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Published on: December 22, 2023
Determinants of left ventricular vortex flow parameters assessed by contrast echocardiography in an in vivo animal
Dae-Hee Kim1, Jeong-Sook Seo, Yun-Sil Choi
1Cardiac Imaging Center, Asan Heart Institute Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Insights
Left ventricular (LV) vortex parameters, including geometric and pulsatility measures, show distinct associations with LV volume and hemodynamic function. Understanding these differences is crucial for accurate interpretation in cardiac diagnostics.
Area of Science:
- Cardiovascular Physiology
- Medical Imaging
- Biomedical Engineering
Background:
- Contrast echocardiography (CE) enables novel assessment of left ventricular (LV) vortex dynamics.
- Previous studies have introduced various LV vortex parameters.
- The determinants and hemodynamic associations of these parameters require further investigation.
Purpose of the Study:
- To investigate the determinants of LV vortex geometric and pulsatility parameters.
- To analyze the associations between these vortex parameters and conventional hemodynamic variables.
- To clarify the relationship between LV geometry and LV function indices.
Main Methods:
- Contrast echocardiography (CE) and simultaneous LV pressure measurement in mongrel dogs.
- Pharmacologic inotropic modulation to assess parameter changes.
- Customized software for analyzing geometric (vortex depth, length, width, sphericity index) and pulsatility (relative strength, vortex relative strength, vortex pulsation correlation) parameters.
Main Results:
- LV vortex length and sphericity index decreased with dobutamine infusion.
- All pulsatility parameters showed significant linear changes during inotropic modulation.
- LV end-diastolic volume determined geometric parameters, while dp/dtmax influenced pulsatility parameters.
Conclusions:
- LV vortex geometric and pulsatility parameters exhibit differential associations with LV geometry and function.
- These distinct relationships necessitate careful consideration during interpretation of CE-derived vortex analysis.
- The findings aid in understanding the physiological underpinnings of LV vortex dynamics.
Background:
Various left ventricular (LV) vortex parameters obtained during contrast echocardiography (CE) have been recently described. The aim of this study was to investigate their determinants and associations with conventional hemodynamic variables.
Methods:
CE was performed and LV pressure was simultaneously measured during pharmacologic inotropic modulation in 8 mongrel dogs. Customized software was used to assess both vortex geometric parameters (vortex depth [VD], length [VL], width [VW], transverse position, and sphericity index [SI]) and pulsatility parameters (relative strength [RS], vortex relative strength [VRS], and vortex pulsation correlation [VPC]). The associations between each of these parameters and conventional indices representing LV systolic and diastolic function were analyzed.
Results:
VD and VW did not change significantly during pharmacologic modulation, whereas VL (P = 0.0034) and SI (P = 0.001) showed significant and progressive linear decreases from baseline during dobutamine infusion. Significant linear changes during positive and negative inotropic modulation were observed in all pulsatiliy parameters (P < 0.01 each). Geometric parameters were critically dependent on LV volume, with pulsatility parameters showing significant positive correlations with heart rate, systolic and diastolic blood pressure (DBP), dp/dtmax , early and late mitral inflow velocities, and peak systolic and diastolic annular velocities. In multivariate analysis, LV end-diastolic volume was a main determinant for VL (r = 0.29, P < 0.001) and VW (r = 0.65, P < 0.001), whereas dp/dtmax for pulsatility parameters (RS [r = 0.61, P < 0.001], VRS [r = 0.46, P < 0.001] and VPC [r = 0.62, P < 0.001]).
Conclusion:
Geometric and pulsatility parameters differed in their association with LV geometry and conventional physiologic indices representing LV function. These differences should be considered in interpreting these variables.
