scholarly journals Relationship between left ventricular isovolumic relaxation flow patterns and mitral inflow patterns studied by using vector flow mapping

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Yu Han ◽  
Liang Huang ◽  
Zhiguo Li ◽  
Na Ma ◽  
Qiaozhen Li ◽  
...  
Keyword(s):  
Color Doppler ◽  
Left Ventricular ◽  
Flow Mapping ◽  
Mitral Inflow ◽  
Vector Flow Mapping ◽  
Significant Relationships ◽  
Large Vortex ◽  
Artery Disease ◽  
Bidirectional Flow ◽  
Isovolumic Relaxation

Abstract The purpose of this study was to investigate the relationship between isovolumic relaxation flow (IRF) patterns in left ventricle (LV) and mitral inflow patterns. Color Doppler loops were acquired for vector flow mapping in apical long-axis view in 57 patients with coronary artery disease, 31 patients with dilated cardiomyopathy, and 58 healthy controls. IRF patterns were classified into three categories: pattern A, apically directed flow; pattern B, bidirectional flow with small scattered vortices; and pattern C, a large vortex. All normals and patients with normal LV filling (n = 10) showed pattern A. Patients with impaired relaxation consisted of 31 (66%) patients having pattern A, 11 (23%) having pattern B, and 5 (11%) having pattern C. Patients with pseudonormal filling included 4 (31%) patients having pattern A, 7 (54%) having pattern B, and 2 (15%) having pattern C. In patients with restrictive filling, 14 (78%) showed pattern C, 4 (22%) showed pattern B, and no patient showed pattern A. IRF patterns were associated with LV filling patterns (χ2 = 52.026, p < 0.001). There are significant relationships between LV filling and IRF patterns. IRF patterns may provide an index for evaluation of LV diastolic function.

Abstract 15137: Vector Flow Mapping is a Novel Useful Technique in Assessing Inertia Force of Late Systolic Aortic Flow and Left Ventricular Early Diastolic Function

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kazuaki Wakami ◽  
Kenta Hachiya ◽  
Syunsuke Murai ◽  
Tsuyoshi Ito ◽  
Hiroshi Fujita ◽  
...  
Keyword(s):  
Blood Flow ◽  
Time Constant ◽  
Color Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Inertia Force ◽  
Lv Function ◽  
Flow Mapping ◽  
Vector Flow Mapping ◽  
Late Systole

Background: We previously reported that the inertia force (IF) of blood flowing out of left ventricle (LV) during late-systole produces greater LV elastic recoil force and brings faster LV relaxation. Vector flow mapping (VFM TM , Hitachi-Aloka) enables us to see blood flow velocity vectors that are generated from conventional color Doppler imaging data at any phase of cardiac cycle without angle dependency. Using VFM, kinetic energy (KE) of ejecting blood flow during systole at the LV outflow tract (LVOT) can be obtained. Thus, we investigated whether the KE obtained at the LVOT during late systole (KE-ls) had any relations with the IF and invasively obtained LV function parameters. Method: Study subjects were 33 patients who underwent diagnostic cardiac catheterization and echocardiographic examination on the same day. Color Doppler images were acquired in the apical 3-chamber view. The frame rate ranged was from 40 to 51 frames per minute. Data analyses were performed offline using the commercially available software (DAS-RS1 TM, Hitachi-Aloka). A data sampling area was set at the level just below the aortic valve in the LVOT. The KE-ls was computed as the sum of KE values computed in frame by frame basis during late-systole; late-systole was defined as the latter one-third of ejecting time. LV pressure wave was obtained using a catheter-tipped micromanometer, and then, the first derivative of LV pressure (dP/dt) and a time constant τ of LV pressure decay during isovolumic relaxation were calculated. From LV pressure-dP/dt relationships (phase loop), the IF was determined. Results: A significant positive correlation was observed between the KE-ls and the IF (r=0.79, p<0.0001). The log transformed KE-ls had significant correlations with both peak negative dP/dt (r=0.53, p<0.01) and the time constant τ (r=-0.67, p<0.0001). Conclusion: VFM is a new useful technique to see blood flow in the LV chamber. Noninvasively obtained KE-ls using VFM, which may be a noninvasive surrogate for the IF, has significant correlations with the parameters of LV relaxation.

P2477Assessment of intraventricular flow dynamics in acute heart failure studied by Vector Flow Mapping

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Masuda ◽  
S Minami ◽  
M Stugaard ◽  
A Kozuma ◽  
S Takeda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Diastolic Pressure ◽  
Color Doppler ◽  
Propagation Distance ◽  
Left Ventricular ◽  
Flow Dynamics ◽  
Significant Part ◽  
Flow Mapping ◽  
Vector Flow Mapping ◽  
Ejection Rate

Abstract Background Although left ventricular (LV) flow dynamics should be closely related to LV morphology and function, little is known about how heart failure (HF) changes it. Pathline Analysis (PA), a recently developed software based on Vector Flow Mapping (VFM, Hitachi), enables us to trace the virtual blood particles entering to the LV in diastole and being ejected in systole. We investigated the change of flow dynamics in HF induced in dogs using PA. Methods In 15 open-chest dogs, HF was induced by intracoronary injection of microspheres. Color Doppler images of apical long-axis view were acquired using Prosound F75 (Hitachi) before and after HF and were analyzed by PA. We calculated the ratio of the numbers of entering particles in diastole and ejected particles in systole (ejection rate) and the distance reached by the particles in diastole corrected by the LV long-axis diameter (propagation distance). Apical and basal short axis images were acquired using GE Vivid E9 and were analyzed for peak rotation and peak twist. Results After inducing HF, LV end-diastolic pressure increased from 6±2 to 15±5 mmHg (p<0.001) and ejection fraction (EF), apical peak rotation and peak twist decreased significantly (EF; 58±5 to 36±8%, apical peak rotation; 14±5 to 3±2 degree, peak twist; 19±5 to 6±3 degree, p<0.05, respectively). PA showed most of the entering particles to the LV were ejected in the following systole at the control stage, but in HF, a significant part of the entering particles were not ejected and remained in the LV (Figure). Ejection rate decreased from 50±11 to 26±11% (p<0.001) and the propagation distance decreased from 85±9 to 66±13% (p<0.001) after inducing HF. There were significant relationships between indices obtained by PA and EF and peak twist (Table). Conclusion A significant part of inflow is not ejected directly to the outflow in the next systole and remains in the LV in HF, suggesting inefficient flow dynamics.

P3365Relationship between early diastolic intra-ventricular pressure gradient shortly after aortic valve closure estimated by vector flow mapping and left ventricular diastolic untwisting rate in humans

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Hozumi ◽  
Y Nozawa ◽  
K Takemoto ◽  
T Nishi ◽  
T Wada ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Color Doppler ◽  
Left Ventricular ◽  
Valve Closure ◽  
Flow Mapping ◽  
Vector Flow Mapping ◽  
Diastolic Velocity ◽  
Aortic Valve Closure

Abstract Background Early diastolic suction is an important determinant of early diastolic function. Previous studies using color Doppler M-mode and speckle-tracking echocardiography have shown left ventricular (LV) early diastolic LV untwisting rate is directly related to LV intra-ventricular pressure gradient (IVPG) between LV base and apex during early diastole. Recent introduction of vector flow mapping (VFM) using combination of color Doppler and speckle-tracking echocardiography provides noninvasive and feasible assessment of early diastolic IVPG shortly after aortic valve closure including isovolmic relaxation period (ED-IVPG) in humans. However, relationship between VFM–derived ED-IVPG and early diastolic LV untwisting rate has not been well investigated. Purpose The purpose of this study was to examine relationship between ED-IVPG estimated by VFM and LV untwisting rate by speckle-tracking echocardiography. Methods The study population consists of 66 patients without segmental wall motion abnormality, significant valvular diseases, and atrial fibrillation who underwent echocardiography for evaluation of LV function (age: 60±15 years, LVEF: 49±16%). From the apical long-axis views by color Doppler echocardiography, we analyzed peak ED-IVPG between LV base and apex just after aortic valve closure (figure) using commercially available VFM analysis software (DAS-RS1, Hitachi). We assessed peak early diastolic LV untwisting rate and LV torsion from LV basal and apical short-axis view by speckle-tracking echocardiography. We evaluated correlation between ED-IVPG and LV untwisting rate. We also evaluated correlation between ED-IVPG and peak systolic LV torsion, LV end-diastolic (EDV) and end-systolic volumes (ESV), ejection fraction (EF), early diastolic velocity (E) of LV inflow, average early diastolic velocity (e') of mitral annulus, and average E/e'. Results In all the study patients, ED-IVPG was successfully and quickly evaluated. 1) ED-IVPG correlated well with peak LV untwisting rate (r=0.64, p<0.0001). 2) ED-IVPG significantly correlated with LV torsion, LVEDV, LVESV, and LVEF (r=0.47, r=−0.48, r=−0.46, and r=0.48, respectively, p<0.001). 3) There were no significant correlations between ED-IVPG and other indexes including E, average e', and average E/e'. According to receiver operating characteristic analysis, the best cut-off value of ED-IVPG for determining impaired LV untwisting rate (<80 degrees/s) was found at 0.42 mmHg (sensitivity 81%, specificity 76%, and area under the curve 0.86) ED-IVPG measurement by VFM Conclusions The present results showed that noninvasive VFM-derived peak ED-IVPG shortly after aortic valve closure is related to early diastolic peak LV untwisting rate. ED-IVPG easily and quickly estimated by VFM may be used as an additional index for LV diastolic function.

scholarly journals Loss of apical suction assessed by noninvasive pressure differences and twist in acute heart failure: a novel method using vector flow mapping

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Ido ◽  
K Masuda ◽  
S Yoshimura ◽  
H Tanaka ◽  
M Stugaard
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Diastolic Pressure ◽  
Color Doppler ◽  
Left Ventricular ◽  
Frame Rate ◽  
Flow Mapping ◽  
Vector Flow Mapping ◽  
Funding Sources ◽  
Novel Method

Abstract Background Early diastolic intraventricular pressure difference (IVPD) reflects left ventricular (LV) apical suction, and IVPD is closely related to cardiac function, especially LV twist. Vector Flow Mapping (VFM) allows visualization of regional pressure distribution and noninvasive quantification of IVPD. The purpose of the present study was to investigate if and how IVPDs are related to LV twist in a model of acute heart failure (HF). Methods In 15 open-chest dogs, HF was induced by intracoronary injection of microspheres. The HF model was classified into two groups based on the LV end-diastolic pressure (LVEDP) (group1: LVEDP&lt;18 mmHg (n=10), group2: LVEDP≥18 mmHg (n=8)). Color Doppler images from apical long-axis views were acquired at baseline and during HF. From these images, pressure differences (ΔP) were calculated along the LV inflow tract throughout the cardiac cycle. For the purpose of this study, the differences between apex and base during isovolumic relaxation time (ΔPIRT) and rapid early inflow period (ΔPE) were used for analyses. Furthermore, apical and basal short axis high frame rate 2D images were acquired, and peak rotation and peak twist were analyzed. Results LVEDP was 7±9, 14±2, 21±3 mmHg for baseline, group1 HF, and group2 HF, respectively. Pressure differences (both ΔPIRT and ΔPE) were visibly changed by the increase of LVEDP (Figure), and the magnitude of ΔPIRT, ΔPE and peak twist decreased significantly with the severity of heart failure. There were significant relationships between pressure differences (ΔPIRT and ΔPE) and dP/dtmin, tau, EF and peak twist (Table). In multivariate analyses, tau and peak twist were independent predictors for ΔPIRT and peak twist was independent predictor for ΔPE. Conclusion VFM analysis is feasible to noninvasively assess the IVPDs in acute heart failure. The IVPDs are closely related to the twisting motion of the LV, and reflect loss of apical suction during severe HF. FUNDunding Acknowledgement Type of funding sources: None. VFM images of pressure differences Correlations of pressure differences

scholarly journals Familial Hypercholesterolaemia With Premature Coronary Artery Disease: A Case Report

2020 ◽  
Vol 1 (3-4) ◽  
pp. 150-153
Author(s):  
Chandramukhi Sunehra ◽  
Krishnaswamy Raghu
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Systolic Function ◽  
Color Doppler ◽  
Artery Bypass ◽  
Density Lipoprotein ◽  
Left Ventricular ◽  
Lipid Lowering ◽  
Premature Coronary Artery Disease ◽  
Artery Disease

A young, 18-year-old lady presented with history of chest pain on exertion typical of angina. General examination revealed multiple tendon xanthomas. Systemic examination was unremarkable. Electrocardiogram showed segment (ST) depression in inferior and lateral leads. Echocardiogram revealed normal left ventricular systolic function and no left ventricular regional wall motion abnormalities. Diastolic flow turbulence was noted in the left main coronary artery and proximal left anterior descending artery on color Doppler interrogation across the coronary arteries. Lipid profile showed unusually high total cholesterol and low-density lipoprotein cholesterol. Subsequent evaluation with coronary angiogram revealed triple vessel coronary artery disease. The patient underwent coronary artery bypass surgery and is on antiplatelet and lipid-lowering drug therapy.

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