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Background: Swirling flow, organized in vortices, contributes to adequate left ventricular function. In this study, we apply a novel echocardiographic flow-mapping technique, vector flow mapping (VFM), to evaluate the main characteristics of left ventricular vortices and its relation to filling parameters., Methods: Forty-eight subjects underwent conventional transthoracic echocardiographic examination with additional intracardiac flow assessment with VFM using a Aloka Alpha-10 system and experimental VFM analysis software. To analyze vortex behavior, its rotation direction, duration, location inside the left ventricle, size, and intensity were assessed in apical long-axis view. Its relation to conventional left ventricular filling parameters was then analyzed., Results: Two vortex components were consistently identified following each transmitral filling wave. The anterior component of these visualized vortices was analyzed, due to its higher significance in the cardiac cycle, following early filling (V1) and atrial contraction (V2). Differences were observed in several aspects of vortex behavior between V1 and V2, particularly in patients with normal left ventricular filling parameters. These differences may be related to varying roles of vortices in different periods of the cardiac cycle., Conclusions: Vector flow mapping allowed visualization and measurement of several parameters defining vortex behavior inside the cardiac cycle. The differences observed in these parameters between vortices in different phases of the cardiac cycle may be related to their role in optimizing cardiac function., (© 2014, Wiley Periodicals, Inc.)

We describe the use of vector flow mapping (VFM), a novel echocardiographic technique allowing intracardiac flow visualization, to quantify flow intensity inside a left ventricular aneurysm in a 68-year-old man. VFM successfully identified areas of stagnant flow corresponding to the wall region where a thrombus had been formed., (© 2013, Wiley Periodicals, Inc.)

Introduction: Left atrial (LA) size is an indicator of the pressure to which it is chronically subjected. Although guidelines recommend measuring it using volume indexed to body surface, the anteroposterior diameter is still normally used., Aim: To evaluate which of these measurements correlates better with atrial pressure-related echocardiographic parameters., Methods: Atrial diameter and volume, together with parameters of systolic function, diastolic function, pressure, and degree of mitral regurgitation, were measured in 121 consecutive outpatients., Results: Atrial diameter correlated with its indexed volume (r: 0.69) with a low degree of agreement for detecting dilation (Kappa: 0.51). Atrial diameter was related to the parameters associated with atrial pressure: E/E' (r: 0.44), pulmonary vein systolic/diastolic rates quotient (r: 0.25) and degree of mitral regurgitation (r: 0.19). The correlations improved when volume indexed to body surface was measured (r: 0.52; 0.38 and 0.44, respectively). In a multiple regression analysis that included E/E', pulmonary vein flow and degree of mitral regurgitation, LA diameter depended entirely on E/E' (r: 0.44; B: 0.04; P: 0.000). The relationship improved when the diameter was corrected for body surface or the volume was measured (r: 0.54 and 0.54, respectively), and in particular when volume indexed to body surface was measured (r: 0.66). In this case, pulmonary vein flow (B: 6.8; P: 0.03), degree of mitral regurgitation (B: 5.2; P: 0.000) and E/E' ratio (B: 0.8; P : 0.000) were included in the equation., Conclusions: Indexed atrial volume correlates better with LA pressure surrogates than the anteroposterior diameter, even when this is corrected for body surface., (© 2010, Wiley Periodicals, Inc.)