Key result
Vector flow mapping shows ~95% of children over 2 years develop adult LV vortex patterns.
Why the study?
How do left ventricular vortex formation and energy loss patterns measured by vector flow mapping change with age from newborns to young adults?
Cohort (n=66)
How do left ventricular vortex formation and energy loss patterns measured by vector flow mapping change with age from newborns to young adults?
This study provides initial reference insights into how the growing pediatric heart transitions to adult left ventricular vortex flow patterns and diastolic energy loss over the first two years of life.
May inform developmental hemodynamics but should not change practice; hypothesis-generating and requires prospective validation.
Left ventricular vortex formation optimizes the effective transport of blood volume while minimizing energy loss (EL). Vector flow mapping (VFM) derived EL patterns have not been described in children < 1 year. A prospective cohort of 66 (0 days - 22 years, 14 patients ≤ 2 months) cardiovascularly normal children was used to determine LV vortex number, size (mm2), strength (m2/sec) and energy loss (mW/m/m2) in systole and diastole and compared across age groups. One early diastolic (ED) vortex at the anterior mitral leaflet & one late diastolic (LD) vortex at the LV outflow tract (LVOT) were seen in all newborns ≤ 2 months. At > 2 months, two ED vortices and one LD vortex were seen, with 95% of subjects > 2 years demonstrating this vortex pattern. Peak and average diastolic EL acutely increased in the same 2 months - 2 years period and then decreased within the adolescent and young adult age groups. Overall, these findings suggest that the growing heart undergoes a transition to adult vortex flow patterns over the first two years of life with a corresponding acute increase in diastolic EL. These findings offer an initial insight into the dynamic changes of LV flow patterns in pediatric patients and can serve to expand our understanding of cardiac efficiency and physiology in children.
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Becker et al. (2023) conducted a cohort in Cardiovascularly normal children and young adults (n=66). Age / Vector flow mapping (VFM) vs. Comparison across age groups (≤ 2 months, 2 months - 2 years, > 2 years, adolescents, young adults) was evaluated on LV vortex number, size (mm2), strength (m2/sec) and energy loss (mW/m/m2) in systole and diastole. Vector flow mapping revealed that 95% of subjects >2 years demonstrated an adult pattern of two early diastolic and one late diastolic LV vortices, with an acute diastolic energy loss increase from 2 months to 2 years.
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