title: 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.
abstract: OBJECTIVE
  Left ventricular (LV) diastolic filling is characterized by the formation of a vortex that supports an efficient transit into systolic ejection. Aim of this study was to assess the intraventricular (IV) blood flow dynamics among patients with ST elevated myocardial infarction (STEMI) at different degrees of LV dysfunction, in the attempt to find novel indicators of LV pump efficiency.
  
  
  RESULTS
  Sixty-four subjects, 34 consecutive STEMI patients and 30 healthy controls, underwent before hospital discharge 2D speckle tracking echocardiography to assess global longitudinal strain (GLS), and echo-particle image velocimetry analysis to assess flow energetic parameters. Left ventricular volumes ejection fraction (LVEF) and global wall motion score index (GWMSI) were evaluated by 3D echocardiography. ST elevated myocardial infarction patients were subdivided into three groups according to LVEF. Energy dissipation, vorticity fluctuation, and kinetic energy fluctuation indexes, which characterize the degree of disturbance in the flow, exhibit a biphasic behaviour in STEMI patients when compared with controls, with the highest values in patients with still preserved LV function and progressive lower values with LV function worsening. Significant linear correlations were found between energy dissipation index and both LVEF and GLS (r = 0.57, P < 0.001 and r = -0.61, P = 0.001, respectively). Kinetic energy fluctuation index significantly correlates with both LVEF (r = 0.75, P < 0.001) and GLS (-0.58, P = 0.002). Finally, a significant correlation was observed between GWMSI and energy dissipation index (-0.56, P = 0.008).
  
  
  CONCLUSIONS
  The present study describes, for the first time, the progression of IV flow energetic properties in patients with acute myocardial infarction at different stages of LV dysfunction when compared with healthy controls. Further data are needed to assess the role of these parameters in the development and maintenance of LV dysfunction.
authors.affiliation: Department of Cardiology, 'Sapienza' University, Viale del Policlinico 155, Roma 00161, Italy luciano.agati@uniroma1.it.
authors.forename: L
authors.initials: L
authors.lastname: Agati
authors.affiliation: Department of Cardiology, 'Sapienza' University, Viale del Policlinico 155, Roma 00161, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Cimino
authors.affiliation: SS. Annunziata Hospital, Sulmona, AQ, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Tonti
authors.affiliation: Department of Cardiology, 'Sapienza' University, Viale del Policlinico 155, Roma 00161, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Cicogna
authors.affiliation: Department of Cardiology, 'Sapienza' University, Viale del Policlinico 155, Roma 00161, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Petronilli
authors.affiliation: Department of Cardiology, 'Sapienza' University, Viale del Policlinico 155, Roma 00161, Italy.
authors.forename: L
authors.initials: L
authors.lastname: De Luca
authors.affiliation: Department of Cardiology, 'Sapienza' University, Viale del Policlinico 155, Roma 00161, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Iacoboni
authors.affiliation: Department of Engineering and Architecture, University of Trieste, Trieste, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Pedrizzetti
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology*; D016022:Case-Control Studies; D003287:Contrast Media; D004452:Echocardiography / Q000379:methods*; D019560:Echocardiography, Three-Dimensional; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*
chemical_list: D003287:Contrast Media
keywords: Acute myocardial infarction; Intraventricular flow