Publications
13 results found
Chan WX, Zheng Y, Wiputra H, et al., 2021, Full cardiac cycle asynchronous temporal compounding of 3D echocardiography images, Medical Image Analysis, Vol: 74, Pages: 1-14, ISSN: 1361-8415
It is important to improve echocardiography image quality, because the accuracy of echocardiographic assessment and diagnosis relies on image quality. Previous work on 2D temporal image compounding for image frames with matching cardiac phases (synchronous), and for temporally neighbouring image frames (asynchronous) over small ranges of time frames showed good improvement to image quality. Here, we extend this by performing asynchronous temporal compounding to echocardiographic images in 3D, involving all frames within a cardiac cycle, via a robust 3D cardiac motion estimation algorithm to describe the large image deformations. After compounding, the images can be reanimated via the motion model. Various methods of fusing image frames together are tested, including mean, max, and wavelet methods, and outlier rejection algorithms. The compounding algorithm is applied on 3D human adult, porcine adolescent, and human fetal echocardiography images. Results show significant improvements to contrast-to-noise ratio (CNR) and boundary clarity, and significantly decreased variability in manual quantification of cardiac chamber volumes after compounding. Interestingly, compounding can extend the field of view of the echo images, by reconstructing cardiac structures that momentarily exceeded the field of view, using the motion estimation algorithm to calculate their locations outside the field of view during these time periods. Although all compounding methods provide general improvements, the mean method led to blurred boundaries, while the max methods led to high variability of CNR. Outlier rejection algorithms were found to be useful in addressing these weaknesses.
Yap CH, Dai Y, Zhao D, et al., 2021, Echocardiographic assessment of fetal cardiac function in the uterine artery ligation rat model of IUGR, Pediatric Research, Vol: 90, Pages: 801-808, ISSN: 0031-3998
BackgroundIntrauterine growth restriction (IUGR) leads to cardiac dysfunction and adverse remodeling of the fetal heart, as well as a higher risk of postnatal cardiovascular diseases. The rat model of IUGR, via uterine artery ligation, is a popular model but its cardiac sequelae is not well investigated. Here, we performed an echocardiographic evaluation of its cardiac function to determine how well it can represent the disease in humans.MethodsUnilateral uterine artery ligation was performed at embryonic day 17 (E17) and echocardiography was performed at E19 and E20.ResultsGrowth-restricted fetuses were significantly smaller and lighter, and had an higher placenta-to-fetus weight ratio. Growth-restricted fetal hearts had reduced wall thickness-to-diameter ratio, indicating left ventricular (LV) dilatation, and they had elevated trans-mitral and trans-tricuspid E/A ratios and reduced left and right ventricular fractional shortening (FS), suggesting systolic and diastolic dysfunction. These were similar to human IUGR fetuses. However, growth-restricted rat fetuses did not demonstrate head-sparing effect, displayed a lower LV myocardial performance index, and ventricular outflow velocities were not significantly reduced, which were dissimilar to human IUGR fetuses.ConclusionsDespite the differences, our results suggest that this IUGR model has significant cardiac dysfunction, and could be a suitable model for studying IUGR cardiovascular physiology.
Ong CW, Ren M, Wiputra H, et al., 2021, Biomechanics of human fetal hearts with critical aortic stenosis, Annals of Biomedical Engineering, Vol: 49, Pages: 1364-1379, ISSN: 0090-6964
Critical aortic stenosis (AS) of the fetal heart causes a drastic change in the cardiac biomechanical environment. Consequently, a substantial proportion of such cases will lead to a single-ventricular birth outcome. However, the biomechanics of the disease is not well understood. To address this, we performed Finite Element (FE) modelling of the healthy fetal left ventricle (LV) based on patient-specific 4D ultrasound imaging, and simulated various disease features observed in clinical fetal AS to understand their biomechanical impact. These features included aortic stenosis, mitral regurgitation (MR) and LV hypertrophy, reduced contractility, and increased myocardial stiffness. AS was found to elevate LV pressures and myocardial stresses, and depending on severity, can drastically decrease stroke volume and myocardial strains. These effects are moderated by MR. AS alone did not lead to MR velocities above 3 m/s unless LV hypertrophy was included, suggesting that hypertrophy may be involved in clinical cases with high MR velocities. LV hypertrophy substantially elevated LV pressure, valve flow velocities and stroke volume, while reducing LV contractility resulted in diminished LV pressure, stroke volume and wall strains. Typical extent of hypertrophy during fetal AS in the clinic, however, led to excessive LV pressure and valve velocity in the FE model, suggesting that reduced contractility is typically associated with hypertrophy. Increased LV passive stiffness, which might represent fibroelastosis, was found to have minimal impact on LV pressures, stroke volume, and wall strain. This suggested that fibroelastosis could be a by-product of the disease progression and does not significantly impede cardiac function. Our study demonstrates that FE modelling is a valuable tool for elucidating the biomechanics of congenital heart disease and can calculate parameters which are difficult to measure, such as intraventricular pressure and myocardial stresses.
Wiputra H, Chan WX, Foo YY, et al., 2020, Cardiac motion estimation from medical images: a regularisation framework applied on pairwise image registration displacement fields, Scientific Reports, Vol: 10, ISSN: 2045-2322
Accurate cardiac motion estimation from medical images such as ultrasound is important for clinical evaluation. We present a novel regularisation layer for cardiac motion estimation that will be applied after image registration and demonstrate its effectiveness. The regularisation utilises a spatio-temporal model of motion, b-splines of Fourier, to fit to displacement fields from pairwise image registration. In the process, it enforces spatial and temporal smoothness and consistency, cyclic nature of cardiac motion, and better adherence to the stroke volume of the heart. Flexibility is further given for inclusion of any set of registration displacement fields. The approach gave high accuracy. When applied to human adult Ultrasound data from a Cardiac Motion Analysis Challenge (CMAC), the proposed method is found to have 10% lower tracking error over CMAC participants. Satisfactory cardiac motion estimation is also demonstrated on other data sets, including human fetal echocardiography, chick embryonic heart ultrasound images, and zebrafish embryonic microscope images, with the average Dice coefficient between estimation motion and manual segmentation at 0.82–0.87. The approach of performing regularisation as an add-on layer after the completion of image registration is thus a viable option for cardiac motion estimation that can still have good accuracy. Since motion estimation algorithms are complex, dividing up regularisation and registration can simplify the process and provide flexibility. Further, owing to a large variety of existing registration algorithms, such an approach that is usable on any algorithm may be useful.
Foo YY, Pant S, Tay HS, et al., 2020, 4D modelling of fluid mechanics in the zebrafish embryonic heart, Biomechanics and Modeling in Mechanobiology, Vol: 19, Pages: 221-232, ISSN: 1617-7959
Li Z, Milionis A, Zheng Y, et al., 2019, Superhydrophobic hemostatic nanofiber composites for fast clotting and minimal adhesion, Nature Communications, Vol: 10, Pages: 1-11, ISSN: 2041-1723
Hemostatic materials are of great importance in medicine. However, their successful implementation is still challenging as it depends on two, often counteracting, attributes; achieving blood coagulation rapidly, before significant blood loss, and enabling subsequent facile wound-dressing removal, without clot tears and secondary bleeding. Here we illustrate an approach for achieving hemostasis, rationally targeting both attributes, via a superhydrophobic surface with immobilized carbon nanofibers (CNFs). We find that CNFs promote quick fibrin growth and cause rapid clotting, and due to their superhydrophobic nature they severely limit blood wetting to prevent blood loss and drastically reduce bacteria attachment. Furthermore, minimal contact between the clot and the superhydrophobic CNF surface yields an unforced clot detachment after clot shrinkage. All these important attributes are verified in vitro and in vivo with rat experiments. Our work thereby demonstrates that this strategy for designing hemostatic patch materials has great potential.
Ho S, Chan WX, Phan-Thien N, et al., 2019, Organ dynamics and hemodynamic of the whole HH25 avian embryonic heart, revealed by ultrasound biomicroscopy, boundary tracking, and flow simulations, Scientific Reports, Vol: 9, Pages: 1-14, ISSN: 2045-2322
Congenital heart malformations occur to substantial number of pregnancies. Studies showed that abnormal flow biomechanical environments could lead to malformations, making it important to understand the biomechanical environment of the developing heart. We performed 4D high-frequency ultrasound scans of chick embryonic hearts at HH25 to study the biomechanics of the whole heart (atria and ventricle). A novel and high-fidelity motion estimation technique, based on temporal motion model and non-rigid image registration algorithm, allowed automatic tracking of fluid-structure boundaries from scan images, and supported flow simulations. Results demonstrated that atrial appendages were the most contractile portion of the atria, having disproportionately high contribution to atrial blood pumping for its volume in the atria. However, the atria played a small role in blood pumping compared to the ventricle, as it had much lower ejection energy expenditure, and as the ventricle appeared to be able to draw inflow from the veins directly during late diastole. Spatially and temporally averaged wall shear stresses (WSS) for various cardiac structures were 0.062–0.068 Pa, but spatial-averaged WSS could be as high as 0.54 Pa in the RV. WSS was especially elevated at the atrial inlet, atrioventricular junction, regions near to the outflow tract, and at dividing lines between the left and right atrium and left and right side of the ventricle, where septation had begun and the lumen had narrowed. Elevated WSS could serve as biomechanics stimulation for proper growth and development.
Vasudevan V, Wiputra H, Yap CH, 2019, Torsional motion of the left ventricle does not affect ventricular fluid dynamics of both foetal and adult hearts, Journal of Biomechanics, Vol: 96, Pages: 109357-109357, ISSN: 0021-9290
Li Z, Marlena J, Pranantyo D, et al., 2019, A porous superhydrophobic surface with active air plastron control for drag reduction and fluid impalement resistance, Journal of Materials Chemistry A, Vol: 7, Pages: 16387-16396, ISSN: 2050-7488
<p>Robustly sustaining the air plastron by active air pressure control through a porous superhydrophobic surface for high liquid impalement resistance.</p>
Wiputra H, Chen CK, Talbi E, et al., 2018, Human fetal hearts with tetralogy of Fallot have altered fluid dynamics and forces, American Journal of Physiology-Heart and Circulatory Physiology, Vol: 315, Pages: H1649-H1659, ISSN: 0363-6135
Studies have suggested the effect of blood flow forces in pathogenesis and progression of some congenital heart malformations. It is therefore of interest to study the fluid mechanic environment of the malformed prenatal heart, such as the tetralogy of Fallot (TOF), especially when little is known about fetal TOF. In this study, we performed patient-specific ultrasound-based flow simulations of three TOF and seven normal human fetal hearts. TOF right ventricles (RVs) had smaller end-diastolic volumes (EDVs) but similar stroke volumes (SVs), whereas TOF left ventricles (LVs) had similar EDVs but slightly increased SVs compared with normal ventricles. Simulations showed that TOF ventricles had elevated systolic intraventricular pressure gradient (IVPG) and required additional energy for ejection but IVPG elevations were considered to be mild relative to arterial pressure. TOF RVs and LVs had similar pressures because of equalization via ventricular septal defect (VSD). Furthermore, relative to normal, TOF RVs had increased diastolic wall shear stresses (WSS) but TOF LVs were not. This was caused by high tricuspid inflow that exceeded RV SV, leading to right-to-left shunting and chaotic flow with enhanced vorticity interaction with the wall to elevate WSS. Two of the three TOF RVs but none of the LVs had increased thickness. As pressure elevations were mild, we hypothesized that pressure and WSS elevation could play a role in the RV thickening, among other causative factors. Finally, the endocardium surrounding the VSD consistently experienced high WSS because of RV-to-LV flow shunt and high flow rate through the over-riding aorta.
Saw SN, Tay JJH, Poh YW, et al., 2018, Altered placental chorionic arterial biomechanical properties during intrauterine growth restriction, Scientific Reports, Vol: 8, Pages: 1-12, ISSN: 2045-2322
Intrauterine growth restriction (IUGR) is a pregnancy complication due to placental dysfunction that prevents the fetus from obtaining enough oxygen and nutrients, leading to serious mortality and morbidity risks. There is no treatment for IUGR despite having a prevalence of 3% in developed countries, giving rise to an urgency to improve our understanding of the disease. Applying biomechanics investigation on IUGR placental tissues can give important new insights. We performed pressure-diameter mechanical testing of placental chorionic arteries and found that in severe IUGR cases (RI > 90th centile) but not in IUGR cases (RI < 90th centile), vascular distensibility was significantly increased from normal. Constitutive modeling demonstrated that a simplified Fung-type hyperelastic model was able to describe the mechanical properties well, and histology showed that severe IUGR had the lowest collagen to elastin ratio. To demonstrate that the increased distensibility in the severe IUGR group was related to their elevated umbilical resistance and pulsatility indices, we modelled the placental circulation using a Windkessel model, and demonstrated that vascular compliance (and not just vascular resistance) directly affected blood flow pulsatility, suggesting that it is an important parameter for the disease. Our study showed that biomechanics study on placenta could extend our understanding on placenta physiology.
Wang Y, Li Z, Qin L, et al., 2018, Dielectric Elastomer Fluid Pump of High Pressure and Large Volume Via Synergistic Snap-Through, Journal of Applied Mechanics, Vol: 85, ISSN: 0021-8936
<jats:p>Harnessing reversible snap-through of a dielectric elastomer (DE), which is a mechanism for large deformation provided by an electromechanical instability, for large-volume pumping has proven to be feasible. However, the output volume of snap-through pumping is drastically reduced by adverse pressure gradient, and large-volume pumping under high adverse pressure gradient by a DE pump has not been realized. In this paper, we propose a new mechanism of DE fluid pumping that can address this shortcoming by connecting DE pumps of different membrane stiffnesses serially in a pumping circuit and by harnessing synergistic interactions between neighboring pump units. We build a simple serial DE pump to verify the concept, which consists of two DE membranes. By adjusting the membrane stiffness appropriately, a synergistic effect is observed, where the snap-through of membrane 1 triggers the snap-through of membrane 2, ensuring that a large volume (over 70 ml/cycle) can be achieved over a wide range of large adverse pressure gradients. In comparison, the conventional single DE pump's pumping volume rapidly decreased beyond a low adverse pressure gradient of 0.196 kPa. At the pressure difference of 0.98 kPa, the serial DE pump's pumping volume is 4185.1% larger than that of the conventional DE pump. This pumping mechanism is customizable for various pressure ranges and enables a new approach to design DE-based soft pumping devices such as a DE total artificial heart, which requires large-volume pumping over a wide range of pressure difference.</jats:p>
Li Z, Wang Y, Foo CC, et al., 2017, The mechanism for large-volume fluid pumping via reversible snap-through of dielectric elastomer, Journal of Applied Physics, Vol: 122, ISSN: 0021-8979
<jats:p>Giant deformation of dielectric elastomers (DEs) via electromechanical instability (or the “snap-through” phenomenon) is a promising mechanism for large-volume fluid pumping. Snap-through of a DE membrane coupled with compressible air has been previously investigated. However, the physics behind reversible snap-through of a DE diaphragm coupled with incompressible fluid for the purpose of fluid pumping has not been well investigated, and the conditions required for reversible snap-through in a hydraulic system are unknown. In this study, we have proposed a concept for large-volume fluid pumping by harnessing reversible snap-through of the dielectric elastomer. The occurrence of snap-through was theoretically modeled and experimentally verified. Both the theoretical and experimental pressure-volume curves of the DE membrane under different actuation voltages were used to design the work loop of the pump, and the theoretical work loop agreed with the experimental work loop. Furthermore, the feasibility of reversible snap-through was experimentally verified, and specific conditions were found necessary for this to occur, such as a minimum actuation voltage, an optimal range of hydraulic pressure exerted on the DE membrane and a suitable actuation frequency. Under optimal working conditions, we demonstrated a pumping volume of up to 110 ml per cycle, which was significantly larger than that without snap-through. Furthermore, we have achieved fluid pumping from a region of low pressure to another region of high pressure. Findings of this study would be useful for real world applications such as the blood pump.</jats:p>
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