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Published in: BMC Cardiovascular Disorders 1/2017

Open Access 01-12-2017 | Research article

Vector flow mapping analysis of left ventricular energetic performance in healthy adult volunteers

Authors: Koichi Akiyama, Sachiko Maeda, Tasuku Matsuyama, Atsushi Kainuma, Maki Ishii, Yoshifumi Naito, Mao Kinoshita, Saeko Hamaoka, Hideya Kato, Yasufumi Nakajima, Naotoshi Nakamura, Keiichi Itatani, Teiji Sawa

Published in: BMC Cardiovascular Disorders | Issue 1/2017

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Abstract

Background

Vector flow mapping, a novel flow visualization echocardiographic technology, is increasing in popularity. Energy loss reference values for children have been established using vector flow mapping, but those for adults have not yet been provided. We aimed to establish reference values in healthy adults for energy loss, kinetic energy in the left ventricular outflow tract, and the energetic performance index (defined as the ratio of kinetic energy to energy loss over one cardiac cycle).

Methods

Transthoracic echocardiography was performed in fifty healthy volunteers, and the stored images were analyzed to calculate energy loss, kinetic energy, and energetic performance index and obtain ranges of reference values for these.

Results

Mean energy loss over one cardiac cycle ranged from 10.1 to 59.1 mW/m (mean ± SD, 27.53 ± 13.46 mW/m), with a reference range of 10.32 ~ 58.63 mW/m. Mean systolic energy loss ranged from 8.5 to 80.1 (23.52 ± 14.53) mW/m, with a reference range of 8.86 ~ 77.30 mW/m. Mean diastolic energy loss ranged from 7.9 to 86 (30.41 ± 16.93) mW/m, with a reference range of 8.31 ~ 80.36 mW/m. Mean kinetic energy in the left ventricular outflow tract over one cardiac cycle ranged from 200 to 851.6 (449.74 ± 177.51) mW/m with a reference range of 203.16 ~ 833.15 mW/m. The energetic performance index ranged from 5.3 to 37.6 (18.48 ± 7.74), with a reference range of 5.80 ~ 36.67.

Conclusions

Energy loss, kinetic energy, and energetic performance index reference values were defined using vector flow mapping. These reference values enable the assessment of various cardiac conditions in any clinical situation.
Literature
1.
go back to reference Kilner PJ, Yang GZ, Wilkes AJ, Mohiaddin RH, Firmin DN, Yacoub MH. Asymmetric redirection of flow through the heart. Nature. 2000;404:759–61.CrossRefPubMed Kilner PJ, Yang GZ, Wilkes AJ, Mohiaddin RH, Firmin DN, Yacoub MH. Asymmetric redirection of flow through the heart. Nature. 2000;404:759–61.CrossRefPubMed
2.
go back to reference Rodriguez Munoz D, Moya Mur JL, Fernandez-Golfin C, Becker Filho DC, Gonzalez Gomez A, Fernandez Santos S, et al. Left ventricular vortices as observed by vector flow mapping: main determinants and their relation to left ventricular filling. Echocardiogr. 2015;32:96–105.CrossRef Rodriguez Munoz D, Moya Mur JL, Fernandez-Golfin C, Becker Filho DC, Gonzalez Gomez A, Fernandez Santos S, et al. Left ventricular vortices as observed by vector flow mapping: main determinants and their relation to left ventricular filling. Echocardiogr. 2015;32:96–105.CrossRef
3.
go back to reference Kilner PJ, Henein MY, Gibson DG. Our tortuous heart in dynamic mode--an echocardiographic study of mitral flow and movement in exercising subjects. Heart Vessels. 1997;12:103–10.CrossRefPubMed Kilner PJ, Henein MY, Gibson DG. Our tortuous heart in dynamic mode--an echocardiographic study of mitral flow and movement in exercising subjects. Heart Vessels. 1997;12:103–10.CrossRefPubMed
4.
go back to reference Sengupta PP, Khandheria BK, Korinek J, Jahangir A, Yoshifuku S, Milosevic I, et al. 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. 2007;49:899–908.CrossRefPubMed Sengupta PP, Khandheria BK, Korinek J, Jahangir A, Yoshifuku S, Milosevic I, et al. 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. 2007;49:899–908.CrossRefPubMed
5.
go back to reference Hong GR, Pedrizzetti G, Tonti G, Li P, Wei Z, Kim JK, et al. Characterization and quantification of vortex flow in the human left ventricle by contrast echocardiography using vector particle image velocimetry. JACC Cardiovasc Imaging. 2008;1:705–17.CrossRefPubMedPubMedCentral Hong GR, Pedrizzetti G, Tonti G, Li P, Wei Z, Kim JK, et al. Characterization and quantification of vortex flow in the human left ventricle by contrast echocardiography using vector particle image velocimetry. JACC Cardiovasc Imaging. 2008;1:705–17.CrossRefPubMedPubMedCentral
6.
go back to reference Charonko JJ, Kumar R, Stewart K, Little WC, Vlachos PP. Vortices formed on the mitral valve tips aid normal left ventricular filling. Ann Biomed Eng. 2013;41:1049–61.CrossRefPubMedPubMedCentral Charonko JJ, Kumar R, Stewart K, Little WC, Vlachos PP. Vortices formed on the mitral valve tips aid normal left ventricular filling. Ann Biomed Eng. 2013;41:1049–61.CrossRefPubMedPubMedCentral
7.
go back to reference Martinez-Legazpi P, Bermejo J, Benito Y, Yotti R, Perez Del Villar C, Gonzalez-Mansilla A, et al. Contribution of the diastolic vortex ring to left ventricular filling. J Am Coll Cardiol. 2014;64:1711–21.CrossRefPubMed Martinez-Legazpi P, Bermejo J, Benito Y, Yotti R, Perez Del Villar C, Gonzalez-Mansilla A, et al. Contribution of the diastolic vortex ring to left ventricular filling. J Am Coll Cardiol. 2014;64:1711–21.CrossRefPubMed
8.
go back to reference Agati L, Cimino S, Tonti G, Cicogna F, Petronilli V, De Luca L, et al. Quantitative analysis of intraventricular blood flow dynamics by echocardiographic particle image velocimetry in patients with acute myocardial infarction at different stages of left ventricular dysfunction. Eur Heart J Cardiovasc Imaging. 2014;15:1203–12.CrossRefPubMed Agati L, Cimino S, Tonti G, Cicogna F, Petronilli V, De Luca L, et al. Quantitative analysis of intraventricular blood flow dynamics by echocardiographic particle image velocimetry in patients with acute myocardial infarction at different stages of left ventricular dysfunction. Eur Heart J Cardiovasc Imaging. 2014;15:1203–12.CrossRefPubMed
9.
go back to reference Stugaard M, Koriyama H, Katsuki K, Masuda K, Asanuma T, Takeda Y, et al. 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. 2015;16:723–30.CrossRefPubMed Stugaard M, Koriyama H, Katsuki K, Masuda K, Asanuma T, Takeda Y, et al. 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. 2015;16:723–30.CrossRefPubMed
10.
go back to reference Bahlmann E, Gerdts E, Cramariuc D, Gohlke-Baerwolf C, Nienaber CA, Wachtell K, et al. Prognostic value of energy loss index in asymptomatic aortic stenosis. Circulation. 2013;127:1149–56.CrossRefPubMed Bahlmann E, Gerdts E, Cramariuc D, Gohlke-Baerwolf C, Nienaber CA, Wachtell K, et al. Prognostic value of energy loss index in asymptomatic aortic stenosis. Circulation. 2013;127:1149–56.CrossRefPubMed
11.
go back to reference Pedrizzetti G, La Canna G, Alfieri O, Tonti G. The vortex--an early predictor of cardiovascular outcome? Nat Rev Cardiol. 2014;11:545–53.CrossRefPubMed Pedrizzetti G, La Canna G, Alfieri O, Tonti G. The vortex--an early predictor of cardiovascular outcome? Nat Rev Cardiol. 2014;11:545–53.CrossRefPubMed
12.
go back to reference Honda T, Itatani K, Takanashi M, Mineo E, Kitagawa A, Ando H, et al. Quantitative evaluation of hemodynamics in the Fontan circulation: a cross-sectional study measuring energy loss in vivo. Pediatr Cardiol. 2014;35(2):361–7.CrossRefPubMed Honda T, Itatani K, Takanashi M, Mineo E, Kitagawa A, Ando H, et al. Quantitative evaluation of hemodynamics in the Fontan circulation: a cross-sectional study measuring energy loss in vivo. Pediatr Cardiol. 2014;35(2):361–7.CrossRefPubMed
13.
go back to reference Sengupta PP, Pedrizzetti G, Kilner PJ, Kheradvar A, Ebbers T, Tonti G, et al. Emerging trends in CV flow visualization. JACC Cardiovasc Imaging. 2012;5:305–16.CrossRefPubMed Sengupta PP, Pedrizzetti G, Kilner PJ, Kheradvar A, Ebbers T, Tonti G, et al. Emerging trends in CV flow visualization. JACC Cardiovasc Imaging. 2012;5:305–16.CrossRefPubMed
14.
go back to reference Rodriguez Munoz D, Markl M, Moya Mur JL, Barker A, Fernandez-Golfin C, Lancellotti P, et al. Intracardiac flow visualization: current status and future directions. Eur Heart J Cardiovasc Imaging. 2013;14:1029–38.CrossRefPubMedPubMedCentral Rodriguez Munoz D, Markl M, Moya Mur JL, Barker A, Fernandez-Golfin C, Lancellotti P, et al. Intracardiac flow visualization: current status and future directions. Eur Heart J Cardiovasc Imaging. 2013;14:1029–38.CrossRefPubMedPubMedCentral
15.
go back to reference Hong GR, Kim M, Pedrizzetti G, Vannan MA. Current clinical application of intracardiac flow analysis using echocardiography. J Cardiovasc Ultrasound. 2013;21:155–62.CrossRefPubMedPubMedCentral Hong GR, Kim M, Pedrizzetti G, Vannan MA. Current clinical application of intracardiac flow analysis using echocardiography. J Cardiovasc Ultrasound. 2013;21:155–62.CrossRefPubMedPubMedCentral
16.
go back to reference Garcia D, Del Alamo JC, Tanne D, Yotti R, Cortina C, Bertrand E, et al. Two-dimensional intraventricular flow mapping by digital processing conventional color-Doppler echocardiography images. IEEE Trans Med Imaging. 2010;29:1701–13.CrossRefPubMed Garcia D, Del Alamo JC, Tanne D, Yotti R, Cortina C, Bertrand E, et al. Two-dimensional intraventricular flow mapping by digital processing conventional color-Doppler echocardiography images. IEEE Trans Med Imaging. 2010;29:1701–13.CrossRefPubMed
17.
go back to reference Itatani K, Okada T, Uejima T, Tanaka T, Ono M, Miyaji K, et al. Intraventricular flow velocity vector visualization based on the continuity equation and measurements of vorticity and wall shear stress. Jpn J Appl Phys. 2013;52:07HF16.CrossRef Itatani K, Okada T, Uejima T, Tanaka T, Ono M, Miyaji K, et al. Intraventricular flow velocity vector visualization based on the continuity equation and measurements of vorticity and wall shear stress. Jpn J Appl Phys. 2013;52:07HF16.CrossRef
18.
go back to reference Hayashi T, Itatani K, Inuzuka R, Shimizu N, Shindo T, Hirata Y, et al. Dissipative energy loss within the left ventricle detected by vector flow mapping in children: Normal values and effects of age and heart rate. J Cardiol. 2015;66:403–10.CrossRefPubMed Hayashi T, Itatani K, Inuzuka R, Shimizu N, Shindo T, Hirata Y, et al. Dissipative energy loss within the left ventricle detected by vector flow mapping in children: Normal values and effects of age and heart rate. J Cardiol. 2015;66:403–10.CrossRefPubMed
19.
go back to reference Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28:1–39. e14.CrossRefPubMed Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28:1–39. e14.CrossRefPubMed
20.
go back to reference Faludi R, Szulik M, D’Hooge J, Herijgers P, Rademakers F, Pedrizzetti G, et al. Left ventricular flow patterns in healthy subjects and patients with prosthetic mitral valves: an in vivo study using echocardiographic particle image velocimetry. J Thorac Cardiovasc Surg. 2010;139:1501–10.CrossRefPubMed Faludi R, Szulik M, D’Hooge J, Herijgers P, Rademakers F, Pedrizzetti G, et al. Left ventricular flow patterns in healthy subjects and patients with prosthetic mitral valves: an in vivo study using echocardiographic particle image velocimetry. J Thorac Cardiovasc Surg. 2010;139:1501–10.CrossRefPubMed
21.
go back to reference Chen M, Jin JM, Zhang Y, Gao Y, Liu SL. Assessment of left ventricular diastolic dysfunction based on the intraventricular velocity difference by vector flow mapping. J Ultrasound Med. 2013;32:2063–71.CrossRefPubMed Chen M, Jin JM, Zhang Y, Gao Y, Liu SL. Assessment of left ventricular diastolic dysfunction based on the intraventricular velocity difference by vector flow mapping. J Ultrasound Med. 2013;32:2063–71.CrossRefPubMed
22.
go back to reference Rodriguez Munoz D, Lozano Granero C, Luis ZJ. Vector flow mapping in mitral valve disease: a novel method for the assessment of flow mechanics and their potential implications for mitral valve repair. Curr Cardiovasc Imaging Rep. 2015;8:41.CrossRef Rodriguez Munoz D, Lozano Granero C, Luis ZJ. Vector flow mapping in mitral valve disease: a novel method for the assessment of flow mechanics and their potential implications for mitral valve repair. Curr Cardiovasc Imaging Rep. 2015;8:41.CrossRef
23.
go back to reference Zhang H, Ren X, Song J, Cao X, Wang B, Liu Y, et al. Intraventricular Isovolumic Relaxation Flow Patterns Studied by Using Vector Flow Mapping. Echocardiogr. 2016;33:902–9.CrossRef Zhang H, Ren X, Song J, Cao X, Wang B, Liu Y, et al. Intraventricular Isovolumic Relaxation Flow Patterns Studied by Using Vector Flow Mapping. Echocardiogr. 2016;33:902–9.CrossRef
24.
go back to reference Bolger AF, Heiberg E, Karlsson M, Wigstrom L, Engvall J, Sigfridsson A, et al. Transit of blood flow through the human left ventricle mapped by cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2007;9:741–7.CrossRefPubMed Bolger AF, Heiberg E, Karlsson M, Wigstrom L, Engvall J, Sigfridsson A, et al. Transit of blood flow through the human left ventricle mapped by cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2007;9:741–7.CrossRefPubMed
25.
go back to reference Zhang H, Zhang J, Zhu X, Chen L, Liu L, Duan Y, et al. The left ventricular intracavitary vortex during the isovolumic contraction period as detected by vector flow mapping. Echocardiogr. 2012;29:579–87.CrossRef Zhang H, Zhang J, Zhu X, Chen L, Liu L, Duan Y, et al. The left ventricular intracavitary vortex during the isovolumic contraction period as detected by vector flow mapping. Echocardiogr. 2012;29:579–87.CrossRef
26.
go back to reference Zhang H, Liu L, Chen L, Ma N, Zhou L, Liu Y, et al. The evolution of intraventricular vortex during ejection studied by using vector flow mapping. Echocardiogr. 2013;30:27–36.CrossRef Zhang H, Liu L, Chen L, Ma N, Zhou L, Liu Y, et al. The evolution of intraventricular vortex during ejection studied by using vector flow mapping. Echocardiogr. 2013;30:27–36.CrossRef
27.
go back to reference Pedrizzetti G, Domenichini F. Nature optimizes the swirling flow in the human left ventricle. Phys Rev Lett. 2005;95:108101.CrossRefPubMed Pedrizzetti G, Domenichini F. Nature optimizes the swirling flow in the human left ventricle. Phys Rev Lett. 2005;95:108101.CrossRefPubMed
28.
go back to reference Pedrizzetti G, Domenichini F, Tonti G. On the left ventricular vortex reversal after mitral valve replacement. Ann Biomed Eng. 2010;38:769–73.CrossRefPubMed Pedrizzetti G, Domenichini F, Tonti G. On the left ventricular vortex reversal after mitral valve replacement. Ann Biomed Eng. 2010;38:769–73.CrossRefPubMed
29.
go back to reference Itatani K. When the blood flow becomes bright. Eur Heart J. 2014;35:747–752a.PubMed Itatani K. When the blood flow becomes bright. Eur Heart J. 2014;35:747–752a.PubMed
30.
go back to reference Rodriguez Munoz D, Moya Mur JL, Lozano Granero C, Fernandez-Golfin C, Zamorano Gomez JL. Flow collision in early aortic ejection: an additional source of kinetic energy loss in patients with mitral prosthetic valves. Eur Heart J Cardiovasc Imaging. 2015;16:608.CrossRefPubMed Rodriguez Munoz D, Moya Mur JL, Lozano Granero C, Fernandez-Golfin C, Zamorano Gomez JL. Flow collision in early aortic ejection: an additional source of kinetic energy loss in patients with mitral prosthetic valves. Eur Heart J Cardiovasc Imaging. 2015;16:608.CrossRefPubMed
31.
go back to reference Kakizaki R, Nabeta T, Ishii S, Koitabashi T, Itatani K, Inomata T, et al. Cardiac resynchronization therapy reduces left ventricular energy loss. Int J Cardiol. 2016;221:546–8.CrossRefPubMed Kakizaki R, Nabeta T, Ishii S, Koitabashi T, Itatani K, Inomata T, et al. Cardiac resynchronization therapy reduces left ventricular energy loss. Int J Cardiol. 2016;221:546–8.CrossRefPubMed
32.
go back to reference Ross Jr J, Miura T, Kambayashi M, Eising GP, Ryu KH. Adrenergic control of the force-frequency relation. Circulation. 1995;92:2327–32.CrossRefPubMed Ross Jr J, Miura T, Kambayashi M, Eising GP, Ryu KH. Adrenergic control of the force-frequency relation. Circulation. 1995;92:2327–32.CrossRefPubMed
33.
go back to reference Nogami Y, Ishizu T, Atsumi A, Yamamoto M, Kawamura R, Seo Y, et al. Abnormal early diastolic intraventricular flow ‘kinetic energy index’ assessed by vector flow mapping in patients with elevated filling pressure. Eur Heart J Cardiovasc Imaging. 2013;14:253–60.CrossRefPubMed Nogami Y, Ishizu T, Atsumi A, Yamamoto M, Kawamura R, Seo Y, et al. Abnormal early diastolic intraventricular flow ‘kinetic energy index’ assessed by vector flow mapping in patients with elevated filling pressure. Eur Heart J Cardiovasc Imaging. 2013;14:253–60.CrossRefPubMed
34.
go back to reference Jeong D, Anagnostopoulos PV, Roldan-Alzate A, Srinivasan S, Schiebler ML, Wieben O, et al. Ventricular kinetic energy may provide a novel noninvasive way to assess ventricular performance in patients with repaired tetralogy of Fallot. J Thorac Cardiovasc Surg. 2015;149:1339–47.CrossRefPubMed Jeong D, Anagnostopoulos PV, Roldan-Alzate A, Srinivasan S, Schiebler ML, Wieben O, et al. Ventricular kinetic energy may provide a novel noninvasive way to assess ventricular performance in patients with repaired tetralogy of Fallot. J Thorac Cardiovasc Surg. 2015;149:1339–47.CrossRefPubMed
35.
go back to reference Enriquez-Sarano M, Avierinos JF, Messika-Zeitoun D, Detaint D, Capps M, Nkomo V, et al. Quantitative determinants of the outcome of asymptomatic mitral regurgitation. N Engl J Med. 2005;352:875–83.CrossRefPubMed Enriquez-Sarano M, Avierinos JF, Messika-Zeitoun D, Detaint D, Capps M, Nkomo V, et al. Quantitative determinants of the outcome of asymptomatic mitral regurgitation. N Engl J Med. 2005;352:875–83.CrossRefPubMed
36.
go back to reference Kang DH, Kim JH, Rim JH, Kim MJ, Yun SC, Song JM, et al. Comparison of early surgery versus conventional treatment in asymptomatic severe mitral regurgitation. Circulation. 2009;119:797–804.CrossRefPubMed Kang DH, Kim JH, Rim JH, Kim MJ, Yun SC, Song JM, et al. Comparison of early surgery versus conventional treatment in asymptomatic severe mitral regurgitation. Circulation. 2009;119:797–804.CrossRefPubMed
37.
go back to reference Suri RM, Aviernos JF, Dearani JA, Mahoney DW, Michelena HI, Schaff HV, et al. Management of less-than-severe mitral regurgitation: should guidelines recommend earlier surgical intervention? Eur J Cardiothorac Surg. 2011;40:496–502.PubMed Suri RM, Aviernos JF, Dearani JA, Mahoney DW, Michelena HI, Schaff HV, et al. Management of less-than-severe mitral regurgitation: should guidelines recommend earlier surgical intervention? Eur J Cardiothorac Surg. 2011;40:496–502.PubMed
38.
go back to reference Speir A, Henry LL, Hunt SL, Holmes SD, Ad N. Health-related quality of life following isolated aortic valve surgery: is earlier intervention better? J Heart Valve Dis. 2013;22:270–5.PubMed Speir A, Henry LL, Hunt SL, Holmes SD, Ad N. Health-related quality of life following isolated aortic valve surgery: is earlier intervention better? J Heart Valve Dis. 2013;22:270–5.PubMed
Metadata
Title
Vector flow mapping analysis of left ventricular energetic performance in healthy adult volunteers
Authors
Koichi Akiyama
Sachiko Maeda
Tasuku Matsuyama
Atsushi Kainuma
Maki Ishii
Yoshifumi Naito
Mao Kinoshita
Saeko Hamaoka
Hideya Kato
Yasufumi Nakajima
Naotoshi Nakamura
Keiichi Itatani
Teiji Sawa
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2017
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-016-0444-7

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