Does 4D Flow MRI detect altered intraventricular hemodynamics (vorticity, viscous energy loss, kinetic energy) in Fontan patients compared to healthy subjects?
4D Flow MRI reveals altered intraventricular hemodynamics and energetics in Fontan patients even when standard functional metrics like ejection fraction and stroke volume remain normal.
Physiologic intraventricular hemodynamic interplay/coupling is present in the healthy left ventricle between vorticity versus viscous energy loss and kinetic energy from four-dimensional flow cardiovascular magnetic resonance imaging (4D Flow MRI). Conversely, Fontan patients present compensatory pathophysiologic hemodynamic coupling by an increase in intraventricular vorticity that positively correlates to viscous energy loss and kinetic energy levels in the presence of maintained normal stroke volume. Altered vorticity and energetics are found in the presence of normal ejection fraction in Fontan patients.
Kamphuis et al. (Fri,) studied this question.