Quasisteady Behavior of Pulsatile, Confined, Counterflowing Jets: Implications for the Assessment of Mitral and Tricuspid Regurgitation

[+] Author and Article Information
R. Y. Grimes, G. A. Pulido, A. P. Yoganathan

Cardiovascular Fluid Mechanics Laboratory, Schools of Mechanical and Chemical Engineering, Georgia Institute of Technology, Atlanta, GA 30332-0363

R. A. Levine

Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Department of Medicine, Harvard Medical School, Boston, MA

J Biomech Eng 118(4), 498-505 (Nov 01, 1996) (8 pages) doi:10.1115/1.2796036 History: Received January 01, 1995; Revised November 19, 1995; Online October 30, 2007


Mitral and tricuspid regurgitation create turbulent jets within the atria. Clinically, for the purpose of estimating regurgitant severity, jet size is assumed to be proportional to peak jet flow rate and regurgitant volume. Unfortunately, the relationship is more complex because the determinants of jet size include interactions between jet pulsatility, jet momentum, atrial width, and the velocity of ambient atrial counterftows. These effects on fluorescent jet penetration were measured using an in vitro simulation. Both steady and pulsatile jets were driven into an opposing counterflow velocity field peak jet length (Ljp ) measurements made as a function of (1) peak orifice velocity (Ujp ), (2) the time required for the jet to accelerate from zero to peak velocity and begin to decelerate (Tjp ), (3) jet orifice diameter (Dj ), (4) counterflow velocity (Uc ), and (5) counterflow tube diameter (Dc ). A compact mathematical description was developed using dimensional analysis. Results showed that peak jet length was a function of the counterflow tube diameter, the ratio of peak jet to counterflow momentum, (Mjp /Mc ) = (Ujp 2 Dj 2 )/(Uc 2 Dc 2 ), and a previously undescribed jet pulsatility parameter, the pulsatility index (PI), PI = Dc 2 /(Tjp Ujp Dj ). For the same jet orifice flow conditions, jet penetration decreased as chamber diameter decreased, as the jet PI increased, and as the momentum ratio decreased. These interactions provide insight into why regurgitant jet size is not always a good estimate of regurgitant severity.

Copyright © 1996 by The American Society of Mechanical Engineers
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