Asymmetric redirection of flow through the heart
Asymmetric redirection of flow through the heart
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DOI：
10.1038/35008075
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发表时间：
2000-04-13
期刊：
影响因子：
64.8
通讯作者：
Yacoub, MH
中科院分区：
文献类型：
--
作者：
Kilner, PJ;Yang, GZ;Yacoub, MH
通过胚胎发育期间的心环(1)，流经成熟心脏的血流路径具有方向性改变和不对称性，其拓扑结构和功能意义尚不明确。在这里，我们展示了，使用磁共振速度图（2-5），血流在成人心脏的心房和心室腔中的不对称重定向，具有弯曲的，手性不对称的血流路径。在流场图和流道空间关系图的基础上，我们提出环形心脏的不对称性和曲率具有潜在的流体和动力学优势。心房充盈的模式似乎是不对称的，在某种程度上允许流入的血流的动量重定向到房室瓣膜，并且在心室水平上的方向改变是这样的，远离喷射血液的反冲方向可以增强而不是抑制心室-心房耦合(6)。手性不对称可能有助于减少进入、再循环和流出流之间的耗散相互作用(7)。当运动期间心率和输出量增加时，这些因素可能结合在一起，形成一种往复的、像吊索一样的“形态动力学”作用模式(6)。
Through cardiac looping during embryonic development(1), paths of flow through the mature heart have direction changes and asymmetries whose topology and functional significance remain relatively unexplored. Here we show, using magnetic resonance velocity mapping(2-5), the asymmetric redirection of streaming blood in atrial and ventricular cavities of the adult human heart, with sinuous, chirally asymmetric paths of flow through the whole. On the basis of mapped flow fields and drawings that illustrate spatial relations between flow paths, we propose that asymmetries and curvatures of the looped heart have potential fluidic and dynamic advantages. Patterns of atrial filling seem to be asymmetric in a manner that allows the momentum of inflowing streams to be redirected towards atrio-ventricular valves, and the change in direction at ventricular level is such that recoil away from ejected blood is in a direction that can enhance rather than inhibit ventriculo-atrial coupling(6). Chiral asymmetry might help to minimize dissipative interaction between entering, recirculating and outflowing streams(7). These factors might combine to allow a reciprocating, sling-like, 'morphodynamic' mode of action to come into effect when heart rate and output increase during exercise(6).