The quantitative relationship between longitudinal and radial function in left, right, and total heart pumping in humans

2007 ◽  
Vol 293 (1) ◽  
pp. H636-H644 ◽  
Author(s):  
Marcus Carlsson ◽  
Martin Ugander ◽  
Einar Heiberg ◽  
Hakan Arheden
Keyword(s):  
Flow Measurement ◽  
Radial Function ◽  
Quantitative Relationship ◽  
Cine Mri ◽  
Heart Volume ◽  
Flow Measurements ◽  
Volume Variation ◽  
Atrioventricular Plane Displacement ◽  
The Right ◽  
Plane Displacement

The total heart volume variation (THVV) during systole has been proposed to be caused by radial function of the ventricles, but definitive data for both ventricles have not been presented. Furthermore, the right ventricle (RV) has been suggested to have a greater longitudinal pumping component than the left ventricle (LV). Therefore, we aimed to compare the stroke volume (SV) generated by radial function to the volume variation of the left, right, and total heart. To do this, we also needed to develop a new method for measuring the contribution of the longitudinal atrioventricular plane displacement (AVPD) to the RVSV (RVSVAVPD). For our study, 11 volunteers underwent cine MRI in the short- and long-axis planes and MRI flow measurement in all vessels leading to and from the heart. The left, right, and total heart showed correlations between volume variation from flow measurements and radial function calculated as SV minus the longitudinal function ( r = 0.81, P < 0.01; r = 0.80, P < 0.01; and r = 0.92, P < 0.001, respectively). Compared with the LV, the RV had a greater AVPD (23.4 ± 0.8 vs. 16.4 ± 0.5 mm), center of volume movement (13.0 ± 0.7 vs. 7.8 ± 0.4 mm), and, RVSVAVPD(82 ± 2% vs. 60 ± 2%) ( P < 0.001 for all). We found that THVV is predominantly caused by radial function of the ventricles. Longitudinal AVPD accounts for ∼80% of the RVSV, compared with ∼60% for the LVSV. This difference explains the larger portion of THVV found on the left side of the heart.

scholarly journals Quantification of left and right atrial kinetic energy using four-dimensional intracardiac magnetic resonance imaging flow measurements

2013 ◽  
Vol 114 (10) ◽  
pp. 1472-1481 ◽  
Author(s):  
Per M. Arvidsson ◽  
Johannes Töger ◽  
Einar Heiberg ◽  
Marcus Carlsson ◽  
Håkan Arheden
Keyword(s):  
Magnetic Resonance ◽  
Kinetic Energy ◽  
Right Atrial ◽  
Elastic Recoil ◽  
Flow Measurements ◽  
Ventricular Systole ◽  
Atrial Contraction ◽  
Atrioventricular Plane Displacement ◽  
The Right ◽  
Plane Displacement

Kinetic energy (KE) of atrial blood has been postulated as a possible contributor to ventricular filling. Therefore, we aimed to quantify the left (LA) and right (RA) atrial blood KE using cardiac magnetic resonance (CMR). Fifteen healthy volunteers underwent CMR at 3 T, including a four-dimensional phase-contrast flow sequence. Mean LA KE was lower than RA KE (1.1 ± 0.1 vs. 1.7 ± 0.1 mJ, P < 0.01). Three KE peaks were seen in both atria: one in ventricular systole, one during early ventricular diastole, and one during atrial contraction. The systolic LA peak was significantly smaller than the RA peak ( P < 0.001), and the early diastolic LA peak was larger than the RA peak ( P < 0.05). Rotational flow contained 46 ± 7% of total KE and conserved energy better than nonrotational flow did. The KE increase in early diastole was higher in the LA ( P < 0.001). Systolic KE correlated with the combination of atrial volume and systolic velocity of the atrioventricular plane displacement ( r2 = 0.57 for LA and r2 = 0.64 for RA). Early diastolic KE of the LA correlated with left ventricle (LV) mass ( r2 = 0.28), however, no such correlation was found in the right heart. This suggests that LA KE increases during early ventricular diastole due to LV elastic recoil, indicating that LV filling is dependent on diastolic suction. Right ventricle (RV) relaxation does not seem to contribute to atrial KE. Instead, RA KE generated during ventricular systole may be conserved in a hydraulic “flywheel” and transferred to the RV through helical flow, which may contribute to RV filling.

Atrioventricular plane displacement is the major contributor to left ventricular pumping in healthy adults, athletes, and patients with dilated cardiomyopathy

2007 ◽  
Vol 292 (3) ◽  
pp. H1452-H1459 ◽  
Author(s):  
Marcus Carlsson ◽  
Martin Ugander ◽  
Henrik Mosén ◽  
Torsten Buhre ◽  
Hakan Arheden
Keyword(s):  
Dilated Cardiomyopathy ◽  
Healthy Subjects ◽  
Radial Function ◽  
Left Ventricular ◽  
Lv Function ◽  
Short Axis ◽  
Resonance Imaging ◽  
Atrioventricular Plane Displacement ◽  
The Mean ◽  
Plane Displacement

Previous studies using echocardiography in healthy subjects have reported conflicting data regarding the percentage of the stroke volume (SV) of the left ventricle (LV) resulting from longitudinal and radial function, respectively. Therefore, the aim was to quantify the percentage of SV explained by longitudinal atrioventricular plane displacement (AVPD) in controls, athletes, and patients with decreased LV function due to dilated cardiomyopathy (DCM). Twelve healthy subjects, 12 elite triathletes, and 12 patients with DCM and ejection fraction below 30% were examined by cine magnetic resonance imaging. AVPD and SV were measured in long- and short-axis images, respectively. The percentage of the SV explained by longitudinal function (SVAVPD%) was calculated as the mean epicardial area of the largest short-axis slices in end diastole multiplied by the AVPD and divided by the SV. SV was higher in athletes [140 ± 4 ml (mean ± SE), P = 0.009] and lower in patients (72 ± 7 ml, P < 0.001) when compared with controls (116 ± 6 ml). AVPD was similar in athletes (17 ± 1 mm, P = 0.45) and lower in patients (7 ± 1 mm, P < 0.001) when compared with controls (16 ± 0 mm). SVAVPD%was similar both in athletes (57 ± 2%, P = 0.51) and in patients (67 ± 4%, P = 0.24) when compared with controls (60 ± 2%). In conclusion, longitudinal AVPD is the primary contributor to LV pumping and accounts for ∼60% of the SV. Although AVPD is less than half in patients with DCM when compared with controls and athletes, the contribution of AVPD to LV function is maintained, which can be explained by the larger short-axis area in DCM.

The relationship between longitudinal, lateral, and septal contribution to stroke volume in patients with pulmonary regurgitation and healthy volunteers

2014 ◽  
Vol 306 (6) ◽  
pp. H895-H903 ◽  
Author(s):  
Sigurdur Stephensen ◽  
Katarina Steding-Ehrenborg ◽  
Peter Munkhammar ◽  
Einar Heiberg ◽  
Hakan Arheden ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Right Atrium ◽  
Pulmonary Regurgitation ◽  
Volume Overload ◽  
Atrioventricular Plane Displacement ◽  
Cardiac Volumes ◽  
The Right ◽  
Plane Displacement ◽  
The Relationship ◽  
Septal Motion

Septal systolic motion is towards the left ventricle (LV) in healthy hearts. Patients with pulmonary regurgitation (PR) and right ventricular (RV) volume overload have systolic septal motion toward the RV. This may affect the longitudinal contribution from atrioventricular plane displacement (AVPD) and septal and lateral contribution to stroke volume (SV). The study aimed to quantify these contributions to SV in patients with PR. Cardiac magnetic resonance imaging was used for assessment of cardiac volumes. Patients ( n = 30; age 9–59 yr) with PR due to surgically corrected tetralogy of Fallot and 54 healthy controls (age 10–66 yr) were studied. Longitudinal contribution to RVSV was 47 ± 2% (means ± SE) in patients with PR and 79 ± 1% in controls ( P < 0.001). Lateral contribution to RVSV and LVSV was 40 ± 1 and 62 ± 2% in patients and 31 ± 1 and 36 ± 1% in controls ( P < 0.001 for both). Septal motion contributed to RVSV by 8 ± 1% in patients and by 7 ± 1% to LVSV in controls ( P < 0.001). PR patients have decreased longitudinal contribution to RVSV and increased lateral pumping, resulting in larger outer volume changes and septal motion towards the RV. The changes in RV pumping physiology may be explained by RV remodeling resulting in lower systolic inflow of blood into the right atrium in relation to SV. This avoids the development of pendulum volume between the caval veins and right atrium, which would occur in PR patients if longitudinal contribution to SV was preserved. Decreased AVPD suggests that tricuspid annular excursion, a marker of RV function, is less valid in these patients.

Investigation of the influence of the flow structure on the accuracy of flow measurement before a hydrometric structure in an open channel

2020 ◽  
pp. 41-44
Author(s):  
Anatoly Kusher
Keyword(s):  
Velocity Profile ◽  
Flow Velocity ◽  
Water Flow ◽  
Flow Measurement ◽  
Water Discharge ◽  
Critical Depth ◽  
Flow Measurements ◽  
Study Results ◽  
Flow Velocity Profile ◽  
Upstream Flow

The reliability of water flow measurement in irrigational canals depends on the measurement method and design features of the flow-measuring structure and the upstream flow velocity profile. The flow velocity profile is a function of the channel geometry and wall roughness. The article presents the study results of the influence of the upstream flow velocity profile on the discharge measurement accuracy. For this, the physical and numerical modeling of two structures was carried out: a critical depth flume and a hydrometric overfall in a rectangular channel. According to the data of numerical simulation of the critical depth flume with a uniform and parabolic (1/7) velocity profile in the upstream channel, the values of water discharge differ very little from the experimental values in the laboratory model with a similar geometry (δ < 2 %). In contrast to the critical depth flume, a change in the velocity profile only due to an increase in the height of the bottom roughness by 3 mm causes a decrease of the overfall discharge coefficient by 4…5 %. According to the results of the numerical and physical modeling, it was found that an increase of backwater by hydrometric structure reduces the influence of the upstream flow velocity profile and increases the reliability of water flow measurements.

scholarly journals Neonatal cardiogenic shock revealing obstructive cardiac Hibernoma: case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Rym Gribaa ◽  
Marwen Kacem ◽  
Sami Ouannes ◽  
Wiem Majdoub ◽  
Houssem Thabet ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Transthoracic Echocardiography ◽  
Right Atrium ◽  
Benign Tumors ◽  
Histopathological Analysis ◽  
Tricuspid Valve Repair ◽  
Flow Measurements ◽  
Surgical Specimen ◽  
Eosinophilic Cytoplasm ◽  
The Right

Abstract Background Cardiac Hibernomas are very rare benign tumors and usually remain asymptomatic. Neonatal cardiogenic shock due to cardiac tumors is extremely very rare. Until this date a few cases of cardiac hibernoma have been reported in the literature. Transthoracic echocardiography help in the differential diagnosis, but the definitive diagnosis is histological. The management strategy is not clearly codified. The Aim is to report and discuss the clinical features of a cardiac Hibernoma and review the relevant literature. Case presentation We describe a case of a 2-day-old Caucasian full-term male neonate admitted in neonate intensive care with cardiogenic shock, having fluid resuscitation and inotropic drugs. Ventilatory support was started immediately with the subsequent reestablishment of normal blood pressure. Then he was transferred to the echocardiography laboratory. Transthoracic echocardiography showed two echogenic masses in the right atrium and right ventricle. The masses were extended to the pulmonary trunk. Pulmonary artery flow measurements showed the presence of pulmonary and tricuspid obstruction. Surgery was rapidly considered since the baby was hemodynamically unstable. Intraoperative evaluation showed a mass embedded in the interventricular septum that occupy the right ventricular cavity and the right atrium. The tumor involved also the chordae of the tricuspid. Partial resection was done. Tricuspid valve repair was performed by construction of new chordae from the autologous pericardium. The specimen was sent for histopathological analysis. The baby died immediately after surgery. Histological examination of the surgical specimen revealed clear multivacuolated cells filled with lipid droplets and granular intense eosinophilic cytoplasm which confirms the diagnosis of Hibernoma. Conclusion Cardiac Hibernomas are rare benign tumors. The prognosis and treatment strategy is closely dependent on the location, initial clinical presentation and possible complications. The prognosis can be unfavorable if the tumor was obstructive and infiltrate the myocardium.

scholarly journals Atrioventricular plane displacement versus mitral and tricuspid annular plane systolic excursion: A comparison between cardiac magnetic resonance and M‐mode echocardiography

2021 ◽  
Vol 41 (3) ◽  
pp. 262-270
Author(s):  
Alvaro Sepúlveda‐Martínez ◽  
Katarina Steding‐Ehrenborg ◽  
Mérida Rodríguez‐López ◽  
Ellen Ostenfeld ◽  
Brenda Valenzuela‐Alcaráz ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Atrioventricular Plane Displacement ◽  
Plane Displacement

scholarly journals The Role of Electrode Size on the Incidence of Spreading Depression and on Cortical Cerebral Blood Flow as Measured by H2 Clearance

1992 ◽  
Vol 12 (2) ◽  
pp. 230-237 ◽  
Author(s):  
Marleen J. Verhaegen ◽  
Michael M. Todd ◽  
David S. Warner ◽  
Bruce James ◽  
Julie B. Weeks
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Gray Matter ◽  
Spreading Depression ◽  
Insertion Depth ◽  
Flow Measurements ◽  
Electrode Size ◽  
Cortical Gray Matter ◽  
The Right

Cerebral blood flow was measured by the H2 clearance method 30 and 60 min after the implantation of 300, 250, 125, or 50 μm diameter platinum–iridium electrodes 2 mm deep into the right parietal cortex of normothermic, normocarbic halothane-anesthetized rats. Another group of animals had 50 μm electrodes inserted 1 mm. In all animals, the presence or absence of a wave of spreading depression (SD) was noted at the time of implantation, with recordings made with glass micropipettes. H2 flow values were compared with those measured in gray matter from the same anatomical region (but from different rats), using [3H]nicotine. The incidence of SD ranged from 60% following insertion of 300 μm electrodes to 0% with 50 μm electrodes. H2 clearance flows also varied with electrode size, from 77 ± 21 ml 100 g−1 min−1 (mean ± standard deviation) with 300 μm electrodes to 110 ± 31 and 111 ± 16 ml 100 g−1 min−1 with 125 and 50 μm electrodes, respectively (insertion depth of 2 mm). A CBF value of 155 ± 60 ml 100 g−1 min−1 was obtained with 50 μm electrodes inserted only 1 mm. Cortical gray matter blood flow measured with [3H]nicotine was 154 ± 35 ml 100 g−1 min−1. When the role of SD in subsequent flow measurements was examined, there was a gradual increase in CBF between 30 and 60 min after electrode insertion in those animals with SD, while no such change was seen in rats without SD. These results indicate that the choice of electrode size and implantation depth influences the measurement of CBF by H2 clearance. CBF values equivalent to those obtained with isotopic techniques can be acutely obtained with small (50 μm diameter) electrodes inserted 1 mm into the cortex. While the occurrence of SD does influence CBF in the period immediately after implantation, a relationship between electrode size and measured flow is present that is independent of SD.

The Accuracy of Transit Time Flow Measurement in Predicting Graft Patency after Coronary Artery Bypass Grafting

2013 ◽  
Vol 8 (6) ◽  
pp. 416-419 ◽  
Author(s):  
Patrick F. Walker ◽  
William T. Daniel ◽  
Emmanuel Moss ◽  
Vinod H. Thourani ◽  
Patrick Kilgo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Transit Time ◽  
Pulsatility Index ◽  
Flow Measurement ◽  
Artery Bypass ◽  
Graft Patency ◽  
Bypass Grafting ◽  
Flow Measurements ◽  
Time Flow

Objective Transit time flow measurement (TTFM) is a method used to assess intraoperative blood flow after vascular anastomoses. Angiography represents the criterion standard for the assessment of graft patency after coronary artery bypass grafting (CABG). The purpose of this study was to compare flow measurements from TTFM to diagnostic angiography. Methods From October 9, 2009, to April 30, 2012, a total of 259 patients underwent robotic-assisted CABG procedures at a single institution. Of these, 160 patients had both TTFM and either intraoperative or postoperative angiography of the left internal mammary artery to the left anterior descending coronary artery graft. Transit time flow measurements were obtained after completion of the anastomosis and after administration of protamine before chest closure. Transit time flow measurement assessment included pulsatility index, diastolic fraction, and flow (milliliters per minute). Angiograms were graded according to the Fitzgibbon criteria. The patients were grouped according to angiographic findings, with perfect grafts defined as FitzGibbon A and problematic grafts defined as either Fitzgibbon B or O. Results Overall, there were 152 (95%) of 160 angiographically perfect grafts (FitzGibbon A). Of the eight problematic grafts, five were occluded (Fitzgibbon O) and three had significant flow-limiting lesions (FitzGibbon B). Two patients had intraoperative graft revision after completion angiography, one had redo CABG during the same hospitalization, and five were treated with percutaneous coronary intervention. A significant difference was seen in mean ± SD flow (34.3 ± 16.8 mL/min vs 23.9 ± 12.5 mL/min, P = 0.033) between patent and nonpatent grafts but not in pulsatility index (1.98 ± 0.76 vs 1.65 ± 0.48, P = 0.16) or diastolic fraction (73.5% ± 8.45% vs 70.9% ± 6.15%, P = 0.13). Conclusions Although TTFM can be a useful tool for graft assessment after CABG, false negatives can occur. Angiography remains the criterion standard to assess graft patency and quality of the anastomosis after CABG.

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