Left Ventricular Vortices as Observed by Vector Flow Mapping: Main Determinants and their Relation to Left Ventricular Filling

Muñoz, Daniel; Mur, José Luis Moya; Fernández-Golfín, Covadonga; Filho, Derly Carlos Becker; Gómez, Ariana González; Santos, Sara Fernández; Rivera, Carla Lázaro; Díaz, Luis Miguel Rincón; Rojo, Eduardo Casas; Gómez, José Luis Zamorano

doi:10.1111/echo.12584

Cited by 37 publications

(31 citation statements)

References 21 publications

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“…In our analysis, although the weak counterclockwise vortex quickly diminished, the strong clockwise vortex continued until the isovolumic contraction phase, as reported previously [2, 5, 20–23]. The vortex enables efficient blood streaming and minimizes the flow dissipative EL [24–27].…”

Section: Discussionsupporting

confidence: 82%

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Vector flow mapping analysis of left ventricular energetic performance in healthy adult volunteers

Akiyama

Maeda

Matsuyama³

et al. 2017

BMC Cardiovasc Disord

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BackgroundVector flow mapping, a novel flow visualization echocardiographic technology, is increasing in popularity. Energy loss reference values for children have been established using vector flow mapping, but those for adults have not yet been provided. We aimed to establish reference values in healthy adults for energy loss, kinetic energy in the left ventricular outflow tract, and the energetic performance index (defined as the ratio of kinetic energy to energy loss over one cardiac cycle).MethodsTransthoracic echocardiography was performed in fifty healthy volunteers, and the stored images were analyzed to calculate energy loss, kinetic energy, and energetic performance index and obtain ranges of reference values for these.ResultsMean energy loss over one cardiac cycle ranged from 10.1 to 59.1 mW/m (mean ± SD, 27.53 ± 13.46 mW/m), with a reference range of 10.32 ~ 58.63 mW/m. Mean systolic energy loss ranged from 8.5 to 80.1 (23.52 ± 14.53) mW/m, with a reference range of 8.86 ~ 77.30 mW/m. Mean diastolic energy loss ranged from 7.9 to 86 (30.41 ± 16.93) mW/m, with a reference range of 8.31 ~ 80.36 mW/m. Mean kinetic energy in the left ventricular outflow tract over one cardiac cycle ranged from 200 to 851.6 (449.74 ± 177.51) mW/m with a reference range of 203.16 ~ 833.15 mW/m. The energetic performance index ranged from 5.3 to 37.6 (18.48 ± 7.74), with a reference range of 5.80 ~ 36.67.ConclusionsEnergy loss, kinetic energy, and energetic performance index reference values were defined using vector flow mapping. These reference values enable the assessment of various cardiac conditions in any clinical situation.

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Section: Discussionsupporting

confidence: 82%

“…Blood flow in a healthy human left ventricle forms an energetically efficient vortex [1, 2]. This vortex facilitates inflow into the ventricle, minimizes the dissipation of energy, preserves momentum, and redirects the flow toward the left ventricular outflow [3–7].…”

Section: Introductionmentioning

confidence: 99%

Vector flow mapping analysis of left ventricular energetic performance in healthy adult volunteers

Akiyama

Maeda

Matsuyama³

et al. 2017

BMC Cardiovasc Disord

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“…In the present study, the independent predictors of vorticity other than LV length was peak E wave velocity. Both the vortex and transmitral flow are considered to be influenced by ventricular relaxation 5 , and it is not surprising that the strength of the vortex correlates with the peak E wave velocity in the present study as also reported in study in humans 16 . On the other hand, the relationship between vorticity and peak E can change depending on the pathological conditions.…”

Section: Discussionsupporting

confidence: 87%

“…On the other hand, the relationship between vorticity and peak E can change depending on the pathological conditions. When a relaxation abnormality is observed, the vortex is strongly correlated with the E wave 16 . However, in the volume overloading model dogs, despite the inflow velocity was higher, the obtained vortex strength was weaker than in the normal dog 14 .…”

Section: Discussionmentioning

confidence: 99%

Changes in left ventricular blood flow during diastole due to differences in chamber size in healthy dogs

Matsuura

Sato

Shimada

et al. 2020

Sci Rep

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Vorticity is a novel index that reflects diastolic function of left ventricle. The size of the ventricle can influence the ventricular diastolic blood flow. We evaluated effect of ventricular size on diastolic function and diastolic intracardiac blood flow using a particular species of dogs, which has a wide range of body size. Vector flow mapping was used for evaluation of intracardiac blood flow, and intraventricular pressure gradient (IVPG) was used for evaluation of diastolic function. 58 dogs weighing 1.3-42.3 kg were included in this study. Vorticity was found to be inversely proportional to the length of the ventricular chamber. Intraventricular pressure difference was positively correlated with the length of the left ventricle, whereas IVPG was not. This study showed that the vorticity is influenced by the size of the left ventricle independently of other factors. To evaluate the hemodynamic state of each individual appropriately by using vorticity and IVPD, ventricular size should be taken into account especially in the field of veterinary medicine and human pediatric and adolescent cardiology.www.nature.com/scientificreports www.nature.com/scientificreports/ vorticity and EL. A stepwise method was used for selection of the variables, choosing the variables which minimized Akaike's information criterion. ResultsStudy population. The number of cases was 58. The mean weight was 8.65 (1.3-42.3, SD 6.93) kg. The length of the left ventricle was 34.0 (21.9-49.0, SD 7.3) mm on average. The mean heart rate was 117.6 (66.0-Characteristics of the canine heart with various size. The mean value of the short axis inner diameter of the left ventricle (LVIDd) was SD 7.36) mm. The sphericity index (SI) of the left ventricle was 0.75 (0.51-1.0, SD 0.12). The relationship between short and long axis diameter was shown in Fig. 1. LVL was linearly correlated with LVIDd (R = 0.78, p < 0.01). Statistical correlation was not found between LVL and SI.Conventional indexes of diastolic property (E vel, e′, E/A, E/e′) were not statistically correlated with LVL.Scientific RepoRtS | (2020) 10:1106 | https://doi.

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“…Conventionally, only data received in the direction of the beam are extracted from the Doppler information. Vector Flow Mapping (VFM) is an innovative approach that uses color Doppler velocity data, sound fluid dynamic assumptions, and mathematical techniques to derive intracardiac blood flow distributions in an observation plane, and generates 2D images of the corresponding evolving velocity fields [27–29]. VFM is often able to sketch out the principal structures of intraventricular flows.…”

Section: Digital Noninvasive Imaging Of Intraventricular Diastolicmentioning

confidence: 99%

Mechanotransduction Mechanisms for Intraventricular Diastolic Vortex Forces and Myocardial Deformations: Part 1

Pasipoularides

2015

J. of Cardiovasc. Trans. Res.

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Epigenetic mechanisms are fundamental in cardiac adaptations, remodeling, reverse remodeling, and disease. This 2-article series proposes that variable forces associated with diastolic RV/LV rotatory intraventricular flows can exert physiologically and clinically important, albeit still unappreciated, epigenetic actions influencing functional and morphological cardiac adaptations and/or maladaptations. Taken in-toto, the 2-part survey formulates a new paradigm in which intraventricular diastolic filling vortex-associated forces play a fundamental epigenetic role, and examines how heart cells react to these forces. The objective is to provide a perspective on vortical epigenetic effects, to introduce emerging ideas and suggest directions of multidisciplinary translational research. The main goal is to make pertinent biophysics and cytomechanical dynamic systems concepts accessible to interested translational and clinical cardiologists. I recognize that the diversity of the epigenetic problems can give rise to a diversity of approaches and multifaceted specialized research undertakings. Specificity may dominate the picture. However, I take a contrasting approach. Are there concepts that are central enough that they should be developed in some detail? Broadness competes with specificity. Would however this viewpoint allow for a more encompassing view that may otherwise be lost by generation of fragmented results? Part 1 serves as a general introduction, focusing on background concepts, on intracardiac vortex imaging methods, and on diastolic filling vortex-associated forces acting epigenetically on RV/LV endocardium and myocardium. Part 2 will describe pertinent available pluridisciplinary knowledge/research relating to mechanotransduction mechanisms for intraventricular diastolic vortex forces and myocardial deformations and to their epigenetic actions on myocardial and ventricular function and adaptations.

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Left Ventricular Vortices as Observed by Vector Flow Mapping: Main Determinants and their Relation to Left Ventricular Filling

Cited by 37 publications

References 21 publications

Vector flow mapping analysis of left ventricular energetic performance in healthy adult volunteers

Vector flow mapping analysis of left ventricular energetic performance in healthy adult volunteers

Changes in left ventricular blood flow during diastole due to differences in chamber size in healthy dogs

Mechanotransduction Mechanisms for Intraventricular Diastolic Vortex Forces and Myocardial Deformations: Part 1

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