Key result
Fontan patients exhibited significantly aberrant ventricular flow patterns compared to healthy controls, with main vortices being consistently shorter, wider, and rounder.
Why the study?
Does particle image velocimetry using contrast echocardiography reveal aberrant intracavitary vortex flow patterns in Fontan patients compared to healthy controls?
Cross-Sectional (n=23)
No
Does particle image velocimetry using contrast echocardiography reveal aberrant intracavitary vortex flow patterns in Fontan patients compared to healthy controls?
Particle image velocimetry using contrast echocardiography is feasible in Fontan patients and reveals significantly altered, more spherical intracavitary vortex flow patterns compared to healthy hearts.
Answers are grounded in this paper and cite their sources.
Supports vortex flow analysis as a research tool in Fontan patients; leaves open its prognostic value or role in clinical decision-making.
BACKGROUND: Flow patterns in univentricular hearts may have clinical value. Therefore, it is our objective to asses and characterize vortex flow patterns with Fontan circulation in comparison with healthy controls. METHODS: Twenty-three patients (8 Fontan and 15 normal patients) underwent echocardiography with intravenous contrast agent (Sonovue®) administration. Dedicated software was used to perform particle image velocimetry (PIV) and to visualize intracavitary flow in the systemic ventricles of the patients. Vortex parameters including vortex depth, length, width, and sphericity index were measured. Vortex pulsatility parameters including relative strength, vortex relative strength, and vortex pulsation correlation were also measured. RESULTS: The data from this study show that it is feasible to perform particle velocimetry in Fontan patients. Vortex length (VL) was significantly lower (0.51 ± 0.09 vs 0.65 ± 0.12, P = 0.010) and vortex width (VW) (0.32 ± 0.06 vs 0.27 ± 0.04, p = 0.014), vortex pulsation correlation (VPC) (0.26 ± 0.25 vs -0.22 ± 0.87, p = 0.05) were significantly higher in Fontan patients. Sphericity index (SI) (1.66 ± 0.48 vs 2.42 ± 0.62, p = 0.005), relative strength (RS) (0.77 ± 0.33 vs 1.90 ± 0.47, p = 0.0001), vortex relative strength (VRS) (0.18 ± 0.13 vs 0.43 ± 0.14, p = 0.0001) were significantly lower in the Fontan patients group. CONCLUSIONS: PIV using contrast echocardiography is feasible in Fontan patients. Fontan patients had aberrant flow patterns as compared to normal hearts in terms of position, shape and sphericity of the main vortices. The vortex from the Fontan group was consistently shorter, wider and rounder than in controls. Whether vortex characteristics are related with clinical outcome is subject to further investigation.
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Λαμπρόπουλος et al. (2012) conducted a cross-sectional in Fontan circulation (n=23). Fontan circulation vs. Healthy controls was evaluated on Vortex length (VL) (p=0.010). Fontan patients exhibited significantly aberrant ventricular flow patterns compared to healthy controls, with main vortices being consistently shorter, wider, and rounder.
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