investigating-three-dimensional-flow-separation-induced-model-vocal

Investigating the Three-dimensional Flow Separation Induced by a Model Vocal Fold Polyp

The fluid-structure energy exchange process for normal speech has been studied extensively, but it is not well understood for pathological conditions. ...

The George Washington University

this study evaluated early diastolic filling dynamics using a semiautomated objective analysis of filling velocities obtained from color M-mode echocardiography.

Evaluation of LV diastolic function from color M-mode echocardiography.

Phase-contrast magnetic resonance imaging can potentially assess the dynamics of left ventricular (LV) early diastolic filling.

Assessment of left ventricular diastolic function using 4-dimensional phase-contrast cardiac magnetic resonance.

Normal left ventricular (LV) filling occurs rapidly early in diastole caused by a progressive pressure gradient within the ventricle and with a low left atrial pressure. This normal diastolic function is altered in patients with heart failure. Such impairment of diastolic filling is manifested as an abrupt deceleration of the early filling wave velocity. Although variations within the early filling wave have been observed previously, the underlying hydrodynamic mechanisms are not well understood. Previously, it was proposed that the mitral annulus vortex ring formation time was the total duration of early diastolic filling and provided a measure of the efficiency of diastolic filling. However, we found that the favorable LV pressure difference driving early diastolic filling becomes zero simultaneously with the deceleration of the early filling wave propagation velocity and pinch-off of the LV vortex ring. Thus we calculated the vortex ring formation time using the duration of the early diastolic filling wave from its initiation to the time of the early filling wave propagation velocity deceleration when pinch-off occurs. This formation time does not vary with decreasing intraventricular pressure difference or with degree of diastolic dysfunction. Thus we conclude the vortex ring pinch-off occurs before the completion of early diastole, and its formation time remains invariant to changes of diastolic function.

Left ventricular vortex formation is unaffected by diastolic impairment.

The aim of this study was to evaluate the hypothesis that the adrenergic response of the intraventricular pressure difference (IVPD) is reduced in patients with preserved ejection fraction (EF) and diastolic dysfunction (DD).

Loss of adrenergic augmentation of diastolic intra-LV pressure difference in patients with diastolic dysfunction: evaluation by color M-mode echocardiography.

Hirschberg [J. Acoust. Soc. Am. 134, 9-12 (2013)] presents a commentary and criticisms of the viscous flow model presented by Erath et al. [J. Acoust. Soc. Am. 130, 389-403 (2011)] that solves for the asymmetric pressure loading on the vocal fold walls. This pressure loading arises from asymmetric flow attachment to one vocal fold wall when the glottal channel forms a divergent configuration. Hirschberg proposes an alternative model for the asymmetric loading based upon inviscid flow curvature at the glottal inlet. In this manuscript further evidence is provided in support of the model of Erath et al. and the underlying assumptions, and demonstrates that the primary criticisms presented by Hirschberg are unwarranted. The model presented by Hirschberg is compared with the model from the original paper by Erath et al., and it is shown that each model describes different and complementary aspects of divergent glottal flows.

Response to "Comments on 'A theoretical model of the pressure distributions arising from asymmetric intraglottal flows applied to a two-mass model of the vocal folds'" [J. Acoust. Soc. Am. 130, 389-403 (2011)].

Kelley C. Stewart

Department of Mechanical and Aerospace Engineering

The George Washington University

Investigating the Three-dimensional Flow Separation Induced by a Model Vocal Fold Polyp