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Left ventricle diastolic vortex ring characterization in ischemic cardiomyopathy: insight into atrio-ventricular interplay.

Left ventricle diastolic vortex ring characterization in ischemic cardiomyopathy: insight into atrio-ventricular interplay.

Authors :
Riva A
Saitta S
Sturla F
Disabato G
Tondi L
Camporeale A
Giese D
Castelvecchio S
Menicanti L
Redaelli A
Lombardi M
Votta E
Source :
Medical & biological engineering & computing [Med Biol Eng Comput] 2024 Dec; Vol. 62 (12), pp. 3671-3685. Date of Electronic Publication: 2024 Jul 01.
Publication Year :
2024

Abstract

Diastolic vortex ring (VR) plays a key role in the blood-pumping function exerted by the left ventricle (LV), with altered VR structures being associated with LV dysfunction. Herein, we sought to characterize the VR diastolic alterations in ischemic cardiomyopathy (ICM) patients with systo-diastolic LV dysfunction, as compared to healthy controls, in order to provide a more comprehensive understanding of LV diastolic function. 4D Flow MRI data were acquired in ICM patients (n = 15) and healthy controls (n = 15). The λ <subscript>2</subscript> method was used to extract VRs during early and late diastolic filling. Geometrical VR features, e.g., circularity index (CI), orientation (α), and inclination with respect to the LV outflow tract (ß), were extracted. Kinetic energy (KE), rate of viscous energy loss ( EL ˙ ), vorticity (W), and volume (V) were computed for each VR; the ratios with the respective quantities computed for the entire LV were derived. At peak E-wave, the VR was less circular (p = 0.032), formed a smaller α with the LV long-axis (p = 0.003) and a greater ß (p = 0.002) in ICM patients as compared to controls. At peak A-wave, CI was significantly increased (p = 0.034), while α was significantly smaller (p = 0.016) and β was significantly increased (p = 0.036) in ICM as compared to controls. At both peak E-wave and peak A-wave, EL ˙ VR / EL ˙ LV , W <subscript>VR</subscript> /W <subscript>LV</subscript> , and V <subscript>VR</subscript> /V <subscript>LV</subscript> significantly decreased in ICM patients vs. healthy controls. KE <subscript>VR</subscript> /V <subscript>VR</subscript> showed a significant decrease in ICM patients with respect to controls at peak E-wave, while V <subscript>VR</subscript> remained comparable between normal and pathologic conditions. In the analyzed ICM patients, the diastolic VRs showed alterations in terms of geometry and energetics. These derangements might be attributed to both structural and functional alterations affecting the infarcted wall region and the remote myocardium.<br />Competing Interests: Declarations Ethics approval and consent to participate All participants provided written informed consent, and the study complies with the Helsinki Declaration. Consent for publication Not applicable. Competing interests Daniel Giese is an employee of Siemens Healthineers; all the other authors have no potential conflict of interest related to the contents of the manuscript.<br /> (© 2024. International Federation for Medical and Biological Engineering.)

Details

Language :
English
ISSN :
1741-0444
Volume :
62
Issue :
12
Database :
MEDLINE
Journal :
Medical & biological engineering & computing
Publication Type :
Academic Journal
Accession number :
38954265
Full Text :
https://doi.org/10.1007/s11517-024-03154-4