Correlation between negative near-wall shear stress in human aorta and various stages of congestive heart failure.

The critical effect of advanced congestive heart failure is reduced blood flow in descending aorta resulting from mild to severe reduction in cardiac output, usually accompanying low ejection fraction. In these patients the heart tries to compensate by beating faster, but reduced blood flow combined with increased heart rate can lead to retrograde flow and negative shear stress along the vessel walls during each cardiac cycle. Our studies show that near-wall negative shear stress can result from an entire-retrograde flow at normal heart rates or a Womersley-type phase delayed near-wall retrograde flow at high heart rate and low ejection fraction conditions.

A physical model describing the mechanism for formation of gas microbubbles in patients with mitral mechanical heart valves.

This study was aimed at developing a physical model, supported by experimental observations, to describe the formation and growth of microbubbles seen in patients with mitral mechanical heart valves (MHV). This phenomenon, often referred to as high intensity transient signals (HITS), appears as bright, intense, high-velocity and persistent echoes detected by Doppler ultrasonography at the instant of closure. The long-term clinical implications of HITS has yet to be determined.