An International Journal of Cardiology paper featuring the work of Rajat Mittal, Professor of Mechanical Engineering and core faculty of the Institute for Computational Medicine, shares a new method for predicting those most at risk for blood clots in the heart. The paper titled, The E-wave propagation index (EPI): A novel echocardiographic parameter for prediction of left ventricular thrombus. Derivation from computational fluid dynamic modeling and validation on human subjects, is the result of collaboration between scientists from Johns Hopkins University and Ohio State.

The researchers found that the mitral jet, a stream of blood shot through the mitral value, is key to identifying patients at risk for blood clots in the heart. If the jet doesn’t travel deep enough into the left ventricle, it can prevent the chamber from properly flushing, leading to clots or strokes. Dr. Mittal and his colleagues developed and tested computational models based on their understanding of fluid dynamics in the heart that predict future blood clots in patients more accurately than the ejection fraction, the method currently used to predict which patients are at risk for clotting.

“Because we understood the fluid dynamics in the heart using our computational models, we reached the conclusion that the ejection fraction is not a very accurate measure of flow stasis in the left ventricle,” Mittal said. “We showed very clearly that the ejection fraction is not able to differentiate a large fraction of these patient and stratify risk, whereas this E-wave propagation index can very accurately stratify who will get a clot and who will not,” he said.