In the human body, blood flow of the cardiovascular system is a multi-scale, non-Newtonian, pulsatile flow phenomenon with complex mechanical and biological interactions. We have come a long way in our understanding of this system in the last several decades, with new advances in medical imaging technology, numerical approaches, and experimental methodologies. In-plane phase-contrast (PC) imaging is now a routine component of MRI of regional blood flow in the heart and great vessels. PC MRI provides a volumetric, isotropic, time-resolved cine sequence that enables three-directional velocity encoding, a technique known as four-dimensional (4D) flow MRI.
Though cardiovascular flow covers a broad range of topics, the aim of this Special Issue is to collect papers that demonstrate and enable fundamental insights into cardiovascular flow. In particular, we are seeking to highlight the state-of-the–art, as well as new theoretical and experimental representations of the cardiovascular system, methods for assimilating and combining experimental and medical imaging data with computational simulations, and novel methods for extracting meaningful information from flow data, whether in the form of visualizations, data/model reduction, or biologically meaningful indices. Due to advancements in the acute coronary syndrome setting, the mortality rate of coronary artery disease (CAD) has decreased in recent decades. Furthermore, our understanding of CAD has been steadily improving. Similarly, the recent advances in 4D flow MRI have shortened imaging times, while progress in big-data processing has improved dataset pre- and post-processing, thereby increasing the feasibility of 4D flow MRI in clinical practice. Important technical issues include selection of the optimal velocity-encoding sensitivity before acquisition and preprocessing of the raw data for phase-offset corrections. In this Special Issue, we focus on pearls and pitfalls in the practical application of 4D flow MRI, including how to quantify cardiovascular shunts, valvular or vascular stenosis, and valvular regurgitation.
New methods and indices that can distinguish the physiological importance of epicardial coronary stenoses and the function of microcirculation, in particular, are helping to improve the indication for revascularization and medical therapy. Noninvasive alternatives are being developed at the same time to enable less intrusive and more widely applicable diagnoses. Furthermore, as experience increases, and 4D flow sequences and post-processing software become more broadly available, 4D flow MRI will likely become an essential component of cardiac imaging in practices involved in the management of congenital and acquired structural heart disease. This Special Issue also summarizes the hemodynamic parameters of 4D flow MRI technology and generalizes their usefulness in clinical practice in relation to the cardiovascular system.
This Special Issue also addresses recent advances in vascular mechanobiology in the context of cardiovascular hemodynamic events and the distinct localisation of vascular illness. This Special Issue focuses on the behavior of blood flow in the stenosed vessels. Blood is modelled as an incompressible non-Newtonian fluid which is based on the power law viscosity model. Differential equations for the cardiovascular system are derived by applying the continuity equation of fluid mechanics to the rate of blood flow and variation of blood volume in different parts of the system. The equations are used to explain heart flow phenomenon, such as the Frank-Starling mechanism, which plays an important role in the maintenance of the stability of the distribution of blood in the system. This Special Issue also focuses on physics of the cardiovascular system as an intrinsic control mechanism of the human heart.
This Special Issue covers a broad domain of topics such as:
• Computational Fluid Dynamics analysis of pulsatile blood flow;
• Blood flow behavior in modelled stenosed vessels;
• Arterial disease and gene expression;
• Experimental and computational ionizing and non-ionizing dosimetry, including instrumentation and algorithm development;
• Image reconstruction, image analysis, computer-aided detection and diagnosis, radiomics, biomarkers, machine learning, deep learning, image registration, and feature extraction;
• Treatment optimization, treatment outcomes analysis, mathematical modeling of treatment’s biological effects;
• Hemodynamic assessment of structural heart disease using 4D flow MRI;
• Left atrium blood flow characterization using 4D flow MRI and CFD;
• The physiology of coronary flow: from epicardial arteries to microcirculation;
• Management of patients with CAD and atrial fibrillation;
• New technologies for the treatment of calcified coronary stenoses;
• Novelties in myocardial ischemia assessment;
• Applications of Continuity and Navier-Stokes Equations to blood flow in an artery;
• Arterial blood flow and pulse wave propagation;
• Models to simulate the behavior of the heart from cell to organ level;
• Analysis and processing of widely used cardiac data (such as CT, MRI, ultrasound, and echocardiography) and physiological recordings (such as electrocardiograms and blood pressure), as well as fusion techniques to integrate this wide spectrum of cardiac data to assist with clinical decision-making and therapy guidance;
• Combining clinical and engineering approach with computing methods to provide screening, diagnosis, therapy planning, and treatment follow-ups;
• Computing techniques towards their clinical translations.
Prof. Kelvin K.L. Wong
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