Exercise cardiovascular magnetic resonance shows improved diastolic filling by atrioventricular area difference in athletes and controls.

Hydraulic force, a novel mechanism shown to aid diastolic filling, can be calculated by assessing the geometrical relationship between the left ventricular and atrial short-axis areas (atrioventricular area difference, AVAD). During exercise both ventricular and atrial volumes change due to altered loading conditions compared to rest, but it is unknown to what extent this affects AVAD. The aim of this study was to investigate if AVAD differs when going from rest to exercise in sedentary controls and athletes. We included 13 sedentary controls and 20 endurance athletes to undergo cardiovascular magnetic resonance (CMR) imaging at rest and during moderate and vigorous exercise using a CMR-compatible ergometer. AVAD was calculated as the largest ventricular short-axis area minus the largest atrial short-axis area in end-diastole (ED) and end-systole (ES) as measured from CMR short-axis images. AVAD in ED increased during moderate exercise in both sedentary controls and athletes, thus aiding diastolic filling, but did not increase further during vigorous exercise. AVAD in ES was negative in both groups at rest and decreased further with increasing exercise intensity in sedentary controls, whereas athletes remained unchanged. In conclusion, results from AVAD in ED indicate the net hydraulic force to further augment diastolic filling during moderate exercise when compared to rest, providing new insights into the mechanism by which diastolic function increases during exercise.

Atrioventricular Area Difference Aids Diastolic Filling in Patients with Repaired Tetralogy of Fallot.

A hydraulic force aids diastolic filling of the left ventricle (LV) and is proportional to the difference in short-axis area between the left ventricle and atrium; the atrioventricular area difference (AVAD). Patients with repaired Tetralogy of Fallot (rToF) and pulmonary regurgitation (PR) have reduced LV filling which could lead to a negative AVAD and a hydraulic force impeding diastolic filling. The aim was to assess AVAD and to determine whether the hydraulic force aids or impedes diastolic filling in patients with rToF and PR, compared to controls. Twelve children with rToF (11.5 [9-13] years), 12 pediatric controls (10.5 [9-13] years), 12 adults with rToF (21.5 [19-27] years) and 12 adult controls (24 [21-29] years) were retrospectively included. Cine short-axis images were acquired using cardiac magnetic resonance imaging. Atrioventricular area difference was calculated as the largest left ventricular short-axis area minus the largest left atrial short-axis area at beginning of diastole and end diastole and indexed to height (AVADi). Children and adults with rToF and PR had higher AVADi (0.3 cm2/m [- 1.3 to 0.8] and - 0.6 [- 1.5 to - 0.2]) at beginning of diastole compared to controls (- 2.7 cm2/m [- 4.9 to - 1.7], p = 0.015) and - 3.3 cm2/m [- 3.8 to - 2.8], p = 0.017). At end diastole AVADi did not differ between patients and controls. Children and adults with rToF and pulmonary regurgitation have an atrioventricular area difference that do not differ from controls and thus a net hydraulic force that contributes to left ventricular diastolic filling, despite a small underfilled left ventricle due to pulmonary regurgitation.

Diastolic Filling in Patients After Heart Transplantation Is Impaired Due to an Altered Geometrical Relationship Between the Left Atrium and Ventricle.

BACKGROUND: The geometrical relationship between atrial and ventricular short-axis cross-sectional area determines the hydraulic forces acting on intracardiac blood. This is important for diastolic filling. In patients undergoing heart transplantation (HTx), the left atrium is often enlarged as a result of the standard surgical technique. We hypothesized that diastolic filling in HTx patients is affected by the surgery altering the geometrical relationship between atrium and ventricle. METHODS AND RESULTS: This retrospective, cross-sectional study included 25 HTx patients (median age, 52 [range, 25-70] years), 15 patients with heart failure with reduced ejection fraction (median age, 63 [range, 52-75] years), 15 patients with heart failure with preserved ejection fraction (median age, 74 [range, 56-82] years), and 15 healthy controls (median age, 64 [range, 58-67] years) who underwent cardiac magnetic resonance imaging. Left ventricular, atrial, and total heart volumes (THV) were obtained. Atrioventricular area difference at end diastole and end systole was calculated as the largest ventricular short-axis area minus the largest atrial short-axis area. Left atrial minimum volume normalized for THV (LAmin/THV) was larger in HTx patients (median, 0.13 [range, 0.07-0.19]) compared with controls (median, 0.05 [range, 0.03-0.08], P <0.001), whereas left ventricular volume normalized for THV (left ventricular end-diastolic volume/THV) was similar between HTx and controls (median, 0.19 [range, 0.12-0.24] and median, 0.22 [range, 0.20-0.25], respectively). At end diastole, when atrioventricular area difference reached its largest positive value in controls, 11 HTx patients (44%) had a negative atrioventricular area difference, indicating impaired diastolic filling. CONCLUSIONS: Diastolic filling is impaired in HTx patients due to an altered geometrical relationship between the left atrium and ventricle. When performing cardiac transplantation, a surgical technique that creates a smaller left atrium may improve diastolic filling by aiding hydraulic forces.

Role of driven approach on the piezoelectric ozonation processes: Comparing ultrasound with hydro-energy as driving forces.

Driven approach is vital for evaluating degradation and energy efficiencies of piezocatalysis process. Thus, piezoelectric ozonation processes driven by hydraulic (HPE-O3) and ultrasonic (UPE-O3) forces were compared systematically, using BaTiO3 as piezoelectric material for ibuprofen (IBP) degradation. The synergy indexes of HPE-O3 and UPE-O3 processes were 4.51 and 5.78, respectively. Besides, UPE-O3 process (88.84%) achieved better mineralization efficiency than HPE-O3 process (68.80%) in 90 min. Nevertheless, the energy consumptions of HPE-O3 process was only 4.01‰ of UPE-O3 process. The formation rate and concentration of •OH (the dominant active species in both processes) in UPE-O3 process were 2-3 times higher than that in HPE-O3 process. Notably, piezoelectric potential and current density driven by ultrasound were approximately 47500-fold and 40-fold than those by hydro-energy, respectively. These led to the difference of •OH paths between HPE-O3 and UPE-O3 processes. Further analyses indicated that •OH was mainly generated by single-electron transfer without H2O2 generation in HPE-O3 process, whereas both single- and double-electron transfer (with H2O2 generation) contributed to the production of •OH in UPE-O3 process. This study revealed the mechanism of piezoelectric ozonation process with different driven approaches and may provide valuable reference for selection of driven approaches in piezocatalytic study and application.

Effects of two surface acoustic wave sorting chips on particles multi-level sorting.

Particle/cell sorting has great potential in medical diagnosis and chemical analysis. Two kinds of microfluidic sorting chips (sequential sorting chip and direct sorting chip) are designed, which combine hydraulic force and acoustic radiation force to achieve continuous sorting of multiple particles. Firstly, the optimal values of the angle (α) between the interdigital transducer (IDT) and the main channel, the peak-to-peak voltage (Vpp), the main flow velocity (Vmax) and the flow ratio (A) are determined by simulation and experiments, the related optimal parameters were obtained that the α = 15°, Vpp = 25 V, Vmax = 4 mm/s, flow ratio A1 = 0.2, and A2 = 0.5, respectively. Then, the corresponding sorting experiments were carried out using two kinds of sorting chips to sort the polystyrene (PS) particles with diameters of 1 µm, 5 µm, and 10 µm, and the sorting rate and purity of particles were calculated and analyzed. Experimental results show that the two kinds of sorting chips can achieve continuous sorting of multiple particles, and the sorting effect of sequential sorting chip (control flow ratio) is better than that of direct sorting chip. In addition, the sorting chips in our research have the advantages of simple structure, high sorting efficiency, and the ability to sort multiple particles, which can be applied in medical and chemical research fields, such as cell sorting and chemical analysis.

Computational Fluid Dynamics Modeling of the Burr Orbital Motion in Rotational Atherectomy with Particle Image Velocimetry Validation.

Rotational atherectomy (RA) uses a high-speed rotating burr introduced via a catheter through the artery to remove hardened atherosclerotic plaque. Current clinical RA technique lacks consensus on burr size and rotational speed. The rotating burr orbits inside the artery due to the fluid force of the blood. Different from a common RA technique of upsizing burrs for larger luminal gain, a small burr can orbit to treat a large lumen. A 3D computational fluid dynamics (CFD) model was developed to simulate the burr motion and study the fluid flow and force in RA. A particle image velocimetry experiment was conducted to measure and validate the flow field including the radial and axial velocities and a pair of counter-rotating vortices near the burr equator in CFD. The hydraulic force on the burr and the contact force between the burr and the arterial wall were estimated by CFD. The contact force can be reduced by using smaller burr and lower rotational speed. Utilizing the small burr orbital motion has the potential to be an improved RA technique.

Real-time tracking control of electro-hydraulic force servo systems using offline feedback control and adaptive control.

This paper focuses on an application of an electro-hydraulic force tracking controller combined with an offline designed feedback controller (ODFC) and an online adaptive compensator in order to improve force tracking performance of an electro-hydraulic force servo system (EHFS). A proportional-integral controller has been employed and a parameter-based force closed-loop transfer function of the EHFS is identified by a continuous system identification algorithm. By taking the identified system model as a nominal plant model, an H∞ offline design method is employed to establish an optimized feedback controller with consideration of the performance, control efforts, and robustness of the EHFS. In order to overcome the disadvantage of the offline designed controller and cope with the varying dynamics of the EHFS, an online adaptive compensator with a normalized least-mean-square algorithm is cascaded to the force closed-loop system of the EHFS compensated by the ODFC. Some comparative experiments are carried out on a real-time EHFS using an xPC rapid prototype technology, and the proposed controller yields a better force tracking performance improvement.