title: Vortex ring behavior provides the epigenetic blueprint for the human heart.
abstract: The laws of fluid dynamics govern vortex ring formation and precede cardiac development by billions of years, suggesting that diastolic vortex ring formation is instrumental in defining the shape of the heart. Using novel and validated magnetic resonance imaging measurements, we show that the healthy left ventricle moves in tandem with the expanding vortex ring, indicating that cardiac form and function is epigenetically optimized to accommodate vortex ring formation for volume pumping. Healthy hearts demonstrate a strong coupling between vortex and cardiac volumes (R(2) = 0.83), but this optimized phenotype is lost in heart failure, suggesting restoration of normal vortex ring dynamics as a new, and possibly important consideration for individualized heart failure treatment. Vortex ring volume was unrelated to early rapid filling (E-wave) velocity in patients and controls. Characteristics of vortex-wall interaction provide unique physiologic and mechanistic information about cardiac diastolic function that may be applied to guide the design and implantation of prosthetic valves, and have potential clinical utility as therapeutic targets for tailored medicine or measures of cardiac health.
authors.affiliation: Lund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden.
authors.forename: Per M
authors.initials: PM
authors.lastname: Arvidsson
authors.affiliation: Cardiovascular Biophysics Laboratory, Cardiovascular Division, Washington University School of Medicine, Box 8086, 660 St Euclid Avenue, St. Louis, MO 63110 USA.
authors.forename: Sándor J
authors.initials: SJ
authors.lastname: Kovács
authors.affiliation: Lund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden.
authors.forename: Johannes
authors.initials: J
authors.lastname: Töger
authors.affiliation: Dept. of Cardiology, Arrhythmia Clinic, Lund University Hospital, Lund University, 22185 Lund, Sweden.
authors.forename: Rasmus
authors.initials: R
authors.lastname: Borgquist
authors.affiliation: Lund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden.|Dept. of Biomedical Engineering, Faculty of Engineering, Lund University, 221 85 Lund, Sweden.
authors.forename: Einar
authors.initials: E
authors.lastname: Heiberg
authors.affiliation: Lund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden.
authors.forename: Marcus
authors.initials: M
authors.lastname: Carlsson
authors.affiliation: Lund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden.
authors.forename: Håkan
authors.initials: H
authors.lastname: Arheden
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003971:Diastole; D005260:Female; D006352:Heart Ventricles / Q000033:anatomy & histology*; D006801:Humans; D057446:Hydrodynamics; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D009929:Organ Size; D016277:Ventricular Function, Left; D055815:Young Adult