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Related Concept Videos

Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

23
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
23

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Fragmented Vortex in Heart Failure With Reduced Ejection Fraction: A Prospective Vector Flow Mapping Study.

Jeffrey Shi Kai Chan1, Dawnie Ho Hei Lau1, Yiting Fan2

  • 1Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China; Laboratory of Cardiac Imaging and 3D Printing, Li Ka Shing Institute of Health Sciences, Hong Kong, China.

Ultrasound in Medicine & Biology
|December 29, 2022
PubMed
Summary

Patients with heart failure with reduced ejection fraction (HFrEF) exhibit more fragmented intracardiac vortices and reduced energy efficiency, particularly during diastole. This novel finding was revealed using echocardiographic vector flow mapping technology.

Keywords:
EchocardiographyFlow imagingHeart failureVector flow mappingVortex

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Area of Science:

  • Cardiovascular Imaging
  • Hemodynamics
  • Cardiac Physiology

Background:

  • Heart failure with reduced ejection fraction (HFrEF) is characterized by significant structural and functional alterations in the left ventricle.
  • Intracardiac flow dynamics, specifically vortex formation and behavior, are increasingly recognized as important indicators of cardiac health.

Purpose of the Study:

  • To compare intracardiac vortex characteristics between patients with HFrEF and healthy individuals.
  • To investigate the utility of echocardiographic vector flow mapping in assessing intracardiac hemodynamics in HFrEF.

Main Methods:

  • Transthoracic echocardiography with vector flow mapping was performed on 20 HFrEF patients and 20 healthy controls.
  • Key parameters analyzed included vortex area, circulation, energy loss, vortex position, and maximal number of vortices (MNV) during systole and diastole.

Main Results:

  • HFrEF patients demonstrated smaller, more fragmented intracardiac vortices (higher MNV) compared to controls (p < 0.0001).
  • Diastolic energy loss was significantly higher in HFrEF patients (p = 0.001).
  • Apical displacement of diastolic vortices (E-vortex, A-vortex) and reduced systolic vortex strength (S-vortex) were observed in HFrEF.

Conclusions:

  • Patients with HFrEF exhibit significantly altered intracardiac vortex patterns, characterized by increased fragmentation and reduced energy efficiency, primarily during diastole.
  • Vector flow mapping is a valuable tool for quantifying these hemodynamic disturbances in HFrEF.