scholarly journals Left Ventricular Blood Flow Kinetic Energy Assessment by 4D Flow Cardiovascular Magnetic Resonance: A Systematic Review of the Clinical Relevance

2020 ◽  
Vol 7 (3) ◽  
pp. 37
Author(s):  
Harjinder Kaur ◽  
Hosamadin Assadi ◽  
Samer Alabed ◽  
Donnie Cameron ◽  
Vassilios S. Vassiliou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Flow ◽  
Cardiovascular Magnetic Resonance ◽  
Heart Disease ◽  
Magnetic Resonance ◽  
Kinetic Energy ◽  
Left Ventricular ◽  
4D Flow ◽  
Hemodynamic Assessment ◽  
Lv Diastolic Function

Background: There is an emerging body of evidence that supports the potential clinical value of left ventricular (LV) intracavity blood flow kinetic energy (KE) assessment using four-dimensional flow cardiovascular magnetic resonance imaging (4D flow CMR). The aim of this systematic review is to summarize studies evaluating LV intracavity blood flow KE quantification methods and its potential clinical significance. Methods: A systematic review search was carried out on Medline, Pubmed, EMBASE and CINAHL. Results: Of the 677 articles screened, 16 studies met eligibility. These included six (37%) studies on LV diastolic function, another six (37%) studies on heart failure or cardiomyopathies, three (19%) studies on ischemic heart disease or myocardial infarction and finally, one (6%) study on valvular heart disease, namely, mitral regurgitation. One of the main strengths identified by these studies is high reproducibility of LV blood flow KE hemodynamic assessment (mean coefficient of variability = 6 ±  2%) for the evaluation of LV diastolic function. Conclusions: The evidence gathered in this systematic review suggests that LV blood flow KE has great promise for LV hemodynamic assessment. Studies showed increased diagnostic confidence at no cost of additional time. Results were highly reproducible with low intraobserver variability.

scholarly journals Four-dimensional flow cardiovascular magnetic resonance in tetralogy of Fallot: a systematic review

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Ayah Elsayed ◽  
Kathleen Gilbert ◽  
Miriam Scadeng ◽  
Brett R. Cowan ◽  
Kuberan Pushparajah ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Kinetic Energy ◽  
Tetralogy Of Fallot ◽  
4D Flow ◽  
Pilot Studies ◽  
Systolic Volume ◽  
Dimensional Flow ◽  
4D Flow Cmr

Abstract Background Patients with repaired Tetralogy of Fallot (rTOF) often develop cardiovascular dysfunction and require regular imaging to evaluate deterioration and time interventions such as pulmonary valve replacement. Four-dimensional flow cardiovascular magnetic resonance (4D flow CMR) enables detailed assessment of flow characteristics in all chambers and great vessels. We performed a systematic review of intra-cardiac 4D flow applications in rTOF patients, to examine clinical utility and highlight optimal methods for evaluating rTOF patients. Methods A comprehensive literature search was undertaken in March 2020 on Google Scholar and Scopus. A modified version of the Critical Appraisal Skills Programme (CASP) tool was used to assess and score the applicability of each study. Important clinical outcomes were assessed including similarities and differences. Results Of the 635 articles identified, 26 studies met eligibility for systematic review. None of these were below 59% applicability on the modified CASP score. Studies could be broadly classified into four groups: (i) pilot studies, (ii) development of new acquisition methods, (iii) validation and (vi) identification of novel flow features. Quantitative comparison with other modalities included 2D phase contrast CMR (13 studies) and echocardiography (4 studies). The 4D flow study applications included stroke volume (18/26;69%), regurgitant fraction (16/26;62%), relative branch pulmonary artery flow(4/26;15%), systolic peak velocity (9/26;35%), systemic/pulmonary total flow ratio (6/26;23%), end diastolic and end systolic volume (5/26;19%), kinetic energy (5/26;19%) and vorticity (2/26;8%). Conclusions 4D flow CMR shows potential in rTOF assessment, particularly in retrospective valve tracking for flow evaluation, velocity profiling, intra-cardiac kinetic energy quantification, and vortex visualization. Protocols should be targeted to pathology. Prospective, randomized, multi-centered studies are required to validate these new characteristics and establish their clinical use.

Abstract 13435: Deranged Intra-Cardiac Blood Flow Components and Kinetic Energy in Dilated Cardiomyopathy Are an Additional Marker of Disease Severity and Correlate With Established Markers of Prognosis

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Victoria Stoll ◽  
Aaron Hess ◽  
Eylem Levelt ◽  
Jonatan Eriksson ◽  
Petter Dyverfeldt ◽  
...  
Keyword(s):  
Blood Flow ◽  
Kinetic Energy ◽  
Dilated Cardiomyopathy ◽  
Disease Severity ◽  
Myocardial Strain ◽  
Flow Patterns ◽  
Left Ventricular ◽  
4D Flow ◽  
Flow Components ◽  
Functional Components

Introduction: Heart failure (HF) due to dilated cardiomyopathy (DCM) is a complex syndrome in which numerous cellular, mechanical and flow processes/interactions become deranged. Insights into derangement of left ventricular intra-cardiac flow patterns and kinetic energy (KE) are now afforded by the use of 4D flow CMR. Previous studies have found derangements of intra-ventricular flow components and KE within DCM patients compared to healthy volunteers. Hypothesis: We hypothesised that increasing derangement in 4D flow measures would relate to: 1) decreased mechanical cardiac function, as assessed by myocardial strain, 2) increased levels of biochemical remodelling markers and 3) worsening patient symptoms and functional capacity. Methods: 26 idiopathic DCM patients (69% male, mean age 55±2 yr, LVEF 35±2%) and 10 controls (70% male, mean age 57±4yr, LVEF 68±1.2%) were assessed with 3T CMR. Results: The LV volume was divided into 4 functional components; direct flow (DF), delayed ejection flow (DEF), retained inflow (RI) and residual volume (RV). Compared to controls DCM’s had significantly decreased DF (11±1% vs 38±2%) and increased RV (51±2% vs 31±1%) (fig a). The KE at end diastole differed significantly for all flow components between groups (fig b). Circumferential strain was significantly impaired in DCM’s vs controls (-9.9±0.8% vs -19.7±0.5%, p<0.0001). DF KE correlated positively to the 6 minute walk test (6MWT) and strain, and negatively to the Minnesota HF questionnaire and BNP (fig c). Conclusions: DCM patients demonstrated less efficient blood flow patterns and deranged KE profiles. The greater the derangement of flow parameters from normal, the worse the myocardial strain, BNP, 6MWT and patient symptoms. This study suggests that flow parameter derangements are novel biomarkers of disease severity in DCM, correlating with established markers of prognosis such as BNP and 6MWT and may become useful in monitoring novel therapies and predicting prognosis.

scholarly journals ESTIMATION OF WALL SHEAR STRESS USING 4D FLOW CARDIOVASCULAR MRI AND COMPUTATIONAL FLUID DYNAMICS

2016 ◽  
Vol 17 (03) ◽  
pp. 1750046 ◽  
Author(s):  
E. SOUDAH ◽  
J. CASACUBERTA ◽  
P. J. GAMEZ-MONTERO ◽  
J. S. PÉREZ ◽  
M. RODRÍGUEZ-CANCIO ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Blood Flow ◽  
Shear Stress ◽  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Wall Shear Stress ◽  
Thoracic Aorta ◽  
4D Flow ◽  
Wall Shear

In the last few years, wall shear stress (WSS) has arisen as a new diagnostic indicator in patients with arterial disease. There is a substantial evidence that the WSS plays a significant role, together with hemodynamic indicators, in initiation and progression of the vascular diseases. Estimation of WSS values, therefore, may be of clinical significance and the methods employed for its measurement are crucial for clinical community. Recently, four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) has been widely used in a number of applications for visualization and quantification of blood flow, and although the sensitivity to blood flow measurement has increased, it is not yet able to provide an accurate three-dimensional (3D) WSS distribution. The aim of this work is to evaluate the aortic blood flow features and the associated WSS by the combination of 4D flow cardiovascular magnetic resonance (4D CMR) and computational fluid dynamics technique. In particular, in this work, we used the 4D CMR to obtain the spatial domain and the boundary conditions needed to estimate the WSS within the entire thoracic aorta using computational fluid dynamics. Similar WSS distributions were found for cases simulated. A sensitivity analysis was done to check the accuracy of the method. 4D CMR begins to be a reliable tool to estimate the WSS within the entire thoracic aorta using computational fluid dynamics. The combination of both techniques may provide the ideal tool to help tackle these and other problems related to wall shear estimation.

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