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Prolonged vortex formation during the ejection period in the left ventricle with low ejection fraction: a study by vector flow mapping

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Abstract

Purpose

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.

Subjects and 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.

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Conflict of interest

The authors declare no conflict of interest associated with this manuscript.

Ethical considerations

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study.

Author information

Authors and Affiliations

  1. Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Nobuaki Fukuda & Masahiko Kurabayashi

  2. Department of Hemodynamic Analysis, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan

    Keiichi Itatani

  3. Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan

    Koichi Kimura

  4. Department of Clinical Laboratory, The Cancer Institute Hospital of JFCR, Tokyo, Japan

    Aya Ebihara

  5. Menzies Research Institute Tasmania, Hobart, TAS, Australia

    Kazuaki Negishi

  6. Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo, Japan

    Kansei Uno

  7. Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan

    Kagami Miyaji

  8. Department of Cardiovascular Medicine, Nihon University of Medicine, Itabashi Hospital, Tokyo, Japan

    Katsu Takenaka

Authors
  1. Nobuaki Fukuda
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  2. Keiichi Itatani
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  3. Koichi Kimura
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  4. Aya Ebihara
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  5. Kazuaki Negishi
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  6. Kansei Uno
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  7. Kagami Miyaji
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  8. Masahiko Kurabayashi
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  9. Katsu Takenaka
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Corresponding author

Correspondence to Nobuaki Fukuda.

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Fukuda, N., Itatani, K., Kimura, K. et al. Prolonged vortex formation during the ejection period in the left ventricle with low ejection fraction: a study by vector flow mapping. J Med Ultrasonics 41, 301–310 (2014). https://doi.org/10.1007/s10396-014-0530-3

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  • DOI: https://doi.org/10.1007/s10396-014-0530-3

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