Transit of Blood Flow Through the Human Left Ventricle Mapped by Cardiovascular Magnetic Resonance

Bolger, Ann F.; Heiberg, Einar; Karlsson, Matts; Wigström, Lars; Engvall, Jan; Sigfridsson, Andreas; Ebbers, Tino; Kvitting, John‐Peder Escobar; Carlhäll, Carl‐Johan; Wranne, Bengt

doi:10.1080/10976640701544530

Cited by 185 publications

(226 citation statements)

References 37 publications

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“…In this way the V ED was divided into 4 subvolumes depending on the eventual origin/destination of such trajectories. 8 The direct flow, V direct , is the volume of blood that entered during diastole and transits directly to the aortic outlet during systole; the retained volume, V retained , is the part that entered during diastole but not ejected during the following systole; the delayed volume, V delayed , was already present in the LV at the beginning of diastole and then ejected during the following systole; and the residual volume, V residual , that was present in the LV and yet not ejected in the next systole. In formula, the V ED is divided into four contributions…”

Section: Kinematic Aspects: Flow Transitmentioning

confidence: 99%

Left Ventricular Fluid Mechanics: The Long Way from Theoretical Models to Clinical Applications

Pedrizzetti

Domenichini

2014

Ann Biomed Eng

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Abstract-The flow inside the left ventricle is characterized by the formation of vortices that smoothly accompany blood from the mitral inlet to the aortic outlet. Computational fluid dynamics permitted to shed some light on the fundamental processes involved with vortex motion. More recently, patient-specific numerical simulations are becoming an increasingly feasible tool that can be integrated with the developing imaging technologies. The existing computational methods are reviewed in the perspective of their potential role as a novel aid for advanced clinical analysis. The current results obtained by simulation methods either alone or in combination with medical imaging are summarized. Open problems are highlighted and perspective clinical applications are discussed.

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Section: Kinematic Aspects: Flow Transitmentioning

confidence: 99%

Left Ventricular Fluid Mechanics: The Long Way from Theoretical Models to Clinical Applications

Pedrizzetti

Domenichini

2014

Ann Biomed Eng

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“…This curve represents an extension of the previously introduced subdivision of the EDV into 4 sub-volumes (Bolger et al, 2007;Eriksson et al, 2010) that can be recovered from the first value of the blood transit curve in combination with the ED and ES volumes. The flow in DCM presents a significantly slower renovation of the blood contained in the LV, this is witnessed by the significantly reduction of the direct flow and an increase of either the delayed or the residual volumes.…”

Section: Flow Transit Aspectsmentioning

confidence: 99%

“…From the first, fundamental, value, F 1 , it is possible to compute the indicators introduced in the CMR literature (Bolger et al, 2007;Eriksson et al, 2010). In particular, the Direct Flow, V Direct ¼ F 1 Â EF, is the percentage of the LV End Diastolic Volume (EDV) that directly flows from inlet to outlet during one heartbeat.…”

Section: Fluid Dynamics Analysismentioning

confidence: 99%

“…There is an increasing consensus that maladaptive fluid mechanics contributes to cardiac inefficiency and participates in the modulation toward phenotypic patterns of heart failure (HF) (Bolger et al, 2007;Pedrizzetti et al, 2010;Sengupta et al, 2012b). HF is associated with ventricular remodeling: modification of the LV, which progressively alters its function.…”

Section: Introductionmentioning

confidence: 99%

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Comparative numerical study on left ventricular fluid dynamics after dilated cardiomyopathy

Mangual

Kraigher‐Krainer

Luca

et al. 2013

Journal of Biomechanics

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Results: The flow in DCM exhibited qualitative differences due to the weakness of the formed vortices in the large LV chamber. DCM and healthy subjects show significant volumetric differences; these also reflect inflow properties like the vortex formation time, energy dissipation, and sub-volumes describing flow transit. Proper normalization permitted to define purely fluid dynamics indicators that are not influenced by volumetric measures. Conclusion: Cardiac fluid mechanics can be evaluated by a combination of imaging and numerical simulation. This pilot study on pathological changes in LV blood motion identified intraventricular flow indicators based on pure fluid mechanics that could potentially be integrated with existing indicators of cardiac mechanics in the evaluation of disease progression.

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“…Multiple 4D flow MRI studies showed that patients with LV dysfunction present altered flow patterns through the LV with impaired preservation of inflow KE to the end of diastole and altered KE-time curves (the amount of KE inside the LV during each time step over the total cardiac cycle) [4,6,7,21], even in patients with normal to mild LV remodeling and normal to mildly depressed LV systolic function [7]. These KE changes in the LV could be a valuable diagnostic marker to evaluate diastolic function and might be useful for early detection of deteriorating ventricular function [1, 4-7, 21, 22], which could reduce patient morbidity and mortality [23].…”

Section: Kinetic Energy (Ke) Over LV Diastolementioning

confidence: 99%

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

Kamphuis

Westenberg

Palen

et al. 2018

Int J Cardiovasc Imaging

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The aim of the current study was to assess the scan-rescan reproducibility of left ventricular (LV) kinetic energy (KE), viscous energy loss (EL) and vorticity during diastole from four-dimensional flow magnetic resonance imaging (4D flow MRI) in healthy subjects. Twelve volunteers (age 27 ± 3 years) underwent whole-heart 4D flow MRI twice in one session. In-scan consistency was evaluated by correlation between KE and EL. EL index was computed to measure the amount of EL relative to KE over diastole. Scan-rescan analysis was performed to test reproducibility of volumetric measurements of KE, EL, EL index and vorticity in the LV over early (E) and late (A) diastolic filling. In-scan consistency between KE and EL was strong-excellent (E-filling scan1: r = 0.92, P < 0.001; scan2: ρ = 0.96, P < 0.001 and A-filling scan1: ρ = 0.87, P < 0.001; scan2: r = 0.99, P < 0.001). For the majority of subjects (10 out of 12), KE and EL measures showed good to strong reproducibility. However, with a wide range of agreement [intraclass correlation (ICC): 0.64-0.95] and coefficients of variation (CV) ≤ 25%. EL index showed strong reproducibility for all 12 subjects with a strong ICC (0.94, P < 0.001) and a CV of 9%. Scan-rescan reproducibility of volumetric vorticity showed good-excellent ICCs (0.83-0.95) with CVs ≤ 11%. In conclusion, the current study shows strong-excellent in-scan consistency and overall good agreement between scans for 4D flow MRI assessment of left ventricular kinetic energy, energy loss and vorticity over diastole. However, substantial differences between the scans were also found in some parameters in two out of twelve subjects. Strong reproducibility was found in the dimensionless EL index , which measures the amount of viscous energy loss relative to the average kinetic energy over diastole.

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Transit of Blood Flow Through the Human Left Ventricle Mapped by Cardiovascular Magnetic Resonance

Abstract: Multidimensional flow mapping can measure the paths, compartmentalization and kinetic energy changes of blood flowing into the LV, demonstrating differences of KE loss between compartments, and potentially between the flows in normal and dilated left ventricles.

Cited by 185 publications

References 37 publications

Left Ventricular Fluid Mechanics: The Long Way from Theoretical Models to Clinical Applications

Left Ventricular Fluid Mechanics: The Long Way from Theoretical Models to Clinical Applications

Comparative numerical study on left ventricular fluid dynamics after dilated cardiomyopathy

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

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