Title |
Left ventricular blood flow kinetic energy after myocardial infarction - insights from 4D flow cardiovascular magnetic resonance
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Published in |
Critical Reviews in Diagnostic Imaging, August 2018
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DOI | 10.1186/s12968-018-0483-6 |
Pubmed ID | |
Authors |
Pankaj Garg, Saul Crandon, Peter P. Swoboda, Graham J. Fent, James R. J. Foley, Pei G. Chew, Louise A. E. Brown, Sethumadhavan Vijayan, Mariëlla E. C. J. Hassell, Robin Nijveldt, Malenka Bissell, Mohammed S. M. Elbaz, Abdallah Al-Mohammad, Jos J. M. Westenberg, John P. Greenwood, Rob J. van der Geest, Sven Plein, Erica Dall’Armellina |
Abstract |
Myocardial infarction (MI) leads to complex changes in left ventricular (LV) haemodynamics that are linked to clinical outcomes. We hypothesize that LV blood flow kinetic energy (KE) is altered in MI and is associated with LV function and infarct characteristics. This study aimed to investigate the intra-cavity LV blood flow KE in controls and MI patients, using cardiovascular magnetic resonance (CMR) four-dimensional (4D) flow assessment. Forty-eight patients with MI (acute-22; chronic-26) and 20 age/gender-matched healthy controls underwent CMR which included cines and whole-heart 4D flow. Patients also received late gadolinium enhancement imaging for infarct assessment. LV blood flow KE parameters were indexed to LV end-diastolic volume and include: averaged LV, minimal, systolic, diastolic, peak E-wave and peak A-wave KEiEDV. In addition, we investigated the in-plane proportion of LV KE (%) and the time difference (TD) to peak E-wave KE propagation from base to mid-ventricle was computed. Association of LV blood flow KE parameters to LV function and infarct size were investigated in all groups. LV KEiEDV was higher in controls than in MI patients (8.5 ± 3 μJ/ml versus 6.5 ± 3 μJ/ml, P = 0.02). Additionally, systolic, minimal and diastolic peak E-wave KEiEDV were lower in MI (P < 0.05). In logistic-regression analysis, systolic KEiEDV (Beta = - 0.24, P < 0.01) demonstrated the strongest association with the presence of MI. In multiple-regression analysis, infarct size was most strongly associated with in-plane KE (r = 0.5, Beta = 1.1, P < 0.01). In patients with preserved LV ejection fraction (EF), minimal and in-plane KEiEDV were reduced (P < 0.05) and time difference to peak E-wave KE propagation during diastole increased (P < 0.05) when compared to controls with normal EF. Reduction in LV systolic function results in reduction in systolic flow KEiEDV. Infarct size is independently associated with the proportion of in-plane LV KE. Degree of LV impairment is associated with TD of peak E-wave KE. In patient with preserved EF post MI, LV blood flow KE mapping demonstrated significant changes in the in-plane KE, the minimal KEiEDV and the TD. These three blood flow KE parameters may offer novel methods to identify and describe this patient population. |
X Demographics
Geographical breakdown
Country | Count | As % |
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United Kingdom | 3 | 27% |
United States | 3 | 27% |
Pakistan | 1 | 9% |
Unknown | 4 | 36% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 6 | 55% |
Science communicators (journalists, bloggers, editors) | 3 | 27% |
Practitioners (doctors, other healthcare professionals) | 1 | 9% |
Scientists | 1 | 9% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 82 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Ph. D. Student | 20 | 24% |
Researcher | 12 | 15% |
Student > Master | 6 | 7% |
Student > Doctoral Student | 5 | 6% |
Student > Bachelor | 5 | 6% |
Other | 12 | 15% |
Unknown | 22 | 27% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 20 | 24% |
Engineering | 19 | 23% |
Biochemistry, Genetics and Molecular Biology | 2 | 2% |
Physics and Astronomy | 2 | 2% |
Computer Science | 2 | 2% |
Other | 7 | 9% |
Unknown | 30 | 37% |