4D flow MRI can detect subtle right ventricular dysfunction in primary left ventricular disease

Abstract

Methods4D flow and morphological 3T MRI data were acquired in 22 patients with mild ischemic heart disease, that were stratified into two groups based on LV end-diastolic volume index (EDVI): lower-LVEDVI and higher-LVEDVI, as well as in 11 healthy controls. The RV volume was segmented at end-diastole (ED) and end-systole (ES).Pathlines were emitted from the ED volume and traced forwards and backwards in time to ES. The blood volume was separated into flow components. The Direct Flow (DF) component was defined as RV inflow passing directly to outflow. The kinetic energy (KE) of the DF component was calculated. Echocardiographic conventional RV indices were also assessed. ResultsThe higher-LVEDVI group had larger LVEDVI and lower LV ejection fraction (98±32 ml/m 2 ; 48±13 %) compared to the healthy (67±12, P=0.002; 64±7, P<0.001) and lower-LVEDI group (62±10; 68±7, both P<0.001). The RV 4D flow specific measures "DF/EDV volume-ratio" and "DF/EDV KE-ratio at ED" were lower in the higher-LVEDVI group (38±5 %; 52±6 %) compared to the healthy (44±6; 65±7, P=0.018 and P<0.001) and lower-LVEDVI groups (44±6; 64±7, P=0.011 and P<0.001). There was no difference in any of the conventional MRI and echocardiographic RV indices between the three groups.4 ConclusionWe found that in primary LV disease, mild impairment of RV function can be detected by 4D flow specific measures, but not by the conventional MRI and echocardiographic indices.

Estimation of Right Ventricular Diastolic Function in Patients With Ischemic Heart Disease in Different Age Groups

“…Неодинаковая диагностическая ценность показателей диастолической функции ПЖ отмечена и в настоящем исследовании, причем, в отличие от ряда других работ, показатель, характеризующий распространение потока раннего диастолического наполнения ПЖ в меньшей степени оказался ассоциированным от возраста пациентов. Это не согласуется, например, с результатами недавно опубликованного исследования, в котором при про-ведении МРТ сердца было показано, что при патоло-гии ЛЖ умеренные изменения функции ПЖ выявле-ны при оценке внутрижелудочковых потоков в режи-ме 4-D, но не при использовании обычных структур-ных показателей сердца при МРТ или ЭХОКГ [26]. Вполне возможно, это является следствием того, что у больных ИБС на диастолическую функцию ПЖ влияют не только возрастные изменения, но и нали-чие ишемической дисфункции миокарда.…”

Bioresorbable vascular scaffold overlap evaluation with optical coherence tomography after implantation with or without enhanced stent visualization system (WOLFIE study): a two-centre prospective comparison

“…4D flow MRI has recently emerged as a novel tool for in vivo quantification of intracardiac flow energetics, associated energy losses and vortical flow patterns by means of kinetic energy (KE) [4][5][6][7], viscous energy loss (EL) [1] and vorticity [8,9]. KE is the energy contained in the flow of the bloodstream due to motion and EL is the KE that is irreversibly lost due to viscosity-induced frictional forces within the blood flow [1].…”

“…In acquired heart disease, remodelling occurs which can lead to alterations in intracardiac hemodynamics [4]. Alteration in intraventricular KE derived from 4D flow MRI has been used to assess left ventricular (LV) and right ventricular (RV) (dys)function in patients with different stages of heart failure (HF) [4][5][6][7]. This is also the case in various congenital heart diseases.…”

Diastolic Dysfunction of the Right Ventricle in Coronary Heart Disease Patients

“…Такой подход вполне может оправдать себя в некоторых клинических ситуациях. Например, недавно опубликовано исследование, в котором при проведении МРТ сердца было показано, что при патологии ЛЖ умеренные изменения функции ПЖ выявлены при оценке внутрижелудочковых потоков в режиме 4-D, но не при использовании обычных структурных показателей сердца при МРТ или ЭхоКГ [15].…”