Portal hypertension and cirrhosis are associated with severe hemodynamic changes in hepatic and systemic circulation in the adult population.During cirrhosis progression,circulation becomes hyperdynamic,with cardiac,p...Portal hypertension and cirrhosis are associated with severe hemodynamic changes in hepatic and systemic circulation in the adult population.During cirrhosis progression,circulation becomes hyperdynamic,with cardiac,pulmonary and renal consequences.Cirrhotic adults also present with cirrhotic cardiomyopathy,with systolic and diastolic dysfunction and electrophysiological abnormalities.This article provides an update on normal liver hemodynamics,a brief reminder of the liver and systemic hemodynamics in cirrhotic adults,and a description of liver and systemic hemodynamics in cirrhotic children.This review attempts to clarify whether liver and systemic hemodynamics are altered in cirrhotic children like they are in adults.The characterization of these hemodynamic disturbances could contribute to a better understanding of hepatic and systemic physiopathology in pediatric cirrhosis.展开更多
BACKGROUND Few studies have quantified invasive hemodynamic parameters in post heart transplant recipients.AIM To report the incidence of abnormal hemodynamics in heart transplant recipients at 1-year and 3-year post-...BACKGROUND Few studies have quantified invasive hemodynamic parameters in post heart transplant recipients.AIM To report the incidence of abnormal hemodynamics in heart transplant recipients at 1-year and 3-year post-transplant and determine if there was any correlation with recipient and donor characteristics.METHODS Data from 279 consecutive heart transplant recipients from 2007 through 2020 were analyzed.Clinical variables regarding both recipients and donors as well as hemodynamic variables obtained via right heart catheterization during 1-year and 3-year annual testing were recorded.Simple and multiple linear regression tests were used to determine how recipient and donor variables influenced hemodynamic parameters at 1-year and 3-year.RESULTS Data were available for 260 patients and 224 patients at 1-year and 3-year posttransplant respectively.At 1-year,abnormal hemodynamic parameters were common with 24%patients having right atrial pressure(RAP)>10 mmHg,52%with mean pulmonary artery pressure>20 mmHg,and 12%with pulmonary capillary wedge pressure(PCWP)>18 mmHg.Similar abnormalities were noted at 3-year post-transplant.Recipient body mass index(BMI)demonstrated the strongest correlation with all 3 variables at both 1-year and 3-year by multivariate linear regression analysis(P<0.001 for both).Both donor age and predicted heart mass difference between recipient and donor were significantly linked to RAP and PCWP at 1-year but did not predict any variables at 3-year post-transplant.CONCLUSION Abnormal hemodynamics are common at 1-year and 3-year post-transplant and are associated with recipients with high BMI.展开更多
Portal vein stenosis is one of the common complications after liver transplantation in children.Accurate hemodynamic assessment is crucial for predicting the risk of complications after liver transplantation.In order ...Portal vein stenosis is one of the common complications after liver transplantation in children.Accurate hemodynamic assessment is crucial for predicting the risk of complications after liver transplantation.In order to predict the location of portal vein thrombosis after liver transplantation surgery,single-outlet and three-outlet vascular models were reconstructed from computed tomography images by commercial software MIMICS.The velocity field was measured using a 9.4 T magnetic resonance imaging scanner.Based on the experiment data of magnetic resonance velocimetry,computational fluid dynamics was verified,validated and then used to study the pressure and shear stresses on the wall of the two portal vein models.The simulation results can serve for the clinical prediction of early thrombosis after liver transplantation in portal vein.展开更多
The present study investigates the infiuences of aorta geometry on hemodynamics and material transport.Based on the observation of the human aorta.two geometric paramelers are examined for a model aorta,savine the ane...The present study investigates the infiuences of aorta geometry on hemodynamics and material transport.Based on the observation of the human aorta.two geometric paramelers are examined for a model aorta,savine the anele spanned by the main aorticarc and the diameter of the descending aorta.irect numerical simulations are conducted for nine model aortas with difierencombinations of aorta arc and outlet diameter.Results reveal that the outlet diameter has a sienificant impact on aorta hemodynamics.A smaller outlet diameter compared to the inlet leads to accelerated blood fow in the descending segment,affecting fiowmorphology including the vortex structures,and increasing peak pressure gradient and wall shear stress.However,it reducesthe oscillatory shear index,indicating a more organized fow.Analyses show faster particle transport and reduced accumulativeresidence time for smaller outlet diameters,The arc anele has less sieniicant efiects on these properties.except for delaying thetime to reach the maximum pressure gradient during cjection.The research results may suggest that the diameter of the aorticoutlet has a greater impact on the fiow structures,while the arc angle has a relatively less efiect.These findings provide insightsinto the relation between hemodynamics and aorta geometry,with potential clinical implications.展开更多
文摘Portal hypertension and cirrhosis are associated with severe hemodynamic changes in hepatic and systemic circulation in the adult population.During cirrhosis progression,circulation becomes hyperdynamic,with cardiac,pulmonary and renal consequences.Cirrhotic adults also present with cirrhotic cardiomyopathy,with systolic and diastolic dysfunction and electrophysiological abnormalities.This article provides an update on normal liver hemodynamics,a brief reminder of the liver and systemic hemodynamics in cirrhotic adults,and a description of liver and systemic hemodynamics in cirrhotic children.This review attempts to clarify whether liver and systemic hemodynamics are altered in cirrhotic children like they are in adults.The characterization of these hemodynamic disturbances could contribute to a better understanding of hepatic and systemic physiopathology in pediatric cirrhosis.
文摘BACKGROUND Few studies have quantified invasive hemodynamic parameters in post heart transplant recipients.AIM To report the incidence of abnormal hemodynamics in heart transplant recipients at 1-year and 3-year post-transplant and determine if there was any correlation with recipient and donor characteristics.METHODS Data from 279 consecutive heart transplant recipients from 2007 through 2020 were analyzed.Clinical variables regarding both recipients and donors as well as hemodynamic variables obtained via right heart catheterization during 1-year and 3-year annual testing were recorded.Simple and multiple linear regression tests were used to determine how recipient and donor variables influenced hemodynamic parameters at 1-year and 3-year.RESULTS Data were available for 260 patients and 224 patients at 1-year and 3-year posttransplant respectively.At 1-year,abnormal hemodynamic parameters were common with 24%patients having right atrial pressure(RAP)>10 mmHg,52%with mean pulmonary artery pressure>20 mmHg,and 12%with pulmonary capillary wedge pressure(PCWP)>18 mmHg.Similar abnormalities were noted at 3-year post-transplant.Recipient body mass index(BMI)demonstrated the strongest correlation with all 3 variables at both 1-year and 3-year by multivariate linear regression analysis(P<0.001 for both).Both donor age and predicted heart mass difference between recipient and donor were significantly linked to RAP and PCWP at 1-year but did not predict any variables at 3-year post-transplant.CONCLUSION Abnormal hemodynamics are common at 1-year and 3-year post-transplant and are associated with recipients with high BMI.
基金the Interdisciplinary Program of Shanghai Jiao Tong University(No.YG2021QN36)the National Natural Science Foundation of China(Nos.82000615 and 52106050)the Natural Science Foundation of Shanghai(No.21ZR1431800)。
文摘Portal vein stenosis is one of the common complications after liver transplantation in children.Accurate hemodynamic assessment is crucial for predicting the risk of complications after liver transplantation.In order to predict the location of portal vein thrombosis after liver transplantation surgery,single-outlet and three-outlet vascular models were reconstructed from computed tomography images by commercial software MIMICS.The velocity field was measured using a 9.4 T magnetic resonance imaging scanner.Based on the experiment data of magnetic resonance velocimetry,computational fluid dynamics was verified,validated and then used to study the pressure and shear stresses on the wall of the two portal vein models.The simulation results can serve for the clinical prediction of early thrombosis after liver transplantation in portal vein.
基金the support of the Clinical Medicine Plus X-Young Scholars Project at Peking University for thiswork.
文摘The present study investigates the infiuences of aorta geometry on hemodynamics and material transport.Based on the observation of the human aorta.two geometric paramelers are examined for a model aorta,savine the anele spanned by the main aorticarc and the diameter of the descending aorta.irect numerical simulations are conducted for nine model aortas with difierencombinations of aorta arc and outlet diameter.Results reveal that the outlet diameter has a sienificant impact on aorta hemodynamics.A smaller outlet diameter compared to the inlet leads to accelerated blood fow in the descending segment,affecting fiowmorphology including the vortex structures,and increasing peak pressure gradient and wall shear stress.However,it reducesthe oscillatory shear index,indicating a more organized fow.Analyses show faster particle transport and reduced accumulativeresidence time for smaller outlet diameters,The arc anele has less sieniicant efiects on these properties.except for delaying thetime to reach the maximum pressure gradient during cjection.The research results may suggest that the diameter of the aorticoutlet has a greater impact on the fiow structures,while the arc angle has a relatively less efiect.These findings provide insightsinto the relation between hemodynamics and aorta geometry,with potential clinical implications.
