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Left ventricular energy loss and wall shear stress assessed by vector flow mapping in patients with hypertrophic

Ling Ji1, Wenzhi Hu2, Yonghong Yong1

  • 1Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

The International Journal of Cardiovascular Imaging
|April 8, 2018
PubMed

Insights

Vector Flow Mapping (VFM) reveals altered energy loss and wall shear stress in hypertrophic cardiomyopathy (HCM) patients. These novel hemodynamic parameters effectively assess systolic and diastolic function in HCM.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Imaging

Background:

  • Hypertrophic cardiomyopathy (HCM) is a complex genetic heart disease.
  • Assessing hemodynamic function in HCM is crucial for diagnosis and management.
  • Conventional echocardiography has limitations in fully characterizing HCM hemodynamics.

Purpose of the Study:

  • To evaluate left ventricular (LV) energy loss summation (EL-SUM), average energy loss (EL-AVE), and wall shear stress (WSS) using Vector Flow Mapping (VFM) in HCM patients.
  • To compare these novel hemodynamic parameters between HCM patients and healthy controls.
  • To determine the utility of VFM-derived parameters in assessing systolic and diastolic function in HCM.

Main Methods:

  • Transthoracic echocardiography with VFM was performed on 40 HCM patients and 40 controls.
  • Calculation of EL-SUM, EL-AVE, and WSS in different LV segments and cardiac phases.
  • Comparison of VFM-derived parameters and conventional diastolic measurements between groups.

Main Results:

  • HCM patients exhibited impaired conventional diastolic measurements compared to controls.
  • HCM patients showed increased total EL-SUM and EL-AVE during LV rapid ejection and decreased values at end-early diastole.
  • HCM patients displayed altered WSS patterns, with increases during peak ejection and atrial contraction, and decreases at end-early diastole.

Conclusions:

  • VFM-derived EL and WSS are novel hemodynamic parameters for evaluating HCM.
  • These parameters effectively differentiate HCM patients from controls.
  • VFM offers a valuable tool for assessing systolic and diastolic hemodynamic function in HCM.

Keywords:
EchocardiographyEnergy lossHypertrophic cardiomyopathyLeft ventricularVector flow mappingWall shear stress

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