Left ventricular energy loss and wall shear stress assessed by vector flow mapping in patients with hypertrophic cardiomyopathy
- 29 Downloads
The aim of this study was to assess left ventricular (LV) summation of energy loss (EL-SUM), average energy loss (EL-AVE) and wall shear stress (WSS) using vector flow mapping (VFM) in patients with hypertrophic cardiomyopathy (HCM). Forty HCM patients, and 40 controls were evaluated by transthoracic echocardiography. Conventional echocardiographic parameters, summation and average of energy loss (EL-total, EL-base, EL-mid and EL-apex), and WSS in each segment were calculated at different phases. Compared with controls, conventional diastolic measurements were impaired in HCM patients. HCM patients also showed increased EL-SUM-total and EL-AVE-total at the peak of LV rapid ejection period as well as decreased EL-SUM-total and EL-AVE-total at the end of early diastole. In controls, EL-SUM and EL-AVE showed a gradual decrease from the basal segment to the apex, this regularity was not observed in HCM patients. Compared with controls, HCM patients showed increased WSS at the peak of the LV rapid ejection period and the atrial contraction period as well as decreased WSS at the end of early diastole (all p < 0.05). WSS was increased slightly at the peak of the LV rapid filling period in HCM patients (p = 0.055). EL and WSS values derived from VFM are novel flow dynamic parameters that can effectively evaluate systolic and diastolic hemodynamic function in HCM patients.
KeywordsHypertrophic cardiomyopathy Energy loss Wall shear stress Left ventricular Echocardiography Vector flow mapping
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interests.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.Authors/Task Force members, Elliott PM, Anastasakis A, Borger MA, Borggrefe M, Cecchi F, Charron P, Hagege AA, Lafont A, Limongelli G, Mahrholdt H, McKenna WJ, Mogensen J, Nihoyannopoulos P, Nistri S, Pieper PG, Pieske B, Rapezzi C, Rutten FH, Tillmanns C, Watkins H (2014) 2014 ESC guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J 35:2733–2779CrossRefGoogle Scholar
- 3.Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen SR, Rakowski H, Seidman CE, Towbin JA, Udelson JE, Yancy CW, American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines; American Association for Thoracic Surgery; American Society of Echocardiography; American Society of Nuclear Cardiology; Heart Failure Society of America; Heart Rhythm Society; Society for Cardiovascular Angiography and Interventions; Society of Thoracic Surgeons (2011) 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 124:2761–2796CrossRefPubMedGoogle Scholar
- 5.Urbano-Moral JA, Rowin EJ, Maron MS, Crean A, Pandian NG (2014) Investigation of global and regional myocardial mechanics with 3-dimensional speckle tracking echocardiography and relations to hypertrophy and fibrosis in hypertrophic cardiomyopathy. Circ Cardiovasc Imaging 7:11–19CrossRefPubMedGoogle Scholar
- 6.Wang Y, Hou D, Ma R, Ding G, Yin L, Zhang M (2016) Early detection of left atrial energy loss and mechanics abnormalities in diabetic patients with normal left atrial size: a study combining vector flow mapping and tissue tracking echocardiography. Med Sci Monit 22:958–968CrossRefPubMedPubMedCentralGoogle Scholar
- 9.Garcia D, Del Alamo JC, Tanne D, Yotti R, Cortina C, Bertrand E, Antoranz JC, Perez-David E, Rieu R, Fernandez-Aviles F, Bermejo J (2010) Two-dimensional intraventricular flow mapping by digital processing conventional color-Doppler echocardiography images. IEEE Trans Med Imaging 29:1701–1713CrossRefPubMedGoogle Scholar
- 11.Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 16:233–270CrossRefPubMedGoogle Scholar
- 15.Lu J, Li W, Zhong Y, Luo A, Xie S, Yin L (2012) Intuitive visualization and quantification of intraventricular convection in acute ischemic left ventricular failure during early diastole using color Doppler-based echocardiographic vector flow mapping. Int J Cardiovasc Imaging 28:1035–1047CrossRefPubMedGoogle Scholar
- 16.Rodriguez Munoz D, Moya Mur JL, Fernandez-Golfin C, Becker Filho DC, Gonzalez Gomez A, Fernandez Santos S, Lazaro Rivera C, Rincon Diaz LM, Casas Rojo E, Zamorano Gomez JL (2015) Left ventricular vortices as observed by vector flow mapping: main determinants and their relation to left ventricular filling. Echocardiography 32:96–105CrossRefPubMedGoogle Scholar
- 20.Akiyama K, Maeda S, Matsuyama T, Kainuma A, Ishii M, Naito Y, Kinoshita M, Hamaoka S, Kato H, Nakajima Y, Nakamura N, Itatani K, Sawa T (2017) Vector flow mapping analysis of left ventricular energetic performance in healthy adult volunteers. BMC Cardiovasc Disord 17: 21–30CrossRefPubMedPubMedCentralGoogle Scholar
- 22.Stugaard M, Koriyama H, Katsuki K, Masuda K, Asanuma T, Takeda Y, Sakata Y, Itatani K, Nakatani S (2015) Energy loss in the left ventricle obtained by vector flow mapping as a new quantitative measure of severity of aortic regurgitation: a combined experimental and clinical study. Eur Heart J Cardiovasc Imaging 16:723–730CrossRefPubMedGoogle Scholar
- 24.Sengupta PP, Khandheria BK, Korinek J, Jahangir A, Yoshifuku S, Milosevic I, Belohlavek M (2007) Left ventricular isovolumic flow sequence during sinus and paced rhythms: new insights from use of high-resolution Doppler and ultrasonic digital particle imaging velocimetry. J Am Coll Cardiol 49:899–908CrossRefPubMedGoogle Scholar