Prolonged vortex formation during the ejection period in the left ventricle with low ejection fraction: a study by vector flow mapping.
OBJECTIVE
Vortex formation in the left ventricle (LV) can be visualized by novel vector flow mapping (VFM) based on color Doppler and speckle tracking data. The aim of this study was to evaluate the impact of a vortex during the ejection period using VFM.


METHODS
Color Doppler images were obtained to produce VFM images in 80 subjects (20 normal, 29 with dilated cardiomyopathy, and 31 with old myocardial infarction). The duration of the LV vortex was measured and expressed as the ratio to the ejection time (VTRe).


RESULTS
The VTRe showed significant correlations with EDV (ρ = 0.672, p < 0.001), ESV (ρ = 0.772, p < 0.001), EF (ρ = -0.783, p < 0.001), left atrium diameter (LAd) (ρ = 0.302, p = 0.007), stroke volume (ρ = -0.600, p < 0.001), e' (ρ = -0.389, p < 0.001), a' (ρ = -0.314, p = 0.005), s' (ρ = -0.512, p < 0.001), and E/e' (ρ = 0.330, p = 0.003). The diastolic parameters (e', a', E/e', LAd) were not correlated when they were adjusted by EF.


CONCLUSIONS
In the normal LV, a vortex existed for only a limited time during the early ejection period. In contrast, the lower the EF was, the longer the vortex remained during systole. Evaluation of vortices by VFM may noninvasively provide novel insights into the pathophysiology of impaired cardiac function.
Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan. fukuda75@gmail.com.
Nobuaki
N
Fukuda
Department of Hemodynamic Analysis, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
Keiichi
K
Itatani
Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan.
Koichi
K
Kimura
Department of Clinical Laboratory, The Cancer Institute Hospital of JFCR, Tokyo, Japan.
Aya
A
Ebihara
Menzies Research Institute Tasmania, Hobart, TAS, Australia.
Kazuaki
K
Negishi
Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo, Japan.
Kansei
K
Uno
Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
Kagami
K
Miyaji
Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Masahiko
M
Kurabayashi
Department of Cardiovascular Medicine, Nihon University of Medicine, Itabashi Hospital, Tokyo, Japan.
Katsu
K
Takenaka
D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging / Q000503:physiopathology; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology; D013318:Stroke Volume; D016277:Ventricular Function, Left
Color Doppler; Impaired cardiac function; Speckle tracking; VFM (vector flow mapping); Vortex