Left Ventricular Blood Flow Kinetic Energy Assessment by 4D Flow Cardiovascular Magnetic Resonance: A Systematic Review of the Clinical Relevance

Kaur, Harjinder; Assadi, Hosamadin; Alabed, Samer; Cameron, Donnie; Vassiliou, Vassilios; Westenberg, Jos J.M.; Geest, Rob van der; Zhong, Liang; Swift, Andrew J.; Garg, Pankaj

doi:10.3390/jcdd7030037

Cited by 12 publications

(7 citation statements)

References 26 publications

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“…39,40 Novel emerging CMR technologies including fourdimensional flow mapping are likely to further enhance the model. [41][42][43][44][45] More recent echocardiographic advanced models using LA strain have demonstrated better accuracy for LVFP estimation, especially considering patients with preserved ejection fraction. Left atrial strain assessment does not have a similar limitation to Doppler as it is not angle independent.…”

Section: Future Workmentioning

confidence: 99%

Cardiac magnetic resonance identifies raised left ventricular filling pressure: prognostic implications

Garg

Gosling

Swoboda

et al. 2022

European Heart Journal

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Aims Non-invasive imaging is routinely used to estimate left ventricular (LV) filling pressure (LVFP) in heart failure (HF). Cardiovascular magnetic resonance (CMR) is emerging as an important imaging tool for sub-phenotyping HF. However, currently, LVFP cannot be estimated from CMR. This study sought to investigate (i) if CMR can estimate LVFP in patients with suspected HF and (ii) if CMR-modelled LVFP has prognostic power. Methods and results Suspected HF patients underwent right heart catheterization (RHC), CMR and transthoracic echocardiography (TTE) (validation cohort only) within 24 h of each other. Right heart catheterization measured pulmonary capillary wedge pressure (PCWP) was used as a reference for LVFP. At follow-up, death was considered as the primary endpoint. We enrolled 835 patients (mean age: 65 ± 13 years, 40% male). In the derivation cohort (n = 708, 85%), two CMR metrics were associated with RHC PCWP:LV mass and left atrial volume. When applied to the validation cohort (n = 127, 15%), the correlation coefficient between RHC PCWP and CMR-modelled PCWP was 0.55 (95% confidence interval: 0.41–0.66, P < 0.0001). Cardiovascular magnetic resonance-modelled PCWP was superior to TTE in classifying patients as normal or raised filling pressures (76 vs. 25%). Cardiovascular magnetic resonance-modelled PCWP was associated with an increased risk of death (hazard ratio: 1.77, P < 0.001). At Kaplan–Meier analysis, CMR-modelled PCWP was comparable to RHC PCWP (≥15 mmHg) to predict survival at 7-year follow-up (35 vs. 37%, χ2 = 0.41, P = 0.52). Conclusion A physiological CMR model can estimate LVFP in patients with suspected HF. In addition, CMR-modelled LVFP has a prognostic role.

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Section: Future Workmentioning

confidence: 99%

Cardiac magnetic resonance identifies raised left ventricular filling pressure: prognostic implications

Garg

Gosling

Swoboda

et al. 2022

European Heart Journal

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“…These values are compatible with those existing in the literature. 36,[39][40][41][42] In Fig. 6 shows the flow direction in four cases, two extremes with e ¼ 0:6 and e ¼ À0:6 [Figs.…”

Section: Results a Analysis With Ideal Healthy Valvementioning

confidence: 99%

Mitral valve asymmetry in healthy, pathological, and repaired cases

Collia

2021

Physics of Fluids

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The entry of blood into the left ventricle is regulated by the two valve leaflets. Mitral valve prolapse is the primary cause of mitral regurgitation. Mitral valve repair is the gold standard therapeutic procedure for patients with degenerative mitral valve regurgitation and follows two fundamental principles: restoring a good coaptation surface of the flap and correcting annular dilation. This study presents a first step in the direction of addressing the influence of valve geometry on valve fluid dynamics and mitral regurgitation. To this end, it develops a systematic analysis to identify how the level of regurgitation and the efficiency of flow transit in the left ventricle depend on the degree of asymmetry of the leaflets. The analysis is performed starting from a mathematically designed mitral valve and then extended to the actual valves extracted from medical imaging. The specific objective is to evaluate the changes in mitral regurgitation associated with the symmetrical properties of the mitral valve. The broader aim is to begin building physics-based means for evaluating repair options and prosthetic design. Results showed that valve shape does not affect flow; sub-volumes are similar to inflow and vary to outflow due to the presence of false regurgitation under healthy/repaired conditions and regurgitation under pathological conditions affecting the amount of direct flow, delayed and finally the Stroke volume. The best valve asymmetry point was found to be 0.25, while the optimal range was between 0.4 and 0.2, giving an important suggestion to valve surgery.

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“…Overall, the CMR studies performed on both ventricles show that the LV and RV KE evaluated during diastole varies with age [57]. This variation occurs at the time of the early and late ventricular filling, while an effect from age on the mean diastolic KE and LV non-indexed KE measures has not been clearly documented.…”

Section: Cmr Studies: Right Ventriclementioning

confidence: 97%

Effect of Aging on Intraventricular Kinetic Energy and Energy Dissipation

Mele,

Beccari,

Pedrizzetti

2023

JCDD

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In recent years, analysis of kinetic energy (KE) and the rate of kinetic energy dissipation (KED) or energy loss (EL) within the cardiac chambers, obtained by cardiac imaging techniques, has gained increasing attention. Thus, there is a need to clarify the effect of physiological variables, specifically aging, on these energetic measures. To elucidate this aspect, we reviewed the literature on this topic. Overall, cardiac magnetic resonance and echocardiographic studies published so far indicate that aging affects the energetics of left and right intraventricular blood flow, although not all energy measures during the cardiac cycle seem to be affected by age in the same way. Current studies, however, have limitations. Additional large, multicenter investigations are needed to test the effect of physiological variables on intraventricular KE and KED/EL measures.

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Left Ventricular Blood Flow Kinetic Energy Assessment by 4D Flow Cardiovascular Magnetic Resonance: A Systematic Review of the Clinical Relevance

Cited by 12 publications

References 26 publications

Cardiac magnetic resonance identifies raised left ventricular filling pressure: prognostic implications

Cardiac magnetic resonance identifies raised left ventricular filling pressure: prognostic implications

Mitral valve asymmetry in healthy, pathological, and repaired cases

Effect of Aging on Intraventricular Kinetic Energy and Energy Dissipation

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