Assessment of viscous energy loss and the association with three‐dimensional vortex ring formation in left ventricular inflow: In vivo evaluation using four‐dimensional flow MRI

Abstract

PurposeTo evaluate viscous energy loss and the association with three‐dimensional (3D) vortex ring formation in left ventricular (LV) blood flow during diastolic filling.Theory and MethodsThirty healthy volunteers were compared with 32 patients with corrected atrioventricular septal defect as unnatural mitral valve morphology and inflow are common in these patients. 4DFlow MRI was acquired from which 3D vortex ring formation was identified in LV blood flow at peak early (E)‐filling and late (A)‐filling and characterized by its presence/absence, orientation, and position from the lateral wall. Viscous energy loss was computed over E‐filling, A‐filling, and complete diastole using the Navier‐Stokes energy equations.ResultsCompared with healthy volunteers, viscous energy loss was significantly elevated in patients with disturbed vortex ring formation as characterized by a significantly inclined orientation and/or position closer to the lateral wall. Highest viscous energy loss was found in patients without a ring‐shaped vortex during E‐filling (on average more than double compared with patients with ring‐shape vortex, P < 0.003). Altered A‐filling vortex ring formation was associated with significant increase in total viscous energy loss over diastole even in the presence of normal E‐filling vortex ring.ConclusionAltered vortex ring formation during LV filling is associated with increased viscous energy loss. Magn Reson Med 77:794–805, 2017. © 2016 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Scan–rescan reproducibility of diastolic left ventricular kinetic energy, viscous energy loss and vorticity assessment using 4D flow MRI: analysis in healthy subjects

“…Results of norm_ • EL E-peak in the current study correspond well with that of a different healthy controls cohort of a recent 4D flow MRI study by Elbaz et al [1] Also norm_ • EL E-avg values are consistent. Furthermore, both results of norm_ • EL A−peak , as well as norm_ • EL A−avg are similar to previously reported numbers [1].…”

“…Both EL total diastole and norm_EL total diastole are slightly higher in our study than in the study by Elbaz et al [1]. However, results remain in the same range.…”

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

“…Congenital and acquired heart diseases affect the efficacy of intracardiac flow patterns and energy distribution [1,2]. Given the three-dimensional (3D) time-varying nature of these flow patterns and energetics, specialized in vivo imaging and analysis techniques are needed to evaluate volumetric changes in such complex hemodynamic parameters.…”

“…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].…”

“…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].…”