Quantitative analysis of intraventricular flow-energetics and vortex in ischaemic hearts

Chan BT 1 , Yeoh HK 2 , Liew YM 1 , Dokos S 3 , Al Abed A 3 , Chee KH 4 Show all authors , Abdul Aziz YF 5 , Sridhar GS 4 , Chinna K 6 , Lim E 1

Affiliations 

  • 1 Department of Biomedical Engineering
  • 2 Department of Chemical Engineering
  • 3 Graduate School of Biomedical Engineering, University of New South Wales, Sydney, New South Wales, Australia
  • 4 Department of Medicine
  • 5 Department of Biomedical Imaging, University Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 6 Department of Social and Preventive Medicine
Coron Artery Dis, 2018 06;29(4):316-324.
PMID: 29261521 DOI: 10.1097/MCA.0000000000000596

Abstract

OBJECTIVE: This study investigated the intraventricular flow dynamics in ischaemic heart disease patients.

PATIENTS AND METHODS: Fourteen patients with normal ejection fraction and 16 patients with reduced ejection fraction were compared with 20 healthy individuals. Phase-contrast MRI was used to assess intraventricular flow variables and speckle-tracking echocardiography to assess myocardial strain and left ventricular (LV) dyssynchrony. Infarct size was acquired using delayed-enhancement MRI.

RESULTS: The results obtained showed no significant differences in intraventricular flow variables between the healthy group and the patients with normal ejection fraction group, whereas considerable reductions in kinetic energy (KE) fluctuation index, E' (P<0.001) and vortex KE (P=0.003) were found in the patients with reduced ejection fraction group. In multivariate analysis, only vortex KE and infarct size were significantly related to LV ejection fraction (P<0.001); furthermore, vortex KE was correlated negatively with energy dissipation, energy dissipation index (r=-0.44, P=0.021).

CONCLUSION: This study highlights that flow energetic indices have limited applicability as early predictors of LV progressive dysfunction, whereas vortex KE could be an alternative to LV performance.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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