What does this research mean for the field?

Patients with heart failure and left ventricular dyssynchrony exhibit significantly altered intracardiac hemodynamic forces, such as a loss of longitudinal forces in diastole, which are largely independent of traditional dyssynchrony measures. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.ESTABLISHES_NEW_DIRECTION.

What question did this study set out to answer?

This research aims to explore changes in hemodynamic forces in patients with left ventricular dyssynchrony and their potential significance as biomarkers of cardiac function.

September 14, 2018AJP Heart and Circulatory Physiology

Hemodynamic forces using four-dimensional flow MRI: an independent biomarker of cardiac function in heart failure with left ventricular dyssynchrony?

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Why the study?

Are intracardiac hemodynamic forces computed from 4-D flow MRI altered in patients with heart failure and LV dyssynchrony compared to controls?

Key Points

This research aims to explore changes in hemodynamic forces in patients with left ventricular dyssynchrony and their potential significance as biomarkers of cardiac function.
Thirty-one patients with heart failure and LV dyssynchrony and 39 control subjects underwent 4-D flow cardiac MRI.
Hemodynamic forces were computed using Navier-Stokes equations and assessed over the LV volume.
The ratio of transverse to longitudinal forces was calculated and compared with clinical measures such as ejection fraction.
Patients showed significantly altered hemodynamic force patterns (force ratio: 0.32 vs. 0.90, P < 0.0001).
Systolic force ratio correlated with global longitudinal strain and ejection fraction (P < 0.01).
Diastolic force ratio effectively distinguished patients from controls (AUC: 0.98, P < 0.0001).

Structured PICO

Are intracardiac hemodynamic forces computed from 4-D flow MRI altered in patients with heart failure and LV dyssynchrony compared to controls?

Population

31 patients with heart failure and left ventricular (LV) dyssynchrony, and 39 control subjects

Intervention

Cardiac MRI with acquisition of four-dimensional (4-D) flow to compute intracardiac hemodynamic forces

Comparator

Control subjects

Outcome

Ratio between transverse (lateral-septal and inferior-anterior) and longitudinal (apical-basal) hemodynamic forces in systole and diastolesurrogate

Hemodynamic forces assessed by 4-D flow MRI reveal distinct diastolic force patterns in heart failure patients with LV dyssynchrony, offering a potential new biomarker for risk stratification and CRT guidance.

Discussion

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Implication

Altered diastolic forces on 4D-flow MRI may identify HF dyssynchrony; hypothesis-generating for CRT selection or risk stratification.

Cite This Study

Arvidsson et al. (2018) studied this question.

synapsesocial.com/papers/6a1bf4846f692abb725efd9a https://doi.org/10.1152/ajpheart.00112.2018

Topics

Heart failure HFrEF treatment

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Hemodynamic forces using four-dimensional flow MRI: an independent biomarker of cardiac function in heart failure with left ventricular dyssynchrony?

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Hemodynamic forces using four-dimensional flow MRI: an independent biomarker of cardiac function in heart failure with left ventricular dyssynchrony?

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider