Key result
A meta-analysis of intraventricular flow parameters revealed no significant difference in vortex length between patients with heart failure and healthy controls (0.53 vs 0.61, p=0.632).
Why the study?
The study was conducted to evaluate current inter-modality agreement of noninvasive clinical intraventricular flow assessment across three emerging imaging modalities: EPIV, VFM, and 4D flow CMR.
What is the inter-modality agreement of noninvasive clinical intraventricular flow assessment using EPIV, VFM, and 4D flow CMR?
Meta-Analysis
What is the inter-modality agreement of noninvasive clinical intraventricular flow assessment using EPIV, VFM, and 4D flow CMR?
Answers are grounded in this paper and cite their sources.
There is low agreement between different imaging modalities for assessing intraventricular flow, highlighting the need for a standardized multimodality framework before clinical implementation.
BACKGROUND: The aim of this systematic review was to evaluate current inter-modality agreement of noninvasive clinical intraventricular flow (IVF) assessment with 3 emerging imaging modalities: echocardiographic particle image velocimetry (EPIV), vector flow mapping (VFM), and 4-dimensional flow cardiovascular magnetic resonance imaging (4D flow CMR). METHODS: We performed a systematic literature review in the databases EMBASE, Medline OVID and Cochrane Central for identification of studies evaluating left ventricular (LV) flow patterns using one of these flow visualization modalities. Of the 2224 initially retrieved records, 10 EPIV, 23 VFM, and 25 4D flow CMR studies were included in the final analysis. RESULTS: Vortex parameters were more extensively studied with EPIV, while LV energetics and LV transport mechanics were mainly studied with 4D flow CMR, and LV energy loss and vortex circulation were implemented by VFM studies. Pooled normative values are provided for these parameters. The meta- analysis for the values of two vortex morphology parameters, vortex length and vortex depth, failed to reveal a significant change between heart failure patients and healthy controls. CONCLUSION: Agreement between the different modalities studying intraventricular flow is low and different methods of measurement and reporting were used among studies. A multimodality framework with a standardized set of flow parameters is necessary for implementation of noninvasive flow visualization in daily clinical practice. The full potential of noninvasive flow visualization in addition to diagnostics could also include guiding medical or interventional treatment.
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Mutluer et al. (2021) conducted a meta-analysis in Heart failure. Heart failure with reduced ejection fraction vs. Healthy controls was evaluated on Vortex length (p=0.632). A meta-analysis of intraventricular flow parameters revealed no significant difference in vortex length between patients with heart failure and healthy controls (0.53 vs 0.61, p=0.632).
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