title: Left ventricular vortices as observed by vector flow mapping: main determinants and their relation to left ventricular filling.
abstract: BACKGROUND
  Swirling flow, organized in vortices, contributes to adequate left ventricular function. In this study, we apply a novel echocardiographic flow-mapping technique, vector flow mapping (VFM), to evaluate the main characteristics of left ventricular vortices and its relation to filling parameters.
  
  
  METHODS
  Forty-eight subjects underwent conventional transthoracic echocardiographic examination with additional intracardiac flow assessment with VFM using a Aloka Alpha-10 system and experimental VFM analysis software. To analyze vortex behavior, its rotation direction, duration, location inside the left ventricle, size, and intensity were assessed in apical long-axis view. Its relation to conventional left ventricular filling parameters was then analyzed.
  
  
  RESULTS
  Two vortex components were consistently identified following each transmitral filling wave. The anterior component of these visualized vortices was analyzed, due to its higher significance in the cardiac cycle, following early filling (V1) and atrial contraction (V2). Differences were observed in several aspects of vortex behavior between V1 and V2, particularly in patients with normal left ventricular filling parameters. These differences may be related to varying roles of vortices in different periods of the cardiac cycle.
  
  
  CONCLUSIONS
  Vector flow mapping allowed visualization and measurement of several parameters defining vortex behavior inside the cardiac cycle. The differences observed in these parameters between vortices in different phases of the cardiac cycle may be related to their role in optimizing cardiac function.
authors.affiliation: Department of Cardiology, Ramón y Cajal University Hospital, Madrid, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Rodríguez Muñoz
authors.forename: José Luis
authors.initials: JL
authors.lastname: Moya Mur
authors.forename: Covadonga
authors.initials: C
authors.lastname: Fernández-Golfín
authors.forename: Derly Carlos
authors.initials: DC
authors.lastname: Becker Filho
authors.forename: Ariana
authors.initials: A
authors.lastname: González Gómez
authors.forename: Sara
authors.initials: S
authors.lastname: Fernández Santos
authors.forename: Carla
authors.initials: C
authors.lastname: Lázaro Rivera
authors.forename: Luis Miguel
authors.initials: LM
authors.lastname: Rincón Díaz
authors.forename: Eduardo
authors.initials: E
authors.lastname: Casas Rojo
authors.forename: José Luis
authors.initials: JL
authors.lastname: Zamorano Gómez
mesh_terms: D001783:Blood Flow Velocity; D004311:Double-Blind Method; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012212:Rheology / Q000379:methods; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*
keywords: intracardiac flow; left ventricular vortex; vector flow mapping