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Intraventricular Isovolumic Relaxation Flow Patterns Studied by Using Vector Flow Mapping
Haibin Zhang1, Xiaofeng Ren1, Jin Song1
1Department of Ultrasound, PLA 210th Hospital, Dalian, China.
Insights
Isovolumic relaxation flow (IRF) patterns in the left ventricle (LV) correlate with LV dysfunction. A persistent large vortex during isovolumic relaxation indicates increasingly depressed LV function.
Area of Science:
- Cardiology
- Medical Imaging
- Fluid Dynamics
Background:
- Left ventricular (LV) dysfunction impacts cardiac performance.
- Characterizing flow dynamics during diastole is crucial for assessing LV function.
- Isovolumic relaxation flow (IRF) represents diastolic filling patterns.
Purpose of the Study:
- To characterize isovolumic relaxation flow (IRF) patterns in the left ventricle (LV).
- To correlate IRF patterns with the spectrum of LV dysfunction in patients.
Main Methods:
- Utilized Color Doppler flow imaging and Vector Flow Mapping.
- Analyzed Doppler data in 61 patients with coronary artery disease, 29 with dilated cardiomyopathy, and 41 healthy controls.
- Classified IRF patterns into three types: apical (A), bidirectional (B), and persistent vortex (C).
Main Results:
- Healthy controls exhibited pattern A (apically directed flow).
- Patients showed varied IRF patterns (A, B, C) significantly differing from controls in LV parameters (ejection fraction, size, wall motion, mitral annular velocities, E/e', atrial diameter).
- Higher wall-motion score index predicted IRF pattern; in severe dysfunction, elevated E/e' predicted persistent vortex (pattern C).
Conclusions:
- IRF patterns are significantly associated with LV function.
- A large intraventricular vortex persisting throughout isovolumic relaxation is indicative of increasingly depressed LV function.
Aims:
The purpose of this study was to characterize isovolumic relaxation flow (IRF) in the left ventricle (LV) in patients with a wide spectrum of LV dysfunction.
Methods:
Color Doppler flow imaging was performed in 61 patients with coronary artery disease, 29 patients with dilated cardiomyopathy, and 41 healthy controls. Vector flow mapping was used to analyze the Doppler data.
Results:
IRF patterns were divided into three types: pattern A, an apically directed flow; pattern B, a bidirectional flow with small scattered vortices; and pattern C, a large vortex persisting throughout the entire isovolumic relaxation (IVR) period. All controls demonstrated an IRF corresponding to pattern A. Of the 90 patients, 42 demonstrated IRF as pattern A, 26 as pattern B, and 22 as pattern C. There were significant differences among the subgroups of patients with different IRF patterns and the control group in LV-ejection fraction, size, wall-motion score index, apical wall-motion score index, systolic and diastolic mitral annular velocities, ratio of the mitral inflow E velocity to early diastolic mitral annular velocity (E/e'), and left atrial diameter (all P < 0.05). In the patient group, a higher wall-motion score index independently predicted the IRF pattern. In patients with severe LV dysfunction, a higher E/e' ratio was the independent predictor of the persistence of a large vortex during the IVR period.
Conclusions:
The IRF pattern is associated with LV function. A large intraventricular vortex persisting during the IVR period should be indicative of increasingly depressed LV function.
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