Key result
In patients with LV systolic dysfunction, the intraventricular vortex persists during ejection and stays mainly at the apex, with duration independently determined by LV dimensions and wall motion.
Why the study?
How does the intraventricular vortex evolve during left ventricular ejection in patients with varying LV systolic function assessed by vector flow mapping?
Observational (n=183)
How does the intraventricular vortex evolve during left ventricular ejection in patients with varying LV systolic function assessed by vector flow mapping?
Vector flow mapping demonstrates that in patients with LV systolic dysfunction, the intraventricular vortex persists longer during ejection and is closely associated with LV dimensions and function.
Answers are grounded in this paper and cite their sources.
Altered vortex persistence may reflect LV remodeling severity; hypothesis-generating for flow-based assessment pending prospective validation.
AIMS: The purpose of this study was to assess the evolution of intraventricular vortex during left ventricular (LV) ejection. METHODS: Vector flow mapping was performed in 51 patients with coronary artery disease and LV ejection fraction (EF) >50%, 70 patients with EF <50% (13 with coronary artery disease and 57 with dilated cardiomyopathy), and 62 healthy volunteers. RESULTS: In normals and patients with EF >50%, the intraventricular vortex dissipated quickly during early ejection. In patients with EF <50%, the vortex stayed mainly at apex and persisted for a significantly longer time. The evolution of vortex during ejection was significantly correlated with QRS width, EF, fractional shortening, LV outflow velocity time integral, wall motion score index (WMSI), LV dimensions, left atrial diameter, and diastolic mitral annular velocities. LV end-diastolic short diameter and WMSI were the independent determinants of the duration of vortex (R(2) = 0.482, P < 0.001). End-systolic short diameter and apical WMSI were the independent determinants of duration of vortex corrected for ejection time (R(2) = 0.565, P < 0.001). End-systolic short diameter was the independent determinant of percentage change in vortex area during early ejection (R(2) = 0.355, P < 0.001). End-systolic short diameter and ejection time were the independent determinants of percentage change in vortex flow volume (R(2) = 0.415, P < 0.001). CONCLUSIONS: In patients with LV systolic dysfunction, the vortex persists during ejection and stays mainly at apex. The vortex evolution during ejection is closely associated with LV dimensions and functions.
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Zhang et al. (2012) conducted an observational in Coronary artery disease and dilated cardiomyopathy (n=183). Left ventricular systolic dysfunction (EF <50%) vs. Normal EF (>50%) and healthy volunteers was evaluated on Evolution of intraventricular vortex during left ventricular ejection. In patients with LV systolic dysfunction, the intraventricular vortex persists during ejection and stays mainly at the apex, with duration independently determined by LV dimensions and wall motion.
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