Characterization of the left atrial vortex flow by two-dimensional transesophageal contrast echocardiography using particle image velocimetry.
This article is the first clinical investigation of the quantitative left atrial (LA) vortex flow by two-dimensional (2-D) transesophageal contrast echocardiography (2-D-TECE) using vector particle image velocimetry (PIV). The aims of this study were to assess the feasibility of LA vortex flow analysis and to characterize and quantify the LA vortex flow in controls and in patients with atrial fibrillation (AF). Thirty-five controls and 30 patients with AF underwent transesophageal contrast echocardiography. The velocity vector was estimated by particle image velocimetry. The morphology and pulsatility of the LA vortex flow were compared between the control and AF groups. In all patients, quantitative LA vortex flow analysis was feasible. In the control group, multiple, pulsatile, compact and elliptical-shaped vortices were seen in the periphery of the LA. These vortices were persistently maintained and vectors were directed toward the atrioventricular inflow. In the AF group, a large, merged, lower pulsatile and round-shaped vortex was observed in the center of the LA. In comparisons of vortex parameters, the relative strength was significantly lower in the AF group (1.624 ± 0.501 vs. 2.105 ± 0.226, p < 0.001). It is feasible to characterize and quantify the LA vortex flow by transesophageal contrast echocardiography in patients with AF, which offers a new method to obtain additional information on LA hemodynamics. The approach has the potential for early detection of the LA dysfunction and in decisions regarding treatment strategy and guiding anticoagulation treatment in patients with AF.
Division of Cardiology, Yeungnam University, Daegu, Korea.
Kyu-Hwan
KH
Park
Jang-Won
JW
Son
Won-Jong
WJ
Park
Sang-Hee
SH
Lee
Ung
U
Kim
Jong-Seon
JS
Park
Dong-Gu
DG
Shin
Young-Jo
YJ
Kim
Jung-Hyun
JH
Choi
Helene
H
Houle
Mani A
MA
Vannan
Geu-Ru
GR
Hong
D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology; D016275:Atrial Function; D003287:Contrast Media; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D012212:Rheology
D003287:Contrast Media