Annals of Biomedical Engineering

, Volume 45, Issue 10, pp 2335–2347 | Cite as

Peristaltic-Like Motion of the Human Fetal Right Ventricle and its Effects on Fluid Dynamics and Energy Dynamics

  • Hadi Wiputra
  • Guat Ling Lim
  • Khong Chun Chua
  • R. Nivetha
  • Sanah Merchant Soomar
  • Arijit Biwas
  • Citra Nurfarah Zaini Mattar
  • Hwa Liang Leo
  • Choon Hwai YapEmail author


In both adult human and canine, the cardiac right ventricle (RV) is known to exhibit a peristaltic-like motion, where RV sinus (inflow region) contracts first and the infundibulum (outflow region) later, in a wave-like contraction motion. The delay in contraction between the sinus and infundibulum averaged at 15% of the cardiac cycle and was estimated to produce an intra-ventricular pressure difference of 15 mmHg. However, whether such a contractile motion occurs in human fetuses as well, its effects on hemodynamics remains unknown, and are the subject of the current study. Hemodynamic studies of fetal hearts are important as previous works showed that healthy cardiac development is sensitive to fluid mechanical forces. We performed 4D clinical ultrasound imaging on eight 20-weeks old human fetuses. In five fetal RVs, peristaltic-like contractile motion from the sinus to infundibulum (“forward peristaltic-like motion”) was observed, but in one RV, peristaltic-like motion was observed from the infundibulum to sinus (“reversed peristaltic-like motion”), and two RVs contraction delay could not be determined due to poor regression fit. Next, we performed dynamic-mesh computational fluid dynamics simulations with varying extents of peristaltic-like motions for three of the eight RVs. Results showed that the peristaltic-like motion did not affect flow patterns significantly, but had significant influence on energy dynamics: increasing extent of forward peristaltic-like motion reduced the energy required for movement of fluid out of the heart during systolic ejection, while increasing extent of reversed peristaltic-like motion increased the required energy. It is currently unclear whether the peristaltic-like motion is an adaptation to reduce physiological energy expenditure, or merely an artefact of the cardiac developmental process.


Human fetus Right ventricle Peristaltic motion Fluid mechanics Ventricular vortex Wall shear stress 



The authors thank the National University of Singapore Young Investigator Award, grant entitled “Fluid Mechanics and Mechanobiology of Congenital Cardiac Outflow Tract Malformations” (PI: Yap) for funding, and the National University of Singapore Graduate School of Integrated Sciences and Engineering Scholarship for funding support for the lead author, Hadi Wiputra.

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Copyright information

© Biomedical Engineering Society 2017

Authors and Affiliations

  • Hadi Wiputra
    • 1
  • Guat Ling Lim
    • 2
  • Khong Chun Chua
    • 1
  • R. Nivetha
    • 1
  • Sanah Merchant Soomar
    • 3
  • Arijit Biwas
    • 2
  • Citra Nurfarah Zaini Mattar
    • 2
  • Hwa Liang Leo
    • 1
  • Choon Hwai Yap
    • 1
    Email author
  1. 1.Department of Biomedical EngineeringNational University of SingaporeSingaporeSingapore
  2. 2.Department of Obstetrics and Gynecology, Yong Loo Lin School of MedicineNational University of Singapore, National University Health SystemsSingaporeSingapore
  3. 3.Department of Paediatrics, Yong Loo Lin School of MedicineNational University of Singapore, National University Health SystemsSingaporeSingapore

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