Abstract
Analysis of the cardiac vortex has been used for a deeper understanding of the pathophysiology in heart diseases. However, physiological changes of the cardiac vortex with normal aging are incompletely defined. Vector flow mapping (VFM) is a novel echocardiographic technique based on Doppler and speckle tracking for analysis of the cardiac vortex. Transthoracic echocardiography and VFM analysis were performed in 100 healthy adults (33 men; age = 18–67 years). The intracardiac flow was assessed throughout the cardiac cycle. The size (cross-sectional area) and circulation (equivalent to the integral of normal component of vorticity) of the largest vortices in systole (S-vortex), early diastole (E-vortex), and late diastole (A-vortex) were measured. Peak energy loss (EL) was calculated from information of the velocity vector of intracardiac flow in systole and diastole. With normal aging, the circulation (p = 0.049) of the E-vortex decreased, while that of the A-vortex increased (both p < 0.001). E-vortex circulation correlated directly to e’ (p = 0.003), A-vortex circulation correlated directly to A and a’ (both p < 0.001), and S-vortex circulation correlated directly to s’ (p = 0.032). Despite changes in vortex patterns, energy loss was not significantly different in older individuals. Normal aging is associated with altered intracardiac vortex patterns throughout the cardiac cycle, with the late-diastolic A-vortex becoming physiologically more dominant. Maintained energy efficiency accompanies changes in vortex patterns in aging hearts.
Highlights
Vortices are rotational whirling bodies of fluid
Data that are directly descriptive of the intracardiac vortex can be generated, including the vortex area and vortex circulation—a summation of all flow velocity components in a vortex, thereby reflecting both the direction and intensity of a vortex
Given that intracardiac vortices facilitate left ventricular (LV) filling and redirect blood flow for LV ejection [5,6,7], vector flow mapping (VFM) may provide incremental information on LV function when compared to conventional methods [8]
Summary
Advances in imaging techniques including cardiac magnetic resonance, particle image velocimetry [1], and vector flow mapping (VFM) have enabled in vivo analysis of intracardiac vortices. VFM is an echocardiographic technique to visualize intracardiac blood flow by combining flow vector components acquired in color Doppler images and wall motion information obtained by speckle tracking. Such a combination of information from color flow Doppler and speckle tracking echocardiography overcomes the angle dependency inherent to traditional. Data that are directly descriptive of the intracardiac vortex can be generated, including the vortex area and vortex circulation—a summation of all flow velocity components in a vortex, thereby reflecting both the direction (with negative values indicating clockwise direction) and intensity of a vortex. Given that intracardiac vortices facilitate left ventricular (LV) filling and redirect blood flow for LV ejection [5,6,7], VFM may provide incremental information on LV function when compared to conventional methods [8]
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