title: Vector flow mapping analysis of left ventricular energetic performance in healthy adult volunteers.
abstract: Vector flow mapping, a novel flow visualization echocardiographic technology, is increasing in popularity. Energy loss reference values for children have been established using vector flow mapping, but those for adults have not yet been provided. We aimed to establish reference values in healthy adults for energy loss, kinetic energy in the left ventricular outflow tract, and the energetic performance index (defined as the ratio of kinetic energy to energy loss over one cardiac cycle).
  
  
  
  Transthoracic echocardiography was performed in fifty healthy volunteers, and the stored images were analyzed to calculate energy loss, kinetic energy, and energetic performance index and obtain ranges of reference values for these.
  
  
  
  Mean energy loss over one cardiac cycle ranged from 10.1 to 59.1 mW/m (mean ± SD, 27.53 ± 13.46 mW/m), with a reference range of 10.32 ~ 58.63 mW/m. Mean systolic energy loss ranged from 8.5 to 80.1 (23.52 ± 14.53) mW/m, with a reference range of 8.86 ~ 77.30 mW/m. Mean diastolic energy loss ranged from 7.9 to 86 (30.41 ± 16.93) mW/m, with a reference range of 8.31 ~ 80.36 mW/m. Mean kinetic energy in the left ventricular outflow tract over one cardiac cycle ranged from 200 to 851.6 (449.74 ± 177.51) mW/m with a reference range of 203.16 ~ 833.15 mW/m. The energetic performance index ranged from 5.3 to 37.6 (18.48 ± 7.74), with a reference range of 5.80 ~ 36.67.
  
  
  
  Energy loss, kinetic energy, and energetic performance index reference values were defined using vector flow mapping. These reference values enable the assessment of various cardiac conditions in any clinical situation.
authors.affiliation: Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo, Kyoto, 602-8566, Japan. kanslik@koto.kpu-m.ac.jp.
authors.forename: Koichi
authors.identifier: 0000-0001-5113-9633
authors.initials: K
authors.lastname: Akiyama
authors.affiliation: Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo, Kyoto, 602-8566, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Maeda
authors.affiliation: Emergency Medicine, Kamigyo, Japan.
authors.forename: Tasuku
authors.initials: T
authors.lastname: Matsuyama
authors.affiliation: Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo, Kyoto, 602-8566, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kainuma
authors.affiliation: Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo, Kyoto, 602-8566, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Ishii
authors.affiliation: Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo, Kyoto, 602-8566, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Naito
authors.affiliation: Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo, Kyoto, 602-8566, Japan.
authors.forename: Mao
authors.initials: M
authors.lastname: Kinoshita
authors.affiliation: Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo, Kyoto, 602-8566, Japan.
authors.forename: Saeko
authors.initials: S
authors.lastname: Hamaoka
authors.affiliation: Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo, Kyoto, 602-8566, Japan.
authors.forename: Hideya
authors.initials: H
authors.lastname: Kato
authors.affiliation: Department of Anesthesiology, Kansai Medical University, Hirakata, Japan.
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Nakajima
authors.affiliation: Department of Statistical Genetics, Kyoto University, Kamigyo, Kyoto, Japan.
authors.forename: Naotoshi
authors.initials: N
authors.lastname: Nakamura
authors.affiliation: Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kamigyo, Kyoto, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Itatani
authors.affiliation: Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo, Kyoto, 602-8566, Japan.
authors.forename: Teiji
authors.initials: T
authors.lastname: Sawa
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D003326:Coronary Circulation; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D004735:Energy Transfer; D005260:Female; D064368:Healthy Volunteers; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D009200:Myocardial Contraction; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015588:Observer Variation; D011237:Predictive Value of Tests; D012016:Reference Values; D015203:Reproducibility of Results; D016277:Ventricular Function, Left; D055815:Young Adult
keywords: Energetic performance index; Energy loss; Kinetic energy; Vector flow mapping; Vortex