{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:10:15Z","timestamp":1789002615623,"version":"build-2803163510"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T00:00:00Z","timestamp":1655856000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T00:00:00Z","timestamp":1655856000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000761","name":"Imperial College London","doi-asserted-by":"publisher","award":["Startup Funding"],"award-info":[{"award-number":["Startup Funding"]}],"id":[{"id":"10.13039\/501100000761","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001459","name":"Ministry of Education - Singapore","doi-asserted-by":"publisher","award":["MOE2018-T2-1-003"],"award-info":[{"award-number":["MOE2018-T2-1-003"]}],"id":[{"id":"10.13039\/501100001459","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Biomed Eng"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\nIn cases of fetal aortic stenosis and evolving Hypoplastic Left Heart Syndrome (feHLHS), aortic stenosis is associated with specific abnormalities such as retrograde or bidirectional systolic transverse arch flow. Many cases progressed to hypoplastic left heart syndrome (HLHS) malformation at birth, but fetal aortic valvuloplasty can prevent  the progression in many cases. Since both disease and intervention involve drastic changes to the biomechanical environment,    <jats:italic>in-vivo<\/jats:italic> biomechanics likely play a role in inducing and preventing disease progression. However, the fluid mechanics of feHLHS is not well-characterized. Here, we conduct patient-specific echocardiography-based flow simulations of normal and feHLHS left ventricles (LV), to understand the essential fluid dynamics distinction between the two cohorts. We found high variability across feHLHS cases, but also the following unifying features. Firstly, feHLHS diastole mitral inflow was in the form of a narrowed and fast jet that impinged onto the apical region, rather than a wide and gentle inflow in normal LVs. This was likely due to a malformed mitral valve with impaired opening dynamics. This altered inflow caused elevated vorticity dynamics and wall shear stresses (WSS) and reduced oscillatory shear index at the apical zone rather than mid-ventricle. Secondly, feHLHS LV also featured elevated systolic and diastolic energy losses, intraventricular pressure gradients, and vortex formation numbers, suggesting energy inefficiency of flow and additional burden on the LV. Thirdly, feHLHS LV had poor blood turnover, suggesting a hypoxic environment, which could be associated with endocardial fibroelastosis that is often observed in these patients.<\/jats:p>","DOI":"10.1007\/s10439-022-02990-5","type":"journal-article","created":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T14:03:09Z","timestamp":1655906589000},"page":"1158-1172","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Fluid Mechanics of Fetal Left Ventricle During Aortic Stenosis with Evolving Hypoplastic Left Heart Syndrome"],"prefix":"10.1007","volume":"50","author":[{"given":"Hong Shen","family":"Wong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hadi","family":"Wiputra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Tulzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald","family":"Tulzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2918-3077","authenticated-orcid":false,"given":"Choon Hwai","family":"Yap","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,6,22]]},"reference":[{"key":"2990_CR1","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1002\/pd.2810","volume":"31","author":"W Arzt","year":"2011","unstructured":"Arzt, W., and G. Tulzer. Fetal surgery for cardiac lesions. Prenatal Diagn. 31:695\u2013698, 2011.","journal-title":"Prenatal Diagn."},{"key":"2990_CR2","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1002\/uog.8927","volume":"37","author":"W Arzt","year":"2011","unstructured":"Arzt, W., D. Wertaschnigg, I. Veit, F. Klement, R. Gitter, and G. Tulzer. Intrauterine aortic valvuloplasty in fetuses with critical aortic stenosis: experience and results of 24 procedures. Ultrasound Obstet. Gynecol. 37:689\u2013695, 2011.","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"2990_CR3","doi-asserted-by":"publisher","first-page":"1557","DOI":"10.1098\/rspb.2005.3109","volume":"272","author":"JO Dabiri","year":"2005","unstructured":"Dabiri, J. O., and M. Gharib. The role of optimal vortex formation in biological fluid transport. Proc. R. Soc. B: Biol. Sci. 272:1557\u20131560, 2005.","journal-title":"Proc. R. Soc. B: Biol. Sci."},{"key":"2990_CR4","doi-asserted-by":"publisher","first-page":"1712","DOI":"10.1016\/0002-8703(92)90834-I","volume":"123","author":"DA Danford","year":"1992","unstructured":"Danford, D. A., and P. Cronican. Hypoplastic left heart syndrome: progression of left ventricular dilation and dysfunction to left ventricular hypoplasia in utero. Am. Heart J. 123:1712\u20131713, 1992.","journal-title":"Am. Heart J."},{"key":"2990_CR5","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1016\/j.amjcard.2014.04.013","volume":"114","author":"KG Friedman","year":"2014","unstructured":"Friedman, K. G., D. Schidlow, L. Freud, M. Escobar-Diaz, and W. Tworetzky. Left ventricular diastolic function and characteristics in fetal aortic stenosis. Am. J. Cardiol. 114:122\u2013127, 2014.","journal-title":"Am. J. Cardiol."},{"key":"2990_CR6","doi-asserted-by":"publisher","first-page":"6305","DOI":"10.1073\/pnas.0600520103","volume":"103","author":"M Gharib","year":"2006","unstructured":"Gharib, M., E. Rambod, A. Kheradvar, D. J. Sahn, and J. O. Dabiri. Optimal vortex formation as an index of cardiac health. Proc. Natl. Acad. Sci. 103:6305\u20136308, 2006.","journal-title":"Proc. Natl. Acad. Sci."},{"key":"2990_CR7","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1017\/S0022112097008410","volume":"360","author":"M Gharib","year":"1998","unstructured":"Gharib, M., E. Rambod, and K. Shariff. A universal time scale for vortex ring formation. J. Fluid Mech. 360:121\u2013140, 1998.","journal-title":"J. Fluid Mech."},{"issue":"76","key":"2990_CR8","first-page":"e71","volume":"205","author":"N Hamill","year":"2011","unstructured":"Hamill, N., L. Yeo, R. Romero, S. S. Hassan, S. A. Myers, P. Mittal, J. P. Kusanovic, M. Balasubramaniam, T. Chaiworapongsa, E. Vaisbuch, J. Espinoza, F. Gotsch, L. F. Goncalves, and W. Lee. Fetal cardiac ventricular volume, cardiac output, and ejection fraction determined with 4-dimensional ultrasound using spatiotemporal image correlation and virtual organ computer-aided analysis. Am. J. Obstet. Gynecol. 205(76):e71-76.e10, 2011.","journal-title":"Am. J. Obstet. Gynecol."},{"key":"2990_CR9","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1159\/000341717","volume":"35","author":"T Ishii","year":"2013","unstructured":"Ishii, T., D. B. Mcelhinney, D. M. Harrild, E. N. Marcus, D. J. Sahn, U. Truong, and W. Tworetzky. Ventricular strain in fetuses with aortic stenosis and evolving hypoplastic left heart syndrome before and after prenatal aortic valvuloplasty. Fetal Diagn. Ther. 35:18\u201326, 2013.","journal-title":"Fetal Diagn. Ther."},{"key":"2990_CR10","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1136\/heart.84.1.59","volume":"84","author":"P Johnson","year":"2000","unstructured":"Johnson, P. Intracardiac pressures in the human fetus. Heart. 84:59\u201363, 2000.","journal-title":"Heart"},{"key":"2990_CR11","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1002\/uog.18913","volume":"52","author":"A Kovacevic","year":"2018","unstructured":"Kovacevic, A., A. \u00d6hman, G. Tulzer, U. Herberg, J. Dangel, J. S. Carvalho, V. Fesslova, H. Jicinska, T. Sarkola, C. Pedroza, I. E. Averiss, M. Mellander, and H. M. Gardiner. Fetal hemodynamic response to aortic valvuloplasty and postnatal outcome: a European multicenter study. Ultrasound Obstet. Gynecol. 52:221\u2013229, 2018.","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"2990_CR12","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1161\/01.ATV.5.3.293","volume":"5","author":"DN Ku","year":"1985","unstructured":"Ku, D. N., D. P. Giddens, C. K. Zarins, and S. Glagov. Pulsatile flow and atherosclerosis in the human carotid bifurcation. Positive correlation between plaque location and low oscillating shear stress. Arteriosclerosis: Off. J. Am. Heart Assoc., Inc. 5:293\u2013302, 1985.","journal-title":"Arteriosclerosis: Off. J. Am. Heart Assoc., Inc."},{"key":"2990_CR13","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1007\/s10237-015-0750-5","volume":"15","author":"CQ Lai","year":"2016","unstructured":"Lai, C. Q., G. L. Lim, M. Jamil, C. N. Z. Mattar, A. Biswas, and C. H. Yap. Fluid mechanics of blood flow in human fetal left ventricles based on patient-specific 4D ultrasound scans. Biomech. Model. Mechanobiol. 15:1159\u20131172, 2016.","journal-title":"Biomech. Model. Mechanobiol."},{"key":"2990_CR14","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1145\/1015706.1015719","volume":"23","author":"Y Li","year":"2004","unstructured":"Li, Y., J. Sun, C.-K. Tang, and H.-Y. Shum. Lazy snapping. ACM Trans. Graph. 23:303\u2013308, 2004.","journal-title":"ACM Trans. Graph."},{"key":"2990_CR15","doi-asserted-by":"publisher","first-page":"1401","DOI":"10.1161\/CIRCULATIONAHA.105.588194","volume":"113","author":"K M\u00e4Kikallio","year":"2006","unstructured":"M\u00e4Kikallio, K., D. B. Mcelhinney, J. C. Levine, G. R. Marx, S. D. Colan, A. C. Marshall, J. E. Lock, E. N. Marcus, and W. Tworetzky. Fetal aortic valve stenosis and the evolution of hypoplastic left heart syndrome. Circulation. 113:1401\u20131405, 2006.","journal-title":"Circulation"},{"key":"2990_CR16","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1016\/j.jpeds.2005.04.055","volume":"147","author":"AC Marshall","year":"2005","unstructured":"Marshall, A. C., W. Tworetzky, L. Bergersen, D. B. Mcelhinney, C. B. Benson, R. W. Jennings, L. E. Wilkins-Haug, G. R. Marx, and J. E. Lock. Aortic valvuloplasty in the fetus: technical characteristics of successful balloon dilation. J. Pediatr. 147:535\u2013539, 2005.","journal-title":"J. Pediatr."},{"key":"2990_CR17","doi-asserted-by":"publisher","first-page":"1482","DOI":"10.1161\/CIRCULATIONAHA.109.848994","volume":"120","author":"DB Mcelhinney","year":"2009","unstructured":"Mcelhinney, D. B., A. C. Marshall, L. E. Wilkins-Haug, D. W. Brown, C. B. Benson, V. Silva, G. R. Marx, A. Mizrahi-Arnaud, J. E. Lock, and W. Tworetzky. Predictors of technical success and postnatal biventricular outcome after in utero aortic valvuloplasty for aortic stenosis with evolving hypoplastic left heart syndrome. Circulation. 120:1482\u20131490, 2009.","journal-title":"Circulation"},{"key":"2990_CR18","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.1161\/CIRCULATIONAHA.109.870246","volume":"121","author":"DB Mcelhinney","year":"2010","unstructured":"Mcelhinney, D. B., W. Tworetzky, and J. E. Lock. Current status of fetal cardiac intervention. Circulation. 121:1256\u20131263, 2010.","journal-title":"Circulation"},{"key":"2990_CR19","doi-asserted-by":"publisher","first-page":"1792","DOI":"10.1016\/j.amjcard.2010.08.022","volume":"106","author":"DB Mcelhinney","year":"2010","unstructured":"Mcelhinney, D. B., M. Vogel, C. B. Benson, A. C. Marshall, L. E. Wilkins-Haug, V. Silva, and W. Tworetzky. Assessment of left ventricular endocardial fibroelastosis in fetuses with aortic stenosis and evolving hypoplastic left heart syndrome. Am. J. Cardiol. 106:1792\u20131797, 2010.","journal-title":"Am. J. Cardiol."},{"key":"2990_CR20","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1016\/j.jacc.2015.05.037","volume":"66","author":"AJ Moon-Grady","year":"2015","unstructured":"Moon-Grady, A. J., S. A. Morris, M. Belfort, R. Chmait, J. Dangel, R. Devlieger, S. Emery, M. Frommelt, A. Galindo, S. Gelehrter, U. Gembruch, S. Grinenco, M. Habli, U. Herberg, E. Jaeggi, M. Kilby, E. Kontopoulos, P. Marantz, O. Miller, L. Ota\u00f1o, C. Pedra, S. Pedra, J. Pruetz, R. Quintero, G. Ryan, G. Sharland, J. Simpson, E. Vlastos, W. Tworetzky, L. Wilkins-Haug, and D. Oepkes. International fetal cardiac intervention registry: a worldwide collaborative description and preliminary outcomes. J. Am. Coll. Cardiol. 66:388\u2013399, 2015.","journal-title":"J. Am. Coll. Cardiol."},{"key":"2990_CR21","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1016\/S1350-4533(97)84634-6","volume":"19","author":"G Pennati","year":"1997","unstructured":"Pennati, G., M. Bellotti, and R. Fumero. Mathematical modelling of the human foetal cardiovascular system based on Doppler ultrasound data. Med. Eng. Phys. 19:327\u2013335, 1997.","journal-title":"Med. Eng. Phys."},{"key":"2990_CR22","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1002\/dvdy.24521","volume":"247","author":"Z Pesevski","year":"2018","unstructured":"Pesevski, Z., A. Kvasilova, T. Stopkova, O. Nanka, E. Drobna Krejci, C. Buffinton, R. Kockova, A. Eckhardt, and D. Sedmera. Endocardial fibroelastosis is secondary to hemodynamic alterations in the chick embryonic model of hypoplastic left heart syndrome. Dev. Dyn. 247:509\u2013520, 2018.","journal-title":"Dev. Dyn."},{"key":"2990_CR23","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.119.006127","author":"SS Pickard","year":"2020","unstructured":"Pickard, S. S., J. B. Wong, E. M. Bucholz, J. W. Newburger, W. Tworetzky, T. Lafranchi, C. B. Benson, L. E. Wilkins-Haug, D. Porras, R. Callahan, and K. G. Friedman. Fetal aortic valvuloplasty for evolving hypoplastic left heart syndrome. Circulation: Cardiovasc. Qual. Outcomes. 2020. https:\/\/doi.org\/10.1161\/CIRCOUTCOMES.119.006127.","journal-title":"Circulation: Cardiovasc. Qual. Outcomes"},{"key":"2990_CR24","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1002\/pd.5232","volume":"38","author":"AR Prosnitz","year":"2018","unstructured":"Prosnitz, A. R., M. Drogosz, A. C. Marshall, L. E. Wilkins-Haug, C. B. Benson, L. A. Sleeper, W. Tworetzky, and K. G. Friedman. Early hemodynamic changes after fetal aortic stenosis valvuloplasty predict biventricular circulation at birth. Prenat. Diagn. 38:286\u2013292, 2018.","journal-title":"Prenat. Diagn."},{"key":"2990_CR25","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1002\/uog.5132","volume":"30","author":"ES Selamet Tierney","year":"2007","unstructured":"Selamet Tierney, E. S., R. M. Wald, D. B. Mcelhinney, A. C. Marshall, C. B. Benson, S. D. Colan, E. N. Marcus, G. R. Marx, J. C. Levine, L. Wilkins-Haug, J. E. Lock, and W. Tworetzky. Changes in left heart hemodynamics after technically successful in-utero aortic valvuloplasty. Ultrasound Obstet. Gynecol. 30:715\u2013720, 2007.","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"2990_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2015\/462469","volume":"2015","author":"S Shimada","year":"2015","unstructured":"Shimada, S., C. Robles, B. M. W. Illigens, A. M. Casar Berazaluce, P. J. Del Nido, and I. Friehs. Distention of the immature left ventricle triggers development of endocardial fibroelastosis: an animal model of endocardial fibroelastosis introducing morphopathological features of evolving fetal hypoplastic left heart syndrome. BioMed Res. Int. 2015:1\u201310, 2015.","journal-title":"BioMed Res. Int."},{"key":"2990_CR27","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1046\/j.1469-0705.2000.00086.x","volume":"15","author":"JM Simpson","year":"2000","unstructured":"Simpson, J. M. Hypoplastic left heart syndrome. Ultrasound Obstet. Gynecol. 15:271\u2013278, 2000.","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"2990_CR28","doi-asserted-by":"publisher","first-page":"1459","DOI":"10.1016\/0002-9149(92)90300-N","volume":"70","author":"J Tan","year":"1992","unstructured":"Tan, J., N. H. Silverman, J. I. E. Hoffman, M. Villegas, and K. G. Schmidt. Cardiac dimensions determined by cross-sectional echocardiography in the normal human fetus from 18 weeks to term. Am. J. Cardiol. 70:1459\u20131467, 1992.","journal-title":"Am. J. Cardiol."},{"key":"2990_CR29","doi-asserted-by":"publisher","first-page":"H959","DOI":"10.1152\/ajpheart.2000.279.3.H959","volume":"279","author":"K Tobita","year":"2000","unstructured":"Tobita, K., and B. B. Keller. Right and left ventricular wall deformation patterns in normal and left heart hypoplasia chick embryos. Am. J. Physiol. Heart Circ. Physiol. 279:H959-969, 2000.","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"2990_CR30","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24792","author":"A Tulzer","year":"2021","unstructured":"Tulzer, A., W. Arzt, R. Gitter, E. Sames-Dolzer, M. Kreuzer, R. Mair, and G. Tulzer. Valvuloplasty in 103 fetuses with critical aortic stenosis: outcome and new predictors for postnatal circulation. Ultrasound Obstet. Gynecol. 2021. https:\/\/doi.org\/10.1002\/uog.24792.","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"2990_CR31","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1016\/j.siny.2013.04.002","volume":"18","author":"G Tulzer","year":"2013","unstructured":"Tulzer, G., and W. Arzt. Fetal cardiac interventions: rationale, risk and benefit. Semin. Fetal Neonatal Med. 18:298\u2013301, 2013.","journal-title":"Semin. Fetal Neonatal Med."},{"key":"2990_CR32","doi-asserted-by":"publisher","first-page":"2125","DOI":"10.1161\/01.CIR.0000144357.29279.54","volume":"110","author":"W Tworetzky","year":"2004","unstructured":"Tworetzky, W., L. Wilkins-Haug, R. W. Jennings, M. E. Van Der Velde, A. C. Marshall, G. R. Marx, S. D. Colan, C. B. Benson, J. E. Lock, and S. B. Perry. Balloon dilation of severe aortic stenosis in the fetus. Circulation. 110:2125\u20132131, 2004.","journal-title":"Circulation"},{"key":"2990_CR33","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.jbiomech.2019.04.026","volume":"90","author":"V Vasudevan","year":"2019","unstructured":"Vasudevan, V., A. J. J. Low, S. P. Annamalai, S. Sampath, C.-L. Chin, A. A. B. Ali, and C. H. Yap. Role of diastolic vortices in flow and energy dynamics during systolic ejection. J. Biomech. 90:50\u201357, 2019.","journal-title":"J. Biomech."},{"key":"2990_CR34","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1542\/peds.67.5.607","volume":"67","author":"HT Versmold","year":"1981","unstructured":"Versmold, H. T., J. A. Kitterman, R. H. Phibbs, G. A. Gregory, and W. H. Tooley. Aortic blood pressure during the first 12 hours of life in infants with birth weight 610 to 4,220 grams. Pediatrics. 67:607\u2013613, 1981.","journal-title":"Pediatrics"},{"key":"2990_CR35","doi-asserted-by":"publisher","first-page":"18510","DOI":"10.1038\/s41598-020-75525-4","volume":"10","author":"H Wiputra","year":"2020","unstructured":"Wiputra, H., W. X. Chan, Y. Y. Foo, S. Ho, and C. H. Yap. Cardiac motion estimation from medical images: a regularisation framework applied on pairwise image registration displacement fields. Sci. Rep. 10:18510, 2020.","journal-title":"Sci. Rep."},{"key":"2990_CR36","doi-asserted-by":"publisher","first-page":"H1649","DOI":"10.1152\/ajpheart.00235.2018","volume":"315","author":"H Wiputra","year":"2018","unstructured":"Wiputra, H., C. K. Chen, E. Talbi, G. L. Lim, S. M. Soomar, A. Biswas, C. N. Z. Mattar, D. Bark, H. L. Leo, and C. H. Yap. Human fetal hearts with tetralogy of Fallot have altered fluid dynamics and forces. Am. J. Physiol.-Heart Circ. Physiol. 315:H1649\u2013H1659, 2018.","journal-title":"Am. J. Physiol.-Heart Circ. Physiol."},{"key":"2990_CR37","doi-asserted-by":"publisher","first-page":"H1498","DOI":"10.1152\/ajpheart.00400.2016","volume":"311","author":"H Wiputra","year":"2016","unstructured":"Wiputra, H., C. Q. Lai, G. L. Lim, J. J. W. Heng, L. Guo, S. M. Soomar, H. L. Leo, A. Biwas, C. N. Z. Mattar, and C. H. Yap. Fluid mechanics of human fetal right ventricles from image-based computational fluid dynamics using 4D clinical ultrasound scans. Am. J. Physiol.-Heart Circ. Physiol. 311:H1498\u2013H1508, 2016.","journal-title":"Am. J. Physiol.-Heart Circ. Physiol."},{"key":"2990_CR38","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1002\/uog.14885","volume":"47","author":"C Wohlmuth","year":"2016","unstructured":"Wohlmuth, C., D. Wertaschnigg, I. Wieser, W. Arzt, and G. Tulzer. Tissue Doppler imaging in fetuses with aortic stenosis and evolving hypoplastic left heart syndrome before and after fetal aortic valvuloplasty. Ultrasound Obstet. Gynecol. 47:608\u2013615, 2016.","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"2990_CR39","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-57694-4","author":"FY Wong","year":"2020","unstructured":"Wong, F. Y., A. Veldman, A. Sasi, M. Teoh, A. Edwards, Y. Chan, O. Graupner, C. Enzensberger, R. Axt-Fliedner, M. J. Black, and D. Schranz. Induction of left ventricular hypoplasia by occluding the foramen ovale in the fetal lamb. Sci. Rep. 2020. https:\/\/doi.org\/10.1038\/s41598-020-57694-4.","journal-title":"Sci. Rep."},{"key":"2990_CR40","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1161\/CIRCRESAHA.116.305629","volume":"116","author":"X Xu","year":"2015","unstructured":"Xu, X., I. Friehs, T. Zhong Hu, I. Melnychenko, B. Tampe, F. Alnour, M. Iascone, R. Kalluri, M. Zeisberg, P. J. Del Nido, and E. M. Zeisberg. Endocardial fibroelastosis is caused by aberrant endothelial to mesenchymal transition. Circ. Res. 116:857\u2013866, 2015.","journal-title":"Circ. Res."},{"key":"2990_CR41","doi-asserted-by":"publisher","DOI":"10.3892\/ijmm.2018.3584","author":"B Zhang","year":"2018","unstructured":"Zhang, B., W. Niu, H. Y. Dong, M. L. Liu, Y. Luo, and Z. C. Li. Hypoxia induces endothelial-mesenchymal transition in pulmonary vascular remodeling. Int. J. Mol. Med. 2018. https:\/\/doi.org\/10.3892\/ijmm.2018.3584.","journal-title":"Int. J. Mol. Med."}],"container-title":["Annals of Biomedical Engineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10439-022-02990-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10439-022-02990-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10439-022-02990-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T18:16:18Z","timestamp":1660068978000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10439-022-02990-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,22]]},"references-count":41,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["2990"],"URL":"https:\/\/doi.org\/10.1007\/s10439-022-02990-5","relation":{},"ISSN":["0090-6964","1573-9686"],"issn-type":[{"value":"0090-6964","type":"print"},{"value":"1573-9686","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,22]]},"assertion":[{"value":"19 January 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 June 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 June 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All authors have no conflict of interest to declare.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}