Skip to main content
SpringerLink
Log in

Role of intra-ventricular vortex in left ventricular ejection elucidated by echo-dynamography

  • Original Article—Cardiology
  • Published:
Journal of Medical Ultrasonics Aims and scope Submit manuscript

Abstract

Purpose

From the correlation between the blood flow dynamics and wall dynamics in the left ventriocle (LV) analyzed using echo-dynamography, the ejection mechanisms and role of the intra-ventricular vortex in the LV were elucidated in detail during the pre-ejection transitional period (pre-ETP), the very short period preceding LV ejection.

Methods

The study included 10 healthy volunteers. Flow structure was analyzed using echo-dynamography, and LV wall dynamics were measured using both high-frame-rate two-dimensional echocardiography and a phase difference tracking method we developed.

Results

A large accelerated vortex occurred at the central basal area of the LV during this period. The main flow axis velocity line of the LV showed a linearly increasing pattern. The slope of the velocity pattern reflected the deformity of the flow route induced by LV contraction during the pre-ETP. The centrifugal force of the vortex at its junction with the main outflow created a stepwise increase of about 50% of the ejection velocity.

Conclusion

Ejection of blood from the LV was accomplished by the extruding action of the ventricular wall and the centrifugal force of the accelerated vortex during this period. During ejection, acceralated outflow was considered to create a spiral flow in the aorta with help from the spherical structure of the Valsalva sinus.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Kilner PJ, Yang GZ, Mohiaddin RH, et al. Helical and retrograde secondary flow pattern in th aortic arch studied by three-directional magnetic resonance velocity mapping. Circulation. 1993;88:2235–47.

    Article  CAS  Google Scholar 

  2. Tanaka M, Sakamoto T, Sugawara S, et al. Spiral systolic blood flow in the ascending aorta and aortic arch analyzed by echo-dynamography. J Cardiol. 2010;56:97–110.

    Article  Google Scholar 

  3. Braunwald E, Sonnenblick EH, Ross J Jr. Contraction of the normal heart. In: Braunwald E, editor. Heart disease. 2nd ed. Philadelphia: WB Saunders Co.; 1984. p. 409–46.

    Google Scholar 

  4. Rushmer RF. Functional anatomy and control of the heart. In: Rushmer RF, editor. Cardiovascular dynamics. 4th ed. Philadelphia: WB Sounders Co.; 1976. p. 76–131.

    Google Scholar 

  5. Ishida N, Takishima T (1992) Cardiodynamics and its clinical application. In: Ishida N, Takishima T (eds) 2nd ed. Bunkodo Co., Tokyo. p 1–214.

  6. Arheden H, Stahlberg F (2013) Blood flow measurement. MRI and CT of the cardiovascular system. In: Higgins CB, Roos A., Lippincott, et al. (eds) 3rd edn. Philadelphia. p 75–92.

  7. Tanaka M, Miyatake K, Kanbe T, et al. (1988) Application of the ultrasonic Doppler method. In: Jpn. Soci. Ultras. Med. (eds) Diagnostic Ultrasound, principles and clinical applications. Igaku-Shoin Ltd., Tokyo. p 167–230.

  8. Tanaka M. Usefulness of ultrasonic imaging in the medical field. In: Shimizu H, Chubachi N, Kushibiki J, editors. Acoustical imaging. New York: Plenum Press; 1989. p. 453–66.

    Chapter  Google Scholar 

  9. Tanaka M (1998) Historical perspective of the development of echocardiography and medical ultrasound. In: Schneider SC, Levy M, McAvoy BR (eds) Proceedings of IEEE ultrasonics symposium. IEEE Inc, New York. p. 1517–24.

  10. Tanaka M, Sakamoto T, Sugawara S, et al. A new concept of the contraction-extension property of the left ventricular myocardium. J Cardiol. 2014;63:313–9.

    Article  Google Scholar 

  11. Tanaka M, Sakamoto T, Sugawara S, et al. Blood flow structure and dynamics, and ejection mechanism in the left ventricle: analyzing using echo-dynamography. J Cardiol. 2008;52:86–101.

    Article  Google Scholar 

  12. Tanaka M, Sakamoto T, Sugawara S, et al. Physiological basis and clinical significance of left ventricular suction using echo-dynamography. J Cardiol. 2011;58:232–44.

    Article  Google Scholar 

  13. Tanaka M, Sakamoto T, Katahira Y, et al. Non-uniform distribution of the contraction/extension (C-E) in the left ventricular myocardium related to the myocardial function. J Cardiol. 2014;64:401–8.

    Article  Google Scholar 

  14. Tanaka M, Sakamoto T, Sugawara S, et al. Deformability of the pulsating left ventricular wall: a new aspect elucidated by high resolution ultrasonic methods. J Cardiol. 2017;69:462–70.

    Article  Google Scholar 

  15. Ohtsuki S, Tanaka M, Okujima M. A method of flow vector mapping deduced Doppler data on scanned plane. In: Shimizu H, Chubachi N, Kushibiki J, editors. Acoustic imaging. New York: Plenum Press; 1989. p. 467–72.

    Chapter  Google Scholar 

  16. Ohtsuki S, Tanaka M. Flow function for streamlines representative of the flow on a plane in three-dimensional flow. J Visual Soc Jap. 1998;18:136–40.

    Google Scholar 

  17. Ohtsuki S, Tanaka M. Doppler pressure field deduced from the Doppler velocity field in an observation plane in a fluid. Ultrasound Med Biol. 2003;29:1431–8.

    Article  Google Scholar 

  18. Ohtsuki S, Tanaka M. The flow velocity distribution from the Doppler information on a plane in three dimensional flow. J Vis. 2006;9:69–82.

    Article  Google Scholar 

  19. Tanaka M, Nitta S, Yamamoto A, et al. Development and application of non-invasive method for the evaluation of cardiac function, Quantifying intracardiac blood flow. Asian Med J. 1994;37:283–6.

    Google Scholar 

  20. Tanaka M, Nitta S, Yamamoto A, et al. Development and application of non-invasive methods for the evaluation of cardiac function: measuring cardiac function. Asian Med J. 1994;37:397–400.

    Google Scholar 

  21. Tanaka M, Yamamoto A, Endo N, et al. (1992) Evaluation of the behavior of blood flow in heart chambers by means of stream line distribution method. In: Visualization Soc Jap editor. Atlas of visualization. Pergamon Press, Oxford. p. 205–219.

  22. Hino M. Introduction to fluid mechanics. In: Hino M, editor. Fluid dynamics. Tokyo: Asakura Book Co.; 2002. p. 28–362.

    Google Scholar 

  23. Tanaka M, Nitta S, Yamamoto A, et al. Development and application of non-invasive method for the evaluation of cardiac function, Visualization of pressure changes in heart chambers. Asian Med J. 1994;37:341–4.

    Google Scholar 

  24. Yoshiara H, Hasegawa H, Kanai H, et al. Ultrasonic imaging of propagation of contraction and relaxation in heart walls at high temporal resolution. Jpn J Appl Phys. 2007;46:4889–96.

    Article  CAS  Google Scholar 

  25. Tanaka M, Kanai H, Sato M, et al. Measurement of the moving speed of local myocardial tissue by using the phase difference tracking method and its clinical significance. J Cardiol. 1996;28:163.

    Google Scholar 

  26. Kanai H, Hasegawa H, Chubachi N, et al. Noninvasive evaluation of local myocardial thickening and its color-coded imaging. IEEE Trans Ultrason Feroelect Freq Contr. 1997;44:752–68.

    Article  Google Scholar 

  27. Kanai H, Hasegawa H, Chubachi N, et al. Non-invasive evaluation of spatial distribution of local instantaneous strain energy in heart wall. In: Lees S, Ferrari LA, editors. Acoustic imaging. New York: Plenum Press; 1997. p. 187–92.

    Chapter  Google Scholar 

  28. Tanaka M. Ultrasonic diagnosis of the heart. Tokyo: Medical Electro Times Ltd; 1978. p. 118–28.

    Google Scholar 

  29. Ueda H, Kaito G, Sakamoto T. Clinical Phonocardiography-Auscultation of the Heart and Phonocardiography. Tokyo: Medical Electro Times Ltd; 1978. p. s100–s239.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiovascular Medicine, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8512, Japan

    Motonao Tanaka, Hiroyuki Nakajima & Takafumi Kurokawa

  2. Hanzomon Hospital, 1-14 Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan

    Tsuguya Sakamoto

  3. Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan

    Yoshifumi Saijo

  4. Katta General Hospital, 36 Shimoharaoki, Kuramoto, Fukuoka, Shiroishi, Miyagi, 989-0231, Japan

    Yoshiaki Katahira

  5. Nihonkai General Hospital, 30 Akiho-machi, Sakata, Yamagata, 998-8501, Japan

    Shigeo Sugawara

  6. Department of Electronic Engineering, Tohoku University, 6-6-05 Aramaki Aza Aoba, Aoba-ku, Sendai, Miyagi, 980-8579, Japan

    Hiroshi Kanai

Authors
  1. Motonao Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tsuguya Sakamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yoshifumi Saijo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yoshiaki Katahira
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shigeo Sugawara
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hiroyuki Nakajima
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Takafumi Kurokawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hiroshi Kanai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Motonao Tanaka.

Ethics declarations

Conflict of interest

There are no financial or other relations that could lead to a conflict of interest.

Ethical aprroval

All procedures followed were in accordance with the standards of the Ethics Committee for Human Research (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tanaka, M., Sakamoto, T., Saijo, Y. et al. Role of intra-ventricular vortex in left ventricular ejection elucidated by echo-dynamography. J Med Ultrasonics 46, 413–423 (2019). https://doi.org/10.1007/s10396-019-00943-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10396-019-00943-5

Keywords

Search

Navigation