Usefulness of Left Ventricular Vortex Flow Analysis for Predicting Clinical Outcomes in Patients with Chronic Heart...

Area of Science:

• Cardiology
• Medical Imaging
• Fluid Dynamics

Background:

• Chronic heart failure with systolic dysfunction poses a significant risk for major adverse cardiac events (MACE).
• Accurate prediction of MACE is crucial for effective patient management and treatment strategies.
• Current predictive models may not fully capture the complex pathophysiology of heart failure.

Purpose of the Study:

• To evaluate if left ventricular vortex flow parameters, assessed via contrast echocardiography, enhance MACE prediction in patients with chronic heart failure and systolic dysfunction.
• To investigate the association between kinetic energy fluctuation (KEF) and the risk of MACE.
• To determine if KEF improves the predictive capability of existing clinical models.

Main Methods:

• Prospective enrollment of 75 patients with systolic dysfunction (ejection fraction ≤45%) undergoing contrast echocardiography.
• Vortex flow analysis using particle image velocimetry to quantify parameters like KEF.
• Follow-up for MACE, defined as cardiovascular hospital admission or cardiac death.

Main Results:

• 29 patients (38.7%) experienced MACE during a median follow-up of 277 days.
• Patients with MACE had higher diabetes incidence and E/e' ratio, and lower hemoglobin and ejection fraction.
• Significantly lower KEF was observed in patients with MACE.
• Higher KEF was independently associated with a lower risk of MACE (HR=0.18, p=0.046).

Conclusions:

• Quantitative left ventricular vortex flow parameter KEF, assessed by contrast echocardiography, is a valuable predictor of MACE in heart failure patients.
• KEF improves the discrimination of MACE risk when added to conventional clinical parameters.
• Elevated KEF is linked to a reduced risk of MACE and better functional status in this patient cohort.