A clinical method for mapping and quantifying blood stasis in the left ventricle

Area of Science:

• Cardiovascular Imaging
• Biomedical Engineering
• Hemodynamics

Background:

• Intraventricular thrombosis risk necessitates balancing anticoagulation benefits against bleeding risks.
• Blood stasis in cardiac chambers is a known risk factor for thrombosis and embolism.
• Accurate assessment of intraventricular stasis is crucial for patient management.

Purpose of the Study:

• To develop and validate a novel flow image-based method for assessing intraventricular blood stasis.
• To quantify the location and extent of stasis regions within the left ventricle (LV).
• To establish subclinical markers for intraventricular thrombosis risk.

Main Methods:

• Digital processing of flow-velocity images from phase-contrast magnetic resonance (PCMR) and 2D color-Doppler velocimetry (echo-CDV).
• Quantification of blood Residence Time (TR) distribution from time-resolved velocity fields in the LV.
• Development of novel metrics integrating flow properties into scalars for risk assessment.

Main Results:

• The method successfully assessed in-vivo the location and extent of stasis regions in the LV.
• Illustrative examples included normal hearts, dilated cardiomyopathy patients, and LVAD patients.
• Developed metrics provide a basis for personalized thrombosis risk assessment.

Conclusions:

• Quantitative flow dynamics offer a new paradigm for identifying subclinical markers of intraventricular thrombosis risk.
• Early prediction of LV blood stasis can optimize anticoagulation therapy for stroke prevention.
• The method has potential implications for left ventricular assist device (LVAD) design and operation.