests, an ultrasound flow phantom was fabricated to conduct ultrasound B-mode visualization and Doppler-PIV comparison. DISCUSSION: The results revealed that the PIV measured through PVA-H material exhibited 0.8% error in the measured maximum velocity compared with PIV through the acrylic material. B-mode images are similar to real tissue visualization with a limitation of a higher sound velocity, when compared with human tissue, of 1792 m/s. Doppler measurement of the phantom revealed approximately 120% and 19% overestimation of maximum and mean velocities, respectively, compared with those from PIV. CONCLUSION: The proposed material possesses the advantage of the single-phantom ability to improve the ultrasound flow phantom for validation of flow.

Local hemodynamics at the rupture point of cerebral aneurysms determined by computational fluid dynamics analysis.

BACKGROUND: Cerebral aneurysms carry a high risk of rupture and so present a major threat to the patient's life. Accurate criteria for predicting aneurysm rupture are important for therapeutic decision-making, and some clinical and morphological factors may help to predict the risk for rupture of unruptured aneurysms, such as sex, size and location. Hemodynamic forces are considered to be key in the natural history of cerebral aneurysms, but the effect on aneurysm rupture is uncertain, and whether low or high wall shear stress (WSS) is the most critical in promoting rupture remains extremely controversial. This study investigated the local hemodynamic features at the aneurysm rupture point. METHODS: Computational models of 6 ruptured middle cerebral artery aneurysms with intraoperative confirmation of rupture point were constructed from 3-dimensional rotational angiography images. Computational fluid dynamics (CFD) simulations were performed under pulsatile flows using patient-specific inlet flow conditions. Time-averaged WSS (TAWSS) and oscillatory shear index (OSI) were calculated, and compared at the rupture point and at the aneurysm wall without the rupture point. We performed an additional CFD simulation of a bleb-removed model for a peculiar case in which bleb formation could be confirmed by magnetic resonance angiography. RESULTS: All rupture points were located at the body or dome of the aneurysm. The TAWSS at the rupture point was significantly lower than that at the aneurysm wall without the rupture point (1.10 vs. 4.96 Pa, p = 0.031). The OSI at the rupture point tended to be higher than at the aneurysm wall without the rupture point, although the difference was not significant (0.0148 vs. 0.0059, p = 0.156). In a bleb-removed simulation, the TAWSS at the bleb-removed area was 6.31 Pa, which was relatively higher than at the aneurysm wall (1.94 Pa). CONCLUSION: The hemodynamics of 6 ruptured cerebral aneurysms of the middle cerebral artery were examined using retrospective CFD analysis. We could confirm the rupture points in all cases. With those findings, local hemodynamics of ruptured aneurysms were quanti-tatively investigated. The rupture point is located in a low WSS region of the aneurysm wall. Bleb-removed simulation showed increased WSS of the bleb-removed area, associated with the flow impaction area. Although the number of subjects in this study was relatively small, our findings suggest that the location of the rupture point is related to a low WSS at the aneurysm wall. Further investigations will elucidate the detailed hemodynamic effects on aneurysm rupture.

The correlation between ultrasonographic findings and pathologic features in breast disorders.

OBJECTIVE: Breast ultrasonography has gained widespread acceptance as a diagnostic tool for the evaluation of human breast disorders. It is important to evaluate the correlation of ultrasonography findings with the corresponding histopathological features. METHOD: We retrospectively reviewed the 154 cases of breast disorders. We evaluated the correlation the ultrasonography findings and carcinoma cells extension with their corresponding histopathological findings. In addition, we also studied the information on estimation of histological types and cancer extension used by the other modalities such as computed tomography and magnetic resonance imaging. RESULTS: The concordance rate for margins between ultrasonography findings and histopathological features was 91.6% (P < 0.001) and that for boundary zone was 87.0% (P < 0.001). Histopathological correlation of internal and posterior echoes demonstrated that internal low echo masses were composed of fibroblastic cells with marked collagenization in the stroma, or the cases in which carcinoma cells proliferated in a monotonous, solid and/or expanding manners. Attenuation of posterior echo was detected in the cases associated with hyperplasia of collagenized fibroblastic stroma. An increased cellularity in the mass with prominent large tumor nests and little fibrous stroma demonstrated the accentuation or no alterations of the posterior echo. The concordance rate of borders was 84.4% (P < 0.001). The correlation between estimated histological type by ultrasonography diagnosis and actual histological types was 87.0%. An overall detection rate of carcinoma extension by ultrasonography was 86.4%. In addition, an overall detection rate of carcinoma extension by ultrasonography, magnetic resonance imaging and computed tomography was 93.8%. CONCLUSION: These results demonstrated correlation between histopathological and ultrasonographic findings of the breast lesions is cardinal for quality control or improving the quality of ultrasonography.

Blood pressure estimation based on pulse rate variation in a certain period.

Availability of daily continuous blood pressure (DCBP) has a strong impact to realization of healthy society. However, existing methods to obtain blood pressure of cuff type and cuff-less types utilizing correlation with pulse waveform, pulse transit time or pulse rate; or computation of circulation model are not suitable to obtain DCBP. Here we implemented a method based on a simple circulatory system model using pulse rate measurement to overcome the limitations, and showed that it provides appropriate estimation of DCBP. The present model consists of a circulatory dynamic system model and an inverse model of a circulatory control system with input of pulse rate and six model parameters representing standard pulse rate, elasticity of systemic arteries, peripheral vascular resistance, and characteristics of resistance and stroke volume control. Validity of the DCBP estimation method was examined by preliminary experiment for one subject in four days and that for four subjects in one day. DCBP estimation was performed with 24-hour pulse rate measurement by a wearable device and sphygmomanometer measurement for parameter determination and verification. Mean absolute errors in systolic/diastolic pressures were appropriate ones for preliminary experiments with 9.4/6.4 mmHg in four days and 7.3/5.9 mmHg in five subjects.

Numerical simulation of distribution of neutrophils in a lattice alveolar capillary network.

Neutrophils are known to be retained in narrow pulmonary capillaries, even in normal lungs, due to their low deformability, resulting in a higher concentration than that in systemic circulation. In this study, to obtain a fundamental understanding of the behavior of neutrophils, we simplified an alveolar capillary network to a rectangular grid of short capillary segments and numerically investigated the flow of a suspension of neutrophils and plasma through the capillary network for various concentrations of the suspension, Csus, injected into the network. The cells traveled limited preferential paths in the network while Csus was low. Retention of a cell or cells induced plugging of the segment with a cessation of blood flow, and as the result of the changed plasma flow field caused by such plugging, the cells took various routes differing from the preferential paths. A low incidence of plugging helped to accelerate the cells flowing in the network with tight segments, resulting in a decrease in their mean transit time through the network as compared with the case of a single-cell transit. On the contrary, however, an increasing incidence of plugging induced backward motion of the cells and a resultant increase in the mean transit time. The time-averaged number of cells in the network increased with the increase in Csus, and the fractional residence time of cells in individual segments approached a constant. This means that a high concentration of neutrophils facilitates their uniform distribution in the network. However, the ratio between the time-averaged concentration of the cells in the network and Csus decreased and our numerical simulation did not reach the experimentally obtained value. This implies that, in a real alveolar capillary bed, plasma leaks through the plugged segments or that the capillary network has bypasses through which the plasma can flow.

Viscosity Estimation of a Suspension with Rigid Spheres in Circular Microchannels Using Particle Tracking Velocimetry.

Suspension flows are ubiquitous in industry and nature. Therefore, it is important to understand the rheological properties of a suspension. The key to understanding the mechanism of suspension rheology is considering changes in its microstructure. It is difficult to evaluate the influence of change in the microstructure on the rheological properties affected by the macroscopic flow field for non-colloidal particles. In this study, we propose a new method to evaluate the changes in both the microstructure and rheological properties of a suspension using particle tracking velocimetry (PTV) and a power-law fluid model. Dilute suspension (0.38%) flows with fluorescent particles in a microchannel with a circular cross section were measured under low Reynolds number conditions (Re ≈ 10-4). Furthermore, the distribution of suspended particles in the radial direction was obtained from the measured images. Based on the power-law index and dependence of relative viscosity on the shear rate, we observed that the non-Newtonian properties of the suspension showed shear-thinning. This method will be useful in revealing the relationship between microstructural changes in a suspension and its rheology.

Numerical simulation of flow for viscoelastic neutrophil models in a rectangular capillary network: effects of capillary shape and cell stiffness on transit time.

The concentration of neutrophils in the pulmonary microvasculature is higher than in large systemic vessels. It is thought that the high concentration of neutrophils facilitates their effective recruitment to sites of inflammation. Thus, in order to understand the role of neutrophils in the immune system, it is important to clarify their flow characteristics in the pulmonary microvasculature. In a previous study, we developed a model to simulate the flow of neutrophils in a capillary network, in which the cells were modeled as spheres of a Maxwell material with a cortical tension and the capillary segments were modeled as arc-shaped constrictions in straight pipes. In the present paper, the flow of neutrophils in a simplified alveolar capillary network model is investigated for various constriction shapes and cell stiffnesses. Finally, it is shown that both the coefficient of variation of the transit time of the cells, which is the standard deviation divided by the mean transit time, and the mean transit time increase as the capillary segments become steep or tight, or when the cells become hard. The mean value of the transit time exceeds the median for all of the conditions that occur in real lungs, although the difference between them is small.

Photoplethysmography and ultrasonic-measurement-integrated simulation to clarify the relation between two-dimensional unsteady blood flow field and forward and backward waves in a carotid artery.

Understanding the spatiotemporal change in hemodynamics is essential for the basic research of atherosclerosis. The objective of this study was to establish a methodology to clarify the relation between a two-dimensional (2D) unsteady blood flow field and forward and backward propagating waves in a carotid artery. This study utilized photoplethysmography (PPG) for blood pressure measurement and two-dimensional ultrasonic-measurement-integrated (2D-UMI) simulation for flow field analysis. The validity of the methodology was confirmed in an experiment for a carotid artery of a healthy volunteer. Synchronization between the pressure measurement and flow field analysis was achieved with an error of <10 ms. A 2D unsteady blood flow field in the carotid artery was characterized in relation to forward and backward waves. 2D-UMI simulation reproduced the flow field in which the wall shear stress takes a maximum at the time of the backward wave superiority in the systolic phase, whereas 2D ordinary simulation failed to reproduce this feature because of poor reproducibility of velocity distribution. In conclusion, the proposed methodology using PPG and 2D-UMI simulation was shown to be a potential tool to clarify the relation between 2D unsteady blood flow field and the forward and backward waves in a carotid artery.

Study of Estimation Method for Unsteady Inflow Velocity in Two-Dimensional Ultrasonic-Measurement-Integrated Blood Flow Simulation.

Information on hemodynamics is essential for elucidation of mechanisms and development of novel diagnostic methods for circulatory diseases. Two-dimensional ultrasonic-measurement-integrated (2D-UMI) simulation can correctly reproduce an intravascular blood flow field and hemodynamics by feeding back an ultrasonic measurement to the numerical blood flow simulation. In this method, it is critically important to give the correct cross-sectional average inflow velocity (inflow velocity) as the boundary condition. However, systematic study has not been done on the relative validity and effectiveness of existing inflow velocity estimation methods for various target flow fields. The aim of this study was to examine the existing methods systematically and to establish a method to accurately estimate inflow velocities for various vessel geometries and flow conditions in 2D-UMI simulations. A numerical experiment was performed for 2D-UMI simulation of blood flow models in a straight vessel with inflow velocity profiles symmetric and asymmetric to the vessel axis using existing evaluation functions based on Doppler velocity error for the inflow velocity estimation. As a result, it was clarified that a significantly large estimation error occurs in the asymmetric flow due to a nonfeedback domain near the downstream end of the calculation domain. Hence, a new inflow velocity estimation method of 2D-UMI simulation is proposed in which the feedback and evaluation domains are extended to the downstream end. Further numerical experiments of 2D-UMI simulation for two realistic vessel geometries of a healthy blood vessel and a stenosed one confirmed the effectiveness of the proposed method.

Effects of inflow velocity profile on two-dimensional hemodynamic analysis by ordinary and ultrasonic-measurement-integrated simulations.

Two-dimensional ultrasonic-measurement-integrated (2D-UMI) simulation correctly reproduces hemodynamics even with an inexact inflow velocity distribution. This study aimed to investigate which is superior, a two-dimensional ordinary (2D-O) simulation with an accurate inflow velocity distribution or a 2D-UMI simulation with an inaccurate one. 2D-O and 2D-UMI simulations were performed for blood flow in a carotid artery with four upstream velocity boundary conditions: a velocity profile with backprojected measured Doppler velocities (condition A), and velocity profiles with a measured Doppler velocity distribution, a parabolic one, and a uniform one, magnitude being obtained by inflow velocity estimation (conditions B, C, and D, respectively). The error of Doppler velocity against the measurement data was sensitive to the inflow velocity distribution in the 2D-O simulation, but not in the 2D-UMI simulation with the inflow velocity estimation. Among the results in conditions B, C, and D, the error in the worst 2D-UMI simulation with condition D was 31 % of that in the best 2D-O simulation with condition B, implying the superiority of the 2D-UMI simulation with an inaccurate inflow velocity distribution over the 2D-O simulation with an exact one. Condition A resulted in a larger error than the other conditions in both the 2D-O and 2D-UMI simulations.

Reduced Uterine Perfusion Pressure (RUPP) Model of Preeclampsia in Mice.

Preeclampsia (PE) is a pregnancy-induced hypertension with proteinuria that typically develops after 20 weeks of gestation. A reduction in uterine blood flow causes placental ischemia and placental release of anti-angiogenic factors such as sFlt-1 followed by PE. Although the reduced uterine perfusion pressure (RUPP) model is widely used in rats, investigating the role of genes on PE using genetically engineered animals has been problematic because it has been difficult to make a useful RUPP model in mice. To establish a RUPP model of PE in mice, we bilaterally ligated ovarian vessels distal to ovarian branches, uterine vessels, or both in ICR-strain mice at 14.5 days post coitum (dpc). Consequently, these mice had elevated BP, increased urinary albumin excretion, severe endotheliosis, and mesangial expansion. They also had an increased incidence of miscarriage and premature delivery. Embryonic weight at 18.5 dpc was significantly lower than that in sham mice. The closer to the ligation site the embryos were, the higher the resorption rate and the lower the embryonic weight. The phenotype was more severe in the order of ligation at the ovarian vessels < uterine vessels < both. Unlike the RUPP models described in the literature, this model did not constrict the abdominal aorta, which allowed BP to be measured with a tail cuff. This novel RUPP model in mice should be useful for investigating the pathogenesis of PE in genetically engineered mice and for evaluating new therapies for PE.

Simulation model for flow of neutrophils in pulmonary capillary network.

The concentration of neutrophils in the pulmonary microvasculature is higher than in systemic large vessels. It is thought that the high concentration of neutrophils facilitates their effective recruitment to sites of inflammation. Thus, in order to understand the role of neutrophils in the immune system, it is important to clarify their flow characteristics in the pulmonary microvasculature. In previous studies, we numerically investigated the motion of a neutrophil through a single capillary segment modeled by a moderate axisymmetric constriction in a straight pipe, developing a mathematical model for the prediction of the transit time of the cell through the segment. In the present study, this model was extended for application to network simulation of the motion of neutrophils. First, we numerically investigated shape recovery of a neutrophil after expulsion from a narrow capillary segment. This process was modeled in two different phases: elastic recovery and viscous recovery. The resulting model was combined with the previously developed models to simulate motion of the cells and plasma flow in a capillary network. A numerical simulation of the motion of neutrophils and plasma flow in a simple lattice capillary network showed that neutrophils were widely dispersed in the network with an increased concentration.

Detection and correction of aliasing in ultrasonic measurement of blood flows with Ultrasonic-Measurement-Integrated simulation.

Detailed information of real blood flows is essential to develop an accurate diagnosis or treatment for serious circulatory diseases such as aortic aneurysms. Ultrasonic-Measurement-Integrated (UMI) simulation, in which feedback signals from the ultrasonic measurement make the simulation converge to the real blood flow, is a key to solving this problem. However, aliasing in the ultrasonic blood velocity measurement causes UMI simulation to converge to an erroneous result. In this paper, we have investigated the detection and the correction of aliasing in UMI simulation. The artificial force in the feedback of UMI simulation can be used as an index to detect the aliasing. We have proposed two ways for the correction of the aliasing. Correction A, in which measurement velocity is replaced with the computational one at the monitoring point where the aliasing is detected, substantially improves the accuracy of UMI simulation. Correction B, in which measurement velocity is replaced with an estimated Doppler velocity, can provide exactly the same result as that of UMI simulation using the nonaliased standard solution. Although correction B gives the most accurate result, correction A seems more robust and, therefore, a beneficial choice considering the other artifacts in the measurement.

Poly(vinyl alcohol) gel ultrasound phantom with durability and visibility of internal flow.

PURPOSE: Among various existing flow phantoms, none is characterized by appropriate acoustic, visibility, and durability properties simultaneously. The aim of this study was to develop a durable ultrasound phantom with visibility of the internal flow. METHODS: Poly(vinyl alcohol) (PVA) gel was chosen as the basic material. The acoustic properties of various PVA gels were measured with 40-MHz ultrasound, the compositions of PVA, dimethyl sulfoxide (DMSO), and glass microbeads being changed, while visually checking the transparency. Wall-less ultrasound flow phantoms with a straight channel 2 mm in diameter were made from PVA gel, and ultrasound B-mode imaging was conducted with blood-mimicking fluid flow. RESULTS: The acoustic properties of in vivo soft tissue were reproduced by PVA gel with a PVA concentration of 15 mass% and a glass microbead concentration of 2.9 mass% in a solvent of 98 mol% DMSO, showing acoustic properties of 1567 ± 4 m/s and 56 ± 5 dB/cm. The PVA gel was durable with visibility of the flow in the ultrasound phantom. The ultrasound B-mode image of the ultrasound flow phantom showed features approximating those of a mouse carotid artery. CONCLUSION: A durable PVA gel ultrasound phantom with visibility of the internal flow was developed.

Microscopic observation of glass bead movement in soft tissue-mimicking phantom under ultrasound PW mode scanning.

Previous studies have demonstrated that stones and calcification in soft tissue show special enhancement in response to color flow (CF) or pulse Doppler (PW) mode ultrasound scan. This phenomenon is known as the "twinkling sign (TS)". The authors conducted an in vitro experiment to investigate the mechanism of TS occurrence by observing a glass bead in a transparent PVA-H soft tissue-mimicking phantom. The TS in PW mode showed a low-power and slow-velocity spectrum. At the same time, analysis of images by high-speed camera showed that the glass bead in the phantom oscillated following the pulse repetition frequency (PRF) of the PW mode ultrasound scan. The harmonic oscillations were confirmed, as well. The ultrasound radiation force-driven micro-oscillation possibly affects the ultrasound propagation around the scatterer and triggers random signals in the received echo signals. The results indicate that TS is a phenomenon based on complicated acoustic-mechanical interaction of multiple mechanisms. Further investigation is required for gaining a full understanding of the mechanism of TS occurrence and its clinical application.

Numerical analysis of hemodynamic changes in the left atrium due to atrial fibrillation.

Atrial fibrillation (AF) disrupts movement of the left atrium (LA) and worsens the vital prognosis by causing thromboembolism. Ultrasound Doppler measurement, phase-contrast magnetic resonance imaging (PC MRI), as well as computational fluid dynamics (CFD) have revealed hemodynamic changes in the LA due to AF, such as stagnation of blood flow in the left atrial appendage (LAA). However, quantitative evaluation of the hemodynamics during AF has not been conducted, and the effects of important AF characteristics, such as a lack of active contraction of the LA (atrial kick) in late diastole and the occurrence of high-frequency fibrillation (>400bpm) of the atrial wall, on blood flow field and concomitant hemodynamic stresses have not been completely understood. In this study, the effects of the above-mentioned two characteristic phenomena of AF on blood flow and hemodynamic parameters were quantitatively investigated. Based on MRI of a healthy volunteer heart, one healthy LA model and two AF models (one without atrial kick, and one without atrial kick and with high-frequency fibrillation) were constructed to perform hemodynamic analysis, and the computational results were compared. The results revealed that each characteristic phenomenon of AF influenced hemodynamics. Especially, atrial wall movement by high-frequency fibrillation had a large impact on the stagnation of blood flow. The relative residence time (RRT), which is an indicator of stagnation of blood flow, increased in the upper part of the LAA during AF. This result implies that there is a local thrombus-prone site in LAA when AF occurs.