Evaluation of Left Intraventricular Flow Dynamics Using the Novel Non-contrast HyperDoppler Technique

STRUCTURED ABSTRACT Background Recently, HyperDoppler, a color Doppler-based ultrasound technique, has been introduced for left ventricular (LV) flow dynamics evaluation in clinical settings, but quantitative information derived from its use are limited. We aimed at establishing reference values and reproducibility of key HyperDoppler LV flow dynamics measures: vortex area, length, depth, intensity, and global kinetic energy dissipation (gKED) in normal subjects. We also explored the influence of physiological and echocardiographic variables on HyperDoppler measures. Methods This multicenter, international study involved 13 echocardiographic laboratories and an independent echo corelab. A total of 467 normal subjects were enrolled and categorized by gender and age (20–39, 40–59, and 60–79 years): of these, 317 subjects were analyzed at the corelab and 419 on-site using different color Doppler cineloops. Results Corelab analysis yielded a median value (25th–75th percentiles) of 25.0% (21.1–28.0%) for vortex area, 57.4% (53.3–62.6%) for vortex length, 34.3% (30.7–38.1%) for vortex depth, -31.9% (-28.0% to -35.8%) for vortex intensity, and 0.55 (0.44–0.70) for gKED. Minor age- and gender-related variations were noted in vortex length, depth, and gKED. Excellent reproducibility was shown for each HyperDoppler measure. Physiological behavior of left intraventricular flow dynamics was adequately captured by the HyperDoppler quantitative measures. Conclusions Reference values for left intraventricular flow dynamics were established using the HyperDoppler technique, which is reproducible and enables the assessment of intracardiac flow dynamics in clinical practice.