Cardiac Flow Analysis Applied to Phase Contrast Magnetic Resonance Imaging of the Heart

Wong, Kelvin Kian Loong; Kelso, Richard; Worthley, Stephen G.; Sanders, Prashanthan; Mazumdar, J.; Abbott, Derek

doi:10.1007/s10439-009-9709-y

Cited by 53 publications

(41 citation statements)

References 69 publications

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“…[17][18][19][20] Hints of these structures come to us from studies performed with methods such as contrast, 21,22 Doppler, 5 and particle velocimetry. 23 These flow structures can be detected in planes through the heart (Figure 1; supplemental Video I), including the variable size and positions of vortical flow 24 that in normal hearts is initiated early in diastole underneath the mitral valve leaflets and reaccelerates during atrial contraction.…”

Section: Flow In the Normal Lv: The Surprise Insidementioning

confidence: 99%

Passing Strange

Carlhäll

Bolger²

2010

Circ: Heart Failure

101

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H eart failure is diverse in its manifestations and pathophysiology with changes in chamber size and volume, wall motion, valvular competence, intracardiac pressures, and electrical events. These are routinely measured with wellestablished methods. However, it is common to observe different degrees of compensation despite echocardiographically similar degrees of cardiac dysfunction. How can we explain this phenomenon? One persistent gap in our understanding of the failing heart is the global behavior of the intracardiac blood flow and its potential impact on pump efficiency and disease progression. The concepts that ventricular filling and ejection are separate events distinct in timing and location and that acceleration and ejection of the stroke volume are only events due to systolic myocardial contraction are familiar but likely oversimplified. It seems reasonable that rather than coming to a halt at end diastole, flowing blood would keep moving as filling transitions to ejection and that it would be efficient for blood in the end-diastolic left ventricle (LV) to already be moving toward the aortic valve for ejection. Until recently, there was a lack of measurement tools able to accurately resolve the complex in vivo 3D flow fields to investigate these and other flow-based questions. New tools that can measure 3D flow throughout the cardiac cycle noninvasively are becoming increasingly mature, and a more detailed perspective is emerging on the organization of intracardiac blood flow. It is now possible to investigate the routes, behaviors, and interactions of the blood transiting the ventricles in normal and failing hearts 1-3 and to consider the possible impact of flow characteristics on the efficiency of ventricular function.A focus on the flow aspects of cardiac function allows us to address a new and complementary set of questions. How does the efficiency of flow through the heart change with chamber dimensions, shape, and wall properties, and how will the passage of blood be affected by abnormal contraction and relaxation? Several of our therapeutic strategies for heart failure could be expected to have implications with respect to flow; thus, is it possible that we might use flow parameters to select best therapies, pacing modes, and surgical interventions for our patients with heart failure? Accurately Measuring 3D Flow Patterns in the Beating HeartTo study flow in the failing heart, we must first understand the process in health. 4 It can be hypothesized that the normally functioning LV will have a consistent and efficient pattern of throughflow, which represents a balance of hemodynamic conditions, chamber configuration, and rhythm. Proving this hypothesis requires an accurate way of measuring and interpreting dynamic flow in the heart. Flow passes through the LV cavity without constraint to any single plane or predefined direction; therefore, the necessary tools used in this task must be accurate in measuring blood flow velocities irrespective of direction in 3 spatial dimensions (3D) and with regis...

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Section: Flow In the Normal Lv: The Surprise Insidementioning

confidence: 99%

Passing Strange

Carlhäll

Bolger²

2010

Circ: Heart Failure

101

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“…Another computational approach has been described recently that uses a control volume technique to analyze the mechanism of energy losses in functional single ventricle patients after Fontan palliation. 15,34,36,38 Recently, CMR-based flow simulations have been performed by Wong et al 39 and Morbiducci et al 25 to access blood flow patterns in heart, and by Funamoto et al 16 for cerebral aneurism that do not require pressure measurements.…”

Section: Introductionmentioning

confidence: 98%

Right Ventricular Inefficiency in Repaired Tetralogy of Fallot: Proof of Concept for Energy Calculations From Cardiac MRI Data

2010

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Repaired tetralogy of Fallot (rTOF) patients develop right ventricular (RV) dilatation and dysfunction. To prevent their demise, pulmonary valve replacement is necessary, though appropriate timing for it is challenged by a paucity of reliable diagnostic parameters. In this pilot study, we hypothesized that stroke work (SW) and energy calculations would delineate the inefficiency of RV performance in rTOF. RV SW was calculated for both an rTOF and a normal subject by utilizing RV pressure and volume measurements obtained during cardiac catheterization and MRI studies. Energy transfer rate and ratio were computed at the main pulmonary artery (PA). Compared to the normal RV, the rTOF RV had higher operating pressure, lower computed SW (0.078 J vs. 0.115 J for normal), and higher negative energy transfer at the PA (0.044 J vs. 0.002 J for normal). Furthermore, the energy transfer ratio was nearly twice as high for the normal RV (1.06) as for the rTOF RV (0.56). RV SW and energy transfer ratio delineate important operational efficiency differences in blood flow from the RV to the PA between rTOF and normal subjects. Our pilot data suggest that the rTOF RV is significantly less efficient than normal.

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“…However, it was able to be shown that vortex flows can occur at non-physiological sites in various diseases. Aneurysms, pulmonary hypertension, and various heart diseases correlate with the occurrence and the intensity of vortex flows [18,19]. In addition, various valve pathologies and the use of artificial heart valves result in different vortex flows [20].…”

Section: Vortex Flowsmentioning

confidence: 99%

4D-Flow MRI: Technique and Applications

Sträter

Huber

Rudolph

et al. 2018

Fortschr Röntgenstr

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ABSTR AC TBackground Blood flow through the cavities of the heart and great vessels is pulsatile and is subject to time and multidirectional variations. To date, the recording of blood flow in multiple directions and phases has been limited. 4D-flow MRI offers advantages for the recording, visualization and analysis of blood flow.Method The status quo of the method was summarized through analysis with the PubMed database using the keywords "4D-flow MRI, phase-contrast magnetic resonance imaging, MR flow imaging/visualization, MR flow quantification, 3 D cine (time-resolved) phase-contrast CMR, threedirectional velocity-encoding MRI". Methode Basierend auf einer Literaturrecherche in der PubMed-Datenbank mit den Begriffen "4D-Flow-MRI, Phasecontrast magnetic-resonance-imaging, MR-flow-imaging/-visualization, MR-Flow-quantification, 3D-cine (time-resolved) phase-contrast CMR, three-directional velocity-encoding MR" wurde der aktuelle Stand der Methode in dieser Über-sichtsarbeit zusammengefasst.Ergebnisse/Schlussfolgerung Diese Übersichtsarbeit fasst den aktuellen Stand der technischen Entwicklung der 4D-Flussmessung zusammen, diskutiert ihre Vor-und Nachteile und zeigt Anwendungsmöglichkeiten auf. Schließlich werden die wichtigsten Prinzipien und Parameter erklärt, sodass der Leser über die Anwendung der Methode, die möglichen klinischen Indikationen, die Auswertung verschiedener Parameter durch Post-processing-Methoden und die Limitationen des Verfahrens relevante Informationen erhält. Review 1025Sträter A et al. 4D-Flow

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Cardiac Flow Analysis Applied to Phase Contrast Magnetic Resonance Imaging of the Heart

Cited by 53 publications

References 69 publications

Passing Strange

Passing Strange

Right Ventricular Inefficiency in Repaired Tetralogy of Fallot: Proof of Concept for Energy Calculations From Cardiac MRI Data

4D-Flow MRI: Technique and Applications

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