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Vortex‐ring mixing as a measure of diastolic function of the human heart: Phantom validation and initial observations in healthy volunteers and patients with heart failure
Author(s) -
Töger Johannes,
Kanski Mikael,
Arvidsson Per M.,
Carlsson Marcus,
Kovács Sándor J.,
Borgquist Rasmus,
Revstedt Johan,
Söderlind Gustaf,
Arheden Håkan,
Heiberg Einar
Publication year - 2016
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25111
Subject(s) - ventricle , diastole , vortex , medicine , heart failure , vortex ring , cardiology , imaging phantom , nuclear medicine , physics , mechanics , blood pressure
Purpose To present and validate a new method for 4D flow quantification of vortex‐ring mixing during early, rapid filling of the left ventricle (LV) as a potential index of diastolic dysfunction and heart failure. Materials and Methods 4D flow mixing measurements were validated using planar laser‐induced fluorescence (PLIF) in a phantom setup. Controls ( n = 23) and heart failure patients ( n = 23) were studied using 4D flow at 1.5T (26 subjects) or 3T (20 subjects) to determine vortex volume (VV) and inflowing volume (VV inflow ). The volume mixed into the vortex‐ring was quantified as VV mix‐in = VV–VV inflow . The mixing ratio was defined as MXR = VV mix‐in /VV. Furthermore, we quantified the fraction of the end‐systolic volume (ESV) mixed into the vortex‐ring (VV mix‐in /ESV) and the fraction of the LV volume at diastasis (DV) occupied by the vortex‐ring (VV/DV). Results PLIF validation of MXR showed fair agreement (R 2 = 0.45, mean ± SD 1 ± 6%). MXR was higher in patients compared to controls (28 ± 11% vs. 16 ± 10%, P < 0.001), while VV mix‐in /ESV and VV/DV were lower in patients (10 ± 6% vs. 18 ± 12%, P < 0.01 and 25 ± 8% vs. 50 ± 6%, P < 0.0001). Conclusion Vortex‐ring mixing can be quantified using 4D flow. The differences in mixing parameters observed between controls and patients motivate further investigation as indices of diastolic dysfunction. J. Magn. Reson. Imaging 2016;43:1386–1397.