Prolonged vortex formation during the ejection period in the left ventricle with low ejection fraction: a study by vector flow mapping
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Vortex formation in the left ventricle (LV) can be visualized by novel vector flow mapping (VFM) based on color Doppler and speckle tracking data. The aim of this study was to evaluate the impact of a vortex during the ejection period using VFM.
Subjects and methods
Color Doppler images were obtained to produce VFM images in 80 subjects (20 normal, 29 with dilated cardiomyopathy, and 31 with old myocardial infarction). The duration of the LV vortex was measured and expressed as the ratio to the ejection time (VTRe).
The VTRe showed significant correlations with EDV (ρ = 0.672, p < 0.001), ESV (ρ = 0.772, p < 0.001), EF (ρ = −0.783, p < 0.001), left atrium diameter (LAd) (ρ = 0.302, p = 0.007), stroke volume (ρ = −0.600, p < 0.001), e′ (ρ = −0.389, p < 0.001), a′ (ρ = −0.314, p = 0.005), s′ (ρ = −0.512, p < 0.001), and E/e′ (ρ = 0.330, p = 0.003). The diastolic parameters (e′, a′, E/e′, LAd) were not correlated when they were adjusted by EF.
In the normal LV, a vortex existed for only a limited time during the early ejection period. In contrast, the lower the EF was, the longer the vortex remained during systole. Evaluation of vortices by VFM may noninvasively provide novel insights into the pathophysiology of impaired cardiac function.
KeywordsVortex VFM (vector flow mapping) Color Doppler Speckle tracking Impaired cardiac function
Conflict of interest
The authors declare no conflict of interest associated with this manuscript.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study.
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