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      Diastolic right ventricular filling vortex in normal and volume overload states.

      American Journal of Physiology - Heart and Circulatory Physiology
      Animals, Biomechanical Phenomena, Blood Flow Velocity, Cardiac Volume, Coronary Circulation, Diastole, Dogs, Echocardiography, Three-Dimensional, Endocardium, physiology, Image Processing, Computer-Assisted, Mechanoreceptors, Tricuspid Valve Insufficiency, Ventricular Function, Right

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          Abstract

          Functional imaging computational fluid dynamics simulations of right ventricular (RV) inflow fields were obtained by comprehensive software using individual animal-specific dynamic imaging data input from three-dimensional (3-D) real-time echocardiography (RT3D) on a CRAY T-90 supercomputer. Chronically instrumented, lightly sedated awake dogs (n = 7) with normal wall motion (NWM) at control and normal or diastolic paradoxical septal motion (PSM) during RV volume overload were investigated. Up to the E-wave peak, instantaneous inflow streamlines extended from the tricuspid orifice to the RV endocardial surface in an expanding fanlike pattern. During the descending limb of the E-wave, large-scale (macroscopic or global) vortical motions ensued within the filling RV chamber. Both at control and during RV volume overload (with or without PSM), blood streams rolled up from regions near the walls toward the base. The extent and strength of the ring vortex surrounding the main stream were reduced with chamber dilatation. A hypothesis is proposed for a facilitatory role of the diastolic vortex for ventricular filling. The filling vortex supports filling by shunting inflow kinetic energy, which would otherwise contribute to an inflow-impeding convective pressure rise between inflow orifice and the large endocardial surface of the expanding chamber, into the rotational kinetic energy of the vortical motion that is destined to be dissipated as heat. The basic information presented should improve application and interpretation of noninvasive (Doppler color flow mapping, velocity-encoded cine magnetic resonance imaging, etc.) diastolic diagnostic studies and lead to improved understanding and recognition of subtle, flow-associated abnormalities in ventricular dilatation and remodeling.

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          Time, structure, and fluctuations.

          Fundamental conceptual problems that arise from the macroscopic and microscopic aspects of the second law of thermodynamics are considered. It is shown that nonequilibrium may become a source of order and that irreversible processes may lead to a new type of dynamic states of matter called "dissipative structures." The thermodynamic theory of such structures is outlined. A microscopic definition of irreversible processes is given, and a transformation theory is developed that allows one to introduce nonunitary equations of motion that explicitly display irreversibility and approach to thermodynamic equilibrium. The work of the group at the University of Brussels in these fields is briefly reviewed. In this new development of theoretical chemistry and physics, it is likely that thermodynamic concepts will play an ever-increasing role.
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            Quantized Energy Cascade and Log-Poisson Statistics in Fully Developed Turbulence

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              Three dimensional flow in the human left atrium.

              Abnormal flow patterns in the left atrium in atrial fibrillation or mitral stenosis are associated with an increased risk of thrombosis and systemic embolisation; the characteristics of normal atrial flow that avoid stasis have not been well defined. To present a three dimensional particle trace visualisation of normal left atrial flow in vivo, constructed from flow velocities in three dimensional space. Particle trace visualisation of time resolved three dimensional magnetic resonance imaging velocity measurements was used to provide a display of intracardiac flow without the limitations of angle sensitivity or restriction to imaging planes. Global flow patterns of the left atrium were studied in 11 healthy volunteers. In all subjects vortical flow was observed in the atrium during systole and diastolic diastasis (mean (SD) duration of systolic vortex, 280 (77) ms; and of diastolic vortex, 256 (118) ms). The volume incorporated and recirculated within the vortices originated predominantly from the left pulmonary veins. Inflow from the right veins passed along the vortex periphery, constrained between the vortex and the atrial wall. Global left atrial flow in the normal human heart comprises consistent patterns specific to the phase of the cardiac cycle. Separate paths of left and right pulmonary venous inflow and vortex formation may have beneficial effects in avoiding left atrial stasis in the normal subject in sinus rhythm.
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