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Asymmetric redirection of flow through the heart

Nature volume 404, pages 759–761 (2000)Cite this article

Abstract

Through cardiac looping during embryonic development1, 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 mapping2,3,4,5, 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 coupling6. Chiral asymmetry might help to minimize dissipative interaction between entering, recirculating and outflowing streams7. 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 exercise6.

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Figure 1: Asymmetric intracardiac flow patterns.
Figure 2: Changes in direction of blood through the heart.
Figure 3: Comparison of linear and looped atrio-ventricular arrangements.

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Acknowledgements

This work was supported by grants from the British Heart Foundation and CORDA, and by a HEFCE JREI award.

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Authors and Affiliations

  1. Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital site of Imperial College of Science, Medicine and Technology, Sydney Street, London, SW3 6NP , UK

    Philip J. Kilner, Guang-Zhong Yang, Raad H. Mohiaddin & David N. Firmin

  2. Visual Information Processing Group of Department of Computing, Royal Brompton Hospital site of Imperial College of Science, Medicine and Technology, Sydney Street, London, SW3 6NP , UK

    Guang-Zhong Yang

  3. Department of Cardiothoracic Surgery, Royal Brompton Hospital site of Imperial College of Science, Medicine and Technology, Sydney Street, London, SW3 6NP , UK

    Magdi H. Yacoub

  4. Flow Design Research Group, Emerson College, Forest Row, RH18 5JX, East Sussex, UK

    A. John Wilkes

Authors
  1. Philip J. Kilner
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  2. Guang-Zhong Yang
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  3. A. John Wilkes
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  4. Raad H. Mohiaddin
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  5. David N. Firmin
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  6. Magdi H. Yacoub
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Correspondence to Philip J. Kilner.

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Kilner, P., Yang, GZ., Wilkes, A. et al. Asymmetric redirection of flow through the heart. Nature 404, 759–761 (2000). https://doi.org/10.1038/35008075

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