Cardiovascular magnetic resonance left ventricular 4D-flow: differences in flow components and kinetic energy across heart failure spectrum

Figures

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  Figure 1. CONSORT flow diagram. The CONSORT flow diagram outlines the patient selection and grouping process in this study based on the inclusion and exclusion criteria. 4D flow, four-dimensional flow; CAD, coronary artery disease; HF, heart failure; HFmrEF, heart failure with mid-range ejection fraction; HFpEF, heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction.

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  Figure 2. Intraventricular component volume distribution in subject groups. In this figure, volume distribution of DF, DE, RI, and ReV in the subject groups are illustrated in (A) a bar chart and (B) a boxplot respectively. (C) Case examples illustrates the difference in portion of DF and ReV component (%) in an asymptomatic control, a HFpEF, a HFmrEF, and a HFrEF patient respectively. (n = 78 controls, 47 HFpEF, 25 HFmrEF, 37 HFrEF) HFpEF, heart failure with preserved ejection fraction; HFmrEF, heart failure with mildly reduced ejection fraction; HFrEF, heart failure with reduced ejection fraction.

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  Figure 3. KEi distribution in controls, HFpEF, HFmrEF, and HFrEF. In these boxplots, systolic or diastolic KEi (A) globally, that of (B) DF, (C) RI, and (D) ReV in subject groups are shown. (n = 78 controls, 47 HFpEF, 25 HFmrEF, 37 HFrEF).

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  Figure 4. KEi Dias/Sys ratio of global, DF, RI, and ReV components. This boxplot shows respectively the KEi Dias/Sys ratio (A) globally and in (B) DF, (C) RI and (D) ReV components in subject groups. (n = 78 controls, 47 HFpEF, 25 HFmrEF, 37 HFrEF).

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  Figure 5. Indexed global KE time curves across groups. Figure shows Global KE time curves normalized by LV-EDV in 4 subject groups in full, age-and-sex-balanced cohort, and non-AF. (Full: n = 78 controls, 47 HFpEF, 25 HFmrEF, 37 HFrEF) (Age-and-sex-balanced cohort: n = 36 controls, 34 HFpEF, 17 HFmrEF, 22 HFrEF) (Non-AF: 78 controls, 32 HFpEF, 16 HFrEF, 25 HFrEF). AF, atrial fibrillation; KE, kinetic energy; LV-EDV, left ventricular end-diastolic volume.

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  Figure 6. KE time curves of each intraventricular component across groups. Figure shows KE time curves of each intraventricular component normalized by its respective intraventricular volume in (A) asymptomatic controls, (B) HFpEF, (C) HFmrEF, and (D) HFrEF. (n = 79 controls, 40 HFpEF, 18 HFmrEF, 30 HFrEF) (= Direct Flow, = Delayed Ejection, =Retained Inflow, =Residual Volume).