Vortex‐ring mixing as a measure of diastolic function of the human heart: Phantom validation and initial observations in healthy volunteers and patients with heart failure

Töger, Johannes; Kanski, Mikael; Arvidsson, Per M.; Carlsson, Marcus; Kovács, Sándor J.; Borgquist, Rasmus; Revstedt, Johan; Söderlind, Gustaf; Arheden, Håkan; Heiberg, Einar

doi:10.1002/jmri.25111

Cited by 15 publications

(11 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…MRI compatible motion systems are much more expensive and this would significantly increase the cost of the phantom. A Magnetic Resonance compatible ring vortex flow has already been demonstrated by Toger et al [27,36], and although the phantom proposed in this paper exploits a comparable technology, our design aspires to be lowcost, compact, portable, easy to manufacture, programmable. Future work will extend the assessment presented here to include comparative studies between medical imaging modalities (Ultrasound, CT, and with some adaptation MRI) and optical modalities (Laser-PIV, Laser-diode) to further assess reliability, long-term stability and detailed flow performance.…”

Section: Discussionmentioning

confidence: 99%

“…The ring vortex flow is well suited to its role as a reference flow because it offers characteristics like stability, predictability, reproducibility and controllability [20,21,26,27] [1,2,8,28,29,30,31,32,33,34,35,36]. Vortex rings are natural fluid phenomena that are known to balance flow within the chambers of the heart or may be observed in the presence of vessel bifurcations or pathological conditions, such as stenosis and aneurysm.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A complex flow phantom for medical imaging: ring vortex phantom design and technical specification

Ambrogio

Walker²,

Narracott

et al. 2019

Journal of Medical Engineering & Technology

View full text Add to dashboard Cite

Cardiovascular fluid dynamics exhibit complex flow patterns, such as recirculation and vortices. Quantitative analysis of these complexities supports diagnosis, leading to early prediction of pathologies. Quality Assurance of technologies that image such flows is challenging but essential, and to this end, a novel, cost-effective, portable, complex flow phantom is proposed and the design specifications are provided. The vortex ring is the flow of choice because it offers patterns comparable to physiological flows and is stable, predictable, reproducible and controllable. This design employs a piston/cylinder system for vortex ring generation, coupled to an imaging tank full of fluid, for vortex propagation. The phantom is motor-driven and by varying piston speed, piston displacement and orifice size, vortex rings with different characteristics can be produced. Two measurement methods, namely Laser-PIV and an optical/video technique, were used to test the phantom under a combination of configurations. Vortex rings with a range of travelling velocities (approximately 1-80cm/s) and different output-orifice diameters (10-25mm) were produced with reproducibility typically better than +/-10%. Although ultrasound compatibility has been demonstrated, longer-term ambitions include adapting the design to support comparative studies with different modalities, such as MRA and X-ray-CTA.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A complex flow phantom for medical imaging: ring vortex phantom design and technical specification

Ambrogio

Walker²,

Narracott

et al. 2019

Journal of Medical Engineering & Technology

View full text Add to dashboard Cite

show abstract

“…; Töger et al. ). Atrial tissue characterization has recently become feasible noninvasively using an MRI method for visualizing fibrosis as LA late gadolinium enhancement (LGE) (McGann et al.…”

Section: Introductionmentioning

confidence: 96%

Assessment of diastolic function and atrial remodeling by MRI - validation and correlation with echocardiography and filling pressure

et al. 2018

Self Cite

View full text Add to dashboard Cite

Atrial fibrosis can be estimated noninvasively by magnetic resonance imaging (MRI) using late gadolinium enhancement (LGE), but diastolic dysfunction is clinically assessed by transthoracic echocardiography (TTE), and rarely by MRI. This study aimed to evaluate well‐established diastolic parameters using MRI, and validate them with TTE and left ventricular (LV) filling pressures, and to study the relationship between left atrial (LA) remodeling and parameters of diastolic function. The study retrospectively included 105 patients (53 ± 16 years, 39 females) who underwent 3D LGE MRI between 2012 and 2016. Medical charts were reviewed for the echocardiographic diastolic parameters E, A, and e′ by TTE, and pressure catheterizations. E and A were measured from in‐plane phase‐contrast cardiac MRI images, and e′ by feature‐tracking, and validated with TTE. Interobserver and intraobserver variability was examined. Furthermore, LA volumes, function, and atrial LGE was correlated with diastolic parameters. Evaluation of e′ in MRI had strong agreement with TTE (r = 0.75, P < 0.0001), and low interobserver and intraobserver variability. E and A by TTE showed strong agreement to MRI (r = 0.77, P = 0.001; r = 0.73, P = 0.003, for E and A, respectively). Agreement between E/e′ by TTE and MRI was strong (r = 0.85, P = 0.0004), and E/e′ by TTE correlated moderately to invasive pressures (r = 0.59, P = 0.03). There was a strong relationship between LA LGE and pulmonary capillary wedge pressure (r = 0.81, P = 0.01). In conclusion, diastolic parameters can be measured with good reproducibility by cardiovascular MRI. LA LGE exhibited a strong relationship with pulmonary capillary wedge pressure, an indicator of diastolic function.

show abstract

“…Most studies have assessed LVDD and LV diastolic filling by quantitative analysis of intra‐ventricular vortex derived from MRI echo or VFM. Töger et al validated quantified vortex‐ring mixing as a novel potential index of diastolic dysfunction using MRI (4D‐Flow). Kheradvar et al found that patients with different patterns of LV diastolic filling had marked changes in LV vortex formation time.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of left ventricular diastolic function based on flow energetic parameters in chronic kidney disease with diastolic dysfunction

Wang

Chen

et al. 2019

Echocardiography

View full text Add to dashboard Cite

Background Intra‐ventricular blood flow dynamics is considered as an important component of left ventricular (LV) function assessment. The purpose of this study was to evaluate the LV diastolic function in chronic kidney disease (CKD) with different degrees of LV diastolic dysfunction (LVDD) by using flow energetic parameters. Methods In this study, a total of 96 cases were recruited, including 58 CKD patients and 38 healthy controls. CKD patients were divided into 2 groups according to LVDD severity, named as DD1 and DD2. Vector flow‐mapping (VFM) analysis was executed to calculate left ventricle average energy loss (EL) during early filling phase (E‐EL_ave), atrial filling phase (A‐EL_ave), diastole phase (D‐EL_ave), and ejection phase (S‐EL_ave). Moreover, the average vortex circulation during early filling phase (E‐cir_ave) and atrial filling phase (A‐cir_ave) was also assessed in the apical three‐chamber view. The rate of average EL during early filling and atrial filling was expressed as E/A‐EL. Result Compared to the control group, A‐EL_ave, S‐EL_ave, and A‐cir_ave in the DD1 group were higher (P < 0.05), and all parameters were obviously higher in the DD2 group (P < 0.05). In the control group and the DD2 subgroup, the E‐EL_ave value was significantly higher than A‐EL_ave value, which was opposite to the DD1 group. As diastolic dysfunction worsened, E‐EL_ave and D‐EL_ave risen gradually (P < 0.05), and A‐EL_ave and S‐EL_ave were slightly elevated with no significance. There were significant correlations between LV diastolic function and flow energetic parameters. Stepwise multiple regression analysis revealed that various LV function parameters could be regarded as independent predictors of average diastolic EL (all P < 0.01). Conclusions For CKD patient with LVDD and LVEF > 50%, effective LV filling and systolic ejection with optimized energy consumption have been impaired. As a new flow‐derived index, EL can quantitatively evaluate LV diastolic function in terms of blood fluid dynamics in CKD with various LVDD.

show abstract

Vortex‐ring mixing as a measure of diastolic function of the human heart: Phantom validation and initial observations in healthy volunteers and patients with heart failure

Cited by 15 publications

References 37 publications

A complex flow phantom for medical imaging: ring vortex phantom design and technical specification

A complex flow phantom for medical imaging: ring vortex phantom design and technical specification

Assessment of diastolic function and atrial remodeling by MRI - validation and correlation with echocardiography and filling pressure

Evaluation of left ventricular diastolic function based on flow energetic parameters in chronic kidney disease with diastolic dysfunction

Contact Info

Product

Resources

About