Left ventricular flow propagation velocity measurement: Is it cast in stone?
This study aims to investigate the measurement of left ventricular flow propagation velocity, Vp, using phase contrast magnetic resonance imaging and to assess the discrepancies resulting from inflow jet direction and individual left ventricular size. Three Vpmeasuring techniques, namely non-adaptive (NA), adaptive positions (AP) and adaptive vectors (AV) method, were suggested and compared. We performed the comparison on nine healthy volunteers and nine post-infarct patients at four measurement positions, respectively, at one-third, one-half, two-thirds and the conventional 4 cm distances from the mitral valve leaflet into the left ventricle. We found that the Vpmeasurement was affected by both the inflow jet direction and measurement positions. Both NA and AP methods overestimated Vp, especially in dilated left ventricles, while the AV method showed the strongest correlation with the isovolumic relaxation myocardial strain rate (r = 0.53, p < 0.05). Using the AV method, notable difference in mean Vpwas also observed between healthy volunteers and post-infarct patients at positions of: one-half (81 ± 31 vs. 58 ± 25 cm/s), two-thirds (89 ± 32 vs. 45 ± 15 cm/s) and 4 cm (98 ± 23 vs. 47 ± 13 cm/s) distances. The use of AV method and measurement position at one-half distance was found to be the most suitable method for assessing diastolic dysfunction given varying left ventricular sizes and inflow jet directions.
Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia.
Bee Ting
http://orcid.org/0000-0002-6625-1430
BT
Chan
Department of Chemical Engineering, Faculty of Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia.|Seri Kembangan Engineering Sdn. Bhd., 61-1, Jalan Anggerik Vanilla T, Kota Kemuning, 40460, Shah Alam, Malaysia.
Hak Koon
HK
Yeoh
Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia.
Yih Miin
YM
Liew
Department of Biomedical Imaging, University Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
Yang Faridah Abdul
YFA
Aziz
Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
Ganiga Srinivasaiah
GS
Sridhar
Heart and Lung Institute, The Prince Charles Hospital, Chermside, QLD, 4032, Australia.|School of Medicine, University of Queensland, Brisbane, QLD, 4006, Australia.
Christian
C
Hamilton-Craig
School of Medicine, University of Queensland, Brisbane, QLD, 4006, Australia.|Department of Echocardiography, The Prince Charles Hospital, Chermside, QLD, 4032, Australia.
David
D
Platts
Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia. einly_lim@um.edu.my.
Einly
E
Lim
D001783:Blood Flow Velocity / Q000502:physiology*; D003971:Diastole / Q000502:physiology; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000502:physiology; D009200:Myocardial Contraction / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*
Diastolic dysfunction; Flow propagation velocity; LV relaxation; Magnetic resonance; V p