Hypertrophic Cardiomyopathy Is Associated with Altered Left                     Ventricular 3D Blood Flow Dynamics

Abstract Purpose Poor left ventricular (LV) function may affect the physiological intraventricular blood flow and physiological vortex formation. The aim of this study was to investigate the pattern of intraventricular blood flow dynamics in patients with LV assist devices (LVADs) using echocardiographic particle image velocimetry. Materials and methods This prospective study included 17 patients (mean age 57 ± 11 years, 82% male) who had received an LVAD (HeartMate 3, Abbott Laboratories, Chicago, Illinois, USA) because of end-stage heart failure and poor LV function. Eleven (64%) patients had ischemic cardiomyopathy, and six patients (36%) had nonischemic cardiomyopathy. All patients underwent echocardiography, including intravenous administration of an ultrasound-enhancing agent (SonoVue, Bracco, Milan, Italy). Echocardiographic particle image velocimetry was used to quantify LV blood flow dynamics, including vortex formation (Hyperflow software, Tomtec imaging systems Gmbh, Unterschleissheim, Germany). Results Contrast-enhanced ultrasound was well tolerated in all patients and was performed without adverse reactions or side effects. The LVAD function parameters did not change during or after the ultrasound examination. The LVAD flow was on average 4.3 ± 0.3 L/min, and the speed was 5247 ± 109 rotations/min. The quantification of LV intraventricular flow demonstrated substantial impairment of vortex parameters. The energy dissipation, vorticity, and kinetic energy fluctuation indices were severely impaired. Conclusions Echo particle velocimetry is safe and feasible for the quantitative assessment of intraventricular flow in patients with an LVAD. The intraventricular LV flow and vortex parameters are severely impaired in these patients.

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Blood Flow Dynamics during the Human Left Ventricular Filling Phase

Cardiac Dynamics - Developments in Cardiovascular Medicine ◽

10.1007/978-94-009-8796-8_17 ◽

1980 ◽

pp. 169-181 ◽

Cited By ~ 2

Author(s):

P. Brun ◽

C. Oddou ◽

P. Dantan ◽

J. P. Laporte ◽

F. Laurent ◽

...

Keyword(s):

Blood Flow ◽

Left Ventricular ◽

Flow Dynamics ◽

Left Ventricular Filling ◽

Blood Flow Dynamics ◽

Filling Phase ◽

Ventricular Filling

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729 Noninvasive evaluation of the systolic left ventricular blood flow dynamics

European Journal of Echocardiography ◽

10.1016/s1525-2167(06)60452-6 ◽

2006 ◽

Vol 7 ◽

pp. S121-S121

Author(s):

T UEJIMA ◽

H SAWADA ◽

M TANAKA ◽

S OHTSUKI ◽

T OKADA ◽

...

Keyword(s):

Blood Flow ◽

Left Ventricular ◽

Flow Dynamics ◽

Noninvasive Evaluation ◽

Blood Flow Dynamics

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Image-Based Computational Hemodynamics Analysis of Systolic Obstruction in Hypertrophic Cardiomyopathy

Frontiers in Physiology ◽

10.3389/fphys.2021.787082 ◽

2022 ◽

Vol 12 ◽

Author(s):

Ivan Fumagalli ◽

Piermario Vitullo ◽

Christian Vergara ◽

Marco Fedele ◽

Antonio F. Corno ◽

...

Keyword(s):

Blood Flow ◽

Hypertrophic Cardiomyopathy ◽

Pathological Condition ◽

Ventricular Outflow Tract ◽

Hypertrophic Obstructive Cardiomyopathy ◽

Left Ventricular ◽

Patient Specific ◽

Cine Mri ◽

Septal Myectomy ◽

Blood Flow Dynamics

Hypertrophic Cardiomyopathy (HCM) is a pathological condition characterized by an abnormal thickening of the myocardium. When affecting the medio-basal portion of the septum, it is named Hypertrophic Obstructive Cardiomyopathy (HOCM) because it induces a flow obstruction in the left ventricular outflow tract. In any type of HCM, the myocardial function can become compromised, possibly resulting in cardiac death. In this study, we investigated with computational analysis the hemodynamics of patients with different types of HCM. The aim was quantifying the effects of this pathology on the intraventricular blood flow and pressure gradients, and providing information potentially useful to guide the indication and the modality of the surgical treatment (septal myectomy). We employed an image-based computational approach, integrating fluid dynamics simulations with geometric and functional data, reconstructed from standard cardiac cine-MRI acquisitions. We showed that with our approach we can better understand the patho-physiological behavior of intraventricular blood flow dynamics due to the abnormal morphological and functional aspect of the left ventricle. The main results of our investigation are: (a) a detailed patient-specific analysis of the blood velocity, pressure and stress distribution associated to HCM; (b) a computation-based classification of patients affected by HCM that can complement the current clinical guidelines for the diagnosis and treatment of HOCM.

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