Intra-Left Ventricular Flow Velocity Distributions, Based on Color Doppler Echo Vector Flow Mapping of Normal Subjects and Heart Failure Patients

2016 ◽  
pp. 421-442
Keyword(s):  
Heart Failure ◽  
Flow Velocity ◽  
Color Doppler ◽  
Normal Subjects ◽  
Left Ventricular ◽  
Flow Mapping ◽  
Heart Failure Patients ◽  
Vector Flow Mapping

P2477Assessment of intraventricular flow dynamics in acute heart failure studied by Vector Flow Mapping

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Masuda ◽  
S Minami ◽  
M Stugaard ◽  
A Kozuma ◽  
S Takeda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Diastolic Pressure ◽  
Color Doppler ◽  
Propagation Distance ◽  
Left Ventricular ◽  
Flow Dynamics ◽  
Significant Part ◽  
Flow Mapping ◽  
Vector Flow Mapping ◽  
Ejection Rate

Abstract Background Although left ventricular (LV) flow dynamics should be closely related to LV morphology and function, little is known about how heart failure (HF) changes it. Pathline Analysis (PA), a recently developed software based on Vector Flow Mapping (VFM, Hitachi), enables us to trace the virtual blood particles entering to the LV in diastole and being ejected in systole. We investigated the change of flow dynamics in HF induced in dogs using PA. Methods In 15 open-chest dogs, HF was induced by intracoronary injection of microspheres. Color Doppler images of apical long-axis view were acquired using Prosound F75 (Hitachi) before and after HF and were analyzed by PA. We calculated the ratio of the numbers of entering particles in diastole and ejected particles in systole (ejection rate) and the distance reached by the particles in diastole corrected by the LV long-axis diameter (propagation distance). Apical and basal short axis images were acquired using GE Vivid E9 and were analyzed for peak rotation and peak twist. Results After inducing HF, LV end-diastolic pressure increased from 6±2 to 15±5 mmHg (p<0.001) and ejection fraction (EF), apical peak rotation and peak twist decreased significantly (EF; 58±5 to 36±8%, apical peak rotation; 14±5 to 3±2 degree, peak twist; 19±5 to 6±3 degree, p<0.05, respectively). PA showed most of the entering particles to the LV were ejected in the following systole at the control stage, but in HF, a significant part of the entering particles were not ejected and remained in the LV (Figure). Ejection rate decreased from 50±11 to 26±11% (p<0.001) and the propagation distance decreased from 85±9 to 66±13% (p<0.001) after inducing HF. There were significant relationships between indices obtained by PA and EF and peak twist (Table). Conclusion A significant part of inflow is not ejected directly to the outflow in the next systole and remains in the LV in HF, suggesting inefficient flow dynamics.

scholarly journals Loss of apical suction assessed by noninvasive pressure differences and twist in acute heart failure: a novel method using vector flow mapping

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Ido ◽  
K Masuda ◽  
S Yoshimura ◽  
H Tanaka ◽  
M Stugaard
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Diastolic Pressure ◽  
Color Doppler ◽  
Left Ventricular ◽  
Frame Rate ◽  
Flow Mapping ◽  
Vector Flow Mapping ◽  
Funding Sources ◽  
Novel Method

Abstract Background Early diastolic intraventricular pressure difference (IVPD) reflects left ventricular (LV) apical suction, and IVPD is closely related to cardiac function, especially LV twist. Vector Flow Mapping (VFM) allows visualization of regional pressure distribution and noninvasive quantification of IVPD. The purpose of the present study was to investigate if and how IVPDs are related to LV twist in a model of acute heart failure (HF). Methods In 15 open-chest dogs, HF was induced by intracoronary injection of microspheres. The HF model was classified into two groups based on the LV end-diastolic pressure (LVEDP) (group1: LVEDP&lt;18 mmHg (n=10), group2: LVEDP≥18 mmHg (n=8)). Color Doppler images from apical long-axis views were acquired at baseline and during HF. From these images, pressure differences (ΔP) were calculated along the LV inflow tract throughout the cardiac cycle. For the purpose of this study, the differences between apex and base during isovolumic relaxation time (ΔPIRT) and rapid early inflow period (ΔPE) were used for analyses. Furthermore, apical and basal short axis high frame rate 2D images were acquired, and peak rotation and peak twist were analyzed. Results LVEDP was 7±9, 14±2, 21±3 mmHg for baseline, group1 HF, and group2 HF, respectively. Pressure differences (both ΔPIRT and ΔPE) were visibly changed by the increase of LVEDP (Figure), and the magnitude of ΔPIRT, ΔPE and peak twist decreased significantly with the severity of heart failure. There were significant relationships between pressure differences (ΔPIRT and ΔPE) and dP/dtmin, tau, EF and peak twist (Table). In multivariate analyses, tau and peak twist were independent predictors for ΔPIRT and peak twist was independent predictor for ΔPE. Conclusion VFM analysis is feasible to noninvasively assess the IVPDs in acute heart failure. The IVPDs are closely related to the twisting motion of the LV, and reflect loss of apical suction during severe HF. FUNDunding Acknowledgement Type of funding sources: None. VFM images of pressure differences Correlations of pressure differences

INTRA-LEFT VENTRICULAR FLOW DISTRIBUTIONS IN DIASTOLIC AND SYSTOLIC PHASES, BASED ON ECHO VELOCITY FLOW MAPPING OF NORMAL SUBJECTS AND HEART FAILURE PATIENTS, TO CHARACTERIZE LEFT VENTRICULAR PERFORMANCE OUTCOMES OF HEART FAILURE

2012 ◽  
Vol 12 (05) ◽  
pp. 1240029 ◽  
Author(s):  
THU-THAO LE ◽  
RU-SAN TAN ◽  
FEIQIONG HUANG ◽  
LIANG ZHONG ◽  
SRIDHAR IDAPALAPATI ◽  
...  
Keyword(s):  
Heart Failure ◽  
Velocity Vector ◽  
Normal Subjects ◽  
Performance Outcomes ◽  
Left Ventricular ◽  
Inflow Rate ◽  
Flow Mapping ◽  
Velocity Flow ◽  
Outflow Rate ◽  
Blood Flow Patterns

Heart failure (HF), one of the most common diseases in the world, causes left ventricular dysfunction (LV) and high mortality. HF patients are stratified into two groups based on their LV ejection fraction (EF) — HF with normal EF (HFNEF) and with reduced EF (HFREF). EF is a commonly used measure of LV contractile performance. Despite preserved EF, a complex mixture of systolic and diastolic dysfunction and variable degrees of LV remodelling underlying HFNEF poses challenges to diagnose and provide pharmacological treatment for HFNEF. In recent years, the velocity flow mapping (VFM) technique has been developed to generate flow velocity vector fields by post-processing color Doppler echocardiographic (echo) images. We aim to obtain the intra-LV blood flow patterns for patients with HFNEF, HFREF, and normal subjects, in order to characterize the LV performance outcomes of normal subjects and HF patients. Two subjects from each group of HFNEF, HFREF, and normal underwent echo scans. Velocity vector distributions throughout the cardiac cycle were then analysed using the VFM technique. In each subject, the outflow rate during systole, inflow rate during diastole, as well as wall stress-based pressure-normalized contractility index, dσ*/dt max , were computed and compared among the groups. This study demonstrated the use of VFM to visualize LV blood flow patterns in HF patients and normal subjects. Different patterns of flow distributions were observed in these subjects. In HFREF patients, dσ*/dt max , the peak outflow rate and peak inflow rate during early filling were markedly reduced. In HFNEF patients, peak outflow rates were increased compared to those of normal subjects.

Abstract 15137: Vector Flow Mapping is a Novel Useful Technique in Assessing Inertia Force of Late Systolic Aortic Flow and Left Ventricular Early Diastolic Function

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kazuaki Wakami ◽  
Kenta Hachiya ◽  
Syunsuke Murai ◽  
Tsuyoshi Ito ◽  
Hiroshi Fujita ◽  
...  
Keyword(s):  
Blood Flow ◽  
Time Constant ◽  
Color Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Inertia Force ◽  
Lv Function ◽  
Flow Mapping ◽  
Vector Flow Mapping ◽  
Late Systole

Background: We previously reported that the inertia force (IF) of blood flowing out of left ventricle (LV) during late-systole produces greater LV elastic recoil force and brings faster LV relaxation. Vector flow mapping (VFM TM , Hitachi-Aloka) enables us to see blood flow velocity vectors that are generated from conventional color Doppler imaging data at any phase of cardiac cycle without angle dependency. Using VFM, kinetic energy (KE) of ejecting blood flow during systole at the LV outflow tract (LVOT) can be obtained. Thus, we investigated whether the KE obtained at the LVOT during late systole (KE-ls) had any relations with the IF and invasively obtained LV function parameters. Method: Study subjects were 33 patients who underwent diagnostic cardiac catheterization and echocardiographic examination on the same day. Color Doppler images were acquired in the apical 3-chamber view. The frame rate ranged was from 40 to 51 frames per minute. Data analyses were performed offline using the commercially available software (DAS-RS1 TM, Hitachi-Aloka). A data sampling area was set at the level just below the aortic valve in the LVOT. The KE-ls was computed as the sum of KE values computed in frame by frame basis during late-systole; late-systole was defined as the latter one-third of ejecting time. LV pressure wave was obtained using a catheter-tipped micromanometer, and then, the first derivative of LV pressure (dP/dt) and a time constant τ of LV pressure decay during isovolumic relaxation were calculated. From LV pressure-dP/dt relationships (phase loop), the IF was determined. Results: A significant positive correlation was observed between the KE-ls and the IF (r=0.79, p<0.0001). The log transformed KE-ls had significant correlations with both peak negative dP/dt (r=0.53, p<0.01) and the time constant τ (r=-0.67, p<0.0001). Conclusion: VFM is a new useful technique to see blood flow in the LV chamber. Noninvasively obtained KE-ls using VFM, which may be a noninvasive surrogate for the IF, has significant correlations with the parameters of LV relaxation.

P3365Relationship between early diastolic intra-ventricular pressure gradient shortly after aortic valve closure estimated by vector flow mapping and left ventricular diastolic untwisting rate in humans

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Hozumi ◽  
Y Nozawa ◽  
K Takemoto ◽  
T Nishi ◽  
T Wada ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Color Doppler ◽  
Left Ventricular ◽  
Valve Closure ◽  
Flow Mapping ◽  
Vector Flow Mapping ◽  
Diastolic Velocity ◽  
Aortic Valve Closure

Abstract Background Early diastolic suction is an important determinant of early diastolic function. Previous studies using color Doppler M-mode and speckle-tracking echocardiography have shown left ventricular (LV) early diastolic LV untwisting rate is directly related to LV intra-ventricular pressure gradient (IVPG) between LV base and apex during early diastole. Recent introduction of vector flow mapping (VFM) using combination of color Doppler and speckle-tracking echocardiography provides noninvasive and feasible assessment of early diastolic IVPG shortly after aortic valve closure including isovolmic relaxation period (ED-IVPG) in humans. However, relationship between VFM–derived ED-IVPG and early diastolic LV untwisting rate has not been well investigated. Purpose The purpose of this study was to examine relationship between ED-IVPG estimated by VFM and LV untwisting rate by speckle-tracking echocardiography. Methods The study population consists of 66 patients without segmental wall motion abnormality, significant valvular diseases, and atrial fibrillation who underwent echocardiography for evaluation of LV function (age: 60±15 years, LVEF: 49±16%). From the apical long-axis views by color Doppler echocardiography, we analyzed peak ED-IVPG between LV base and apex just after aortic valve closure (figure) using commercially available VFM analysis software (DAS-RS1, Hitachi). We assessed peak early diastolic LV untwisting rate and LV torsion from LV basal and apical short-axis view by speckle-tracking echocardiography. We evaluated correlation between ED-IVPG and LV untwisting rate. We also evaluated correlation between ED-IVPG and peak systolic LV torsion, LV end-diastolic (EDV) and end-systolic volumes (ESV), ejection fraction (EF), early diastolic velocity (E) of LV inflow, average early diastolic velocity (e') of mitral annulus, and average E/e'. Results In all the study patients, ED-IVPG was successfully and quickly evaluated. 1) ED-IVPG correlated well with peak LV untwisting rate (r=0.64, p<0.0001). 2) ED-IVPG significantly correlated with LV torsion, LVEDV, LVESV, and LVEF (r=0.47, r=−0.48, r=−0.46, and r=0.48, respectively, p<0.001). 3) There were no significant correlations between ED-IVPG and other indexes including E, average e', and average E/e'. According to receiver operating characteristic analysis, the best cut-off value of ED-IVPG for determining impaired LV untwisting rate (<80 degrees/s) was found at 0.42 mmHg (sensitivity 81%, specificity 76%, and area under the curve 0.86) ED-IVPG measurement by VFM Conclusions The present results showed that noninvasive VFM-derived peak ED-IVPG shortly after aortic valve closure is related to early diastolic peak LV untwisting rate. ED-IVPG easily and quickly estimated by VFM may be used as an additional index for LV diastolic function.

scholarly journals Left Ventricular Deformation and Vortex Analysis in Heart Failure: From Ultrasound Technique to Current Clinical Application

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 892
Author(s):  
Simona Sperlongano ◽  
Antonello D’Andrea ◽  
Donato Mele ◽  
Vincenzo Russo ◽  
Valeria Pergola ◽  
...  
Keyword(s):  
Heart Failure ◽  
Color Doppler ◽  
Left Ventricular ◽  
Response To Therapy ◽  
Cardiac Resynchronization ◽  
Flow Mapping ◽  
Ultrasound Technique ◽  
Left Ventricular Deformation ◽  
Cardiovascular Morbidity And Mortality ◽  
Therapeutic Decision Making

Heart failure (HF) is a leading cause of cardiovascular morbidity and mortality. However, its symptoms and signs are not specific or can be absent. In this context, transthoracic echocardiography plays a key role in diagnosing the various forms of HF, guiding therapeutic decision making and monitoring response to therapy. Over the last few decades, new ultrasound modalities have been introduced in the field of echocardiography, aiming at better understanding the morpho-functional abnormalities occurring in cardiovascular diseases. However, they are still struggling to enter daily and routine use. In our review article, we turn the spotlight on some of the newest ultrasound technologies; in particular, analysis of myocardial deformation by speckle tracking echocardiography, and intracardiac flow dynamics by color Doppler flow mapping, highlighting their promising applications to HF diagnosis and management. We also focus on the importance of these imaging modalities in the selection of responses to cardiac resynchronization therapy.

scholarly journals Relationship between left ventricular isovolumic relaxation flow patterns and mitral inflow patterns studied by using vector flow mapping

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Yu Han ◽  
Liang Huang ◽  
Zhiguo Li ◽  
Na Ma ◽  
Qiaozhen Li ◽  
...  
Keyword(s):  
Color Doppler ◽  
Left Ventricular ◽  
Flow Mapping ◽  
Mitral Inflow ◽  
Vector Flow Mapping ◽  
Significant Relationships ◽  
Large Vortex ◽  
Artery Disease ◽  
Bidirectional Flow ◽  
Isovolumic Relaxation

Abstract The purpose of this study was to investigate the relationship between isovolumic relaxation flow (IRF) patterns in left ventricle (LV) and mitral inflow patterns. Color Doppler loops were acquired for vector flow mapping in apical long-axis view in 57 patients with coronary artery disease, 31 patients with dilated cardiomyopathy, and 58 healthy controls. IRF patterns were classified into three categories: pattern A, apically directed flow; pattern B, bidirectional flow with small scattered vortices; and pattern C, a large vortex. All normals and patients with normal LV filling (n = 10) showed pattern A. Patients with impaired relaxation consisted of 31 (66%) patients having pattern A, 11 (23%) having pattern B, and 5 (11%) having pattern C. Patients with pseudonormal filling included 4 (31%) patients having pattern A, 7 (54%) having pattern B, and 2 (15%) having pattern C. In patients with restrictive filling, 14 (78%) showed pattern C, 4 (22%) showed pattern B, and no patient showed pattern A. IRF patterns were associated with LV filling patterns (χ2 = 52.026, p < 0.001). There are significant relationships between LV filling and IRF patterns. IRF patterns may provide an index for evaluation of LV diastolic function.

scholarly journals THE PROGNOSTIC IMPACT OF RELATIVE PRESSURE GRADIENT OBTAINED FROM VECTOR FLOW MAPPING IN HEART FAILURE PATIENTS

2020 ◽  
Vol 75 (11) ◽  
pp. 1669
Author(s):  
Yuko S. Soyama ◽  
Maria Karmpalioti ◽  
Peter Huntjens ◽  
Nobuyuki Kagiyama ◽  
Masataka Sugahara ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pressure Gradient ◽  
Prognostic Impact ◽  
Relative Pressure ◽  
Flow Mapping ◽  
Heart Failure Patients ◽  
Vector Flow Mapping

Dissociation between microneurographic and heart rate variability estimates of sympathetic tone in normal subjects and patients with heart failure

1999 ◽  
Vol 96 (6) ◽  
pp. 557-565 ◽  
Author(s):  
Catherine F. NOTARIUS ◽  
Gary C. BUTLER ◽  
Shin-ichi ANDO ◽  
Michael J. POLLARD ◽  
Beverley L. SENN ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Sympathetic Nerve ◽  
Sympathetic Nerve Activity ◽  
Low Frequency ◽  
Normal Subjects ◽  
Left Ventricular ◽  
Nerve Activity ◽  
Heart Failure Patients ◽  
Sympathetic Nervous

The concept that spectral analysis of heart rate variability (HRV) can estimate cardiac sympathetic nerve traffic in subjects with both normal and impaired left ventricular systolic function has not been validated against muscle sympathetic nerve activity (MSNA). We used coarse-graining spectral analysis to quantify the harmonic and non-harmonic, or fractal, components of HRV and to determine low-frequency (0.0–0.15 Hz; PL) and high-frequency (0.15–0.5 Hz; PH) harmonic power. To test the hypothesis that MSNA and HRV representations of sympathetic nerve activity (PL and PL/PH) increase in parallel in heart failure, we recorded heart rate and MSNA during supine rest in 35 patients (age 52.4±2 years; mean±S.E.M.), with a mean left ventricular ejection fraction of 22±2%, and in 34 age-matched normal subjects. Power density was log10 transformed. Mean MSNA was 52.9±2.6 bursts/min in heart failure patients and 34.9±1.9 bursts/min in normal subjects (P < 0.0001). In normal subjects, but not in heart failure patients, total power (PT) (r = -0.41; P = 0.02) and fractal power (PF) (r = -0.36; P = 0.04) were inversely related to age. In heart failure patients, total and fractal power were reduced (P < 0.009 for both), and were inversely related to MSNA burst frequency (r = -0.55, P = 0.001 and r = -0.60, P = 0.0003 respectively). In normal subjects, there was no relationship between MSNA and either PL or PH. In heart failure patients, as anticipated, PH was inversely related to MSNA (r = -0.41; P < 0.02). However, PL was also inversely rather than directly related to MSNA (r = 0.44 for 1/log10 PL; P < 0.01). There was no relationship between other sympathetic (PL/PH) or parasympathetic (PH/PT) indices and MSNA in either heart failure patients or normal subjects. The lack of concordance between these direct and indirect estimates of sympathetic nervous system activity indicates that this component of HRV cannot be used for between-subject comparisons of central sympathetic nervous outflow. It is the absence of low-frequency power that relates most closely to sympathetic activation in heart failure.

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