Assessment of biventricular hemodynamics and energy dynamics using lumen-tracking 4D flow MRI without contrast medium
Assessment of biventricular hemodynamics and energy dynamics using lumen-tracking 4D flow MRI without contrast medium
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DOI：
10.1016/j.jjcc.2021.01.004
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发表时间：
2021-05-28
影响因子：
2.5
通讯作者：
Yamada, Kei
中科院分区：
文献类型：
--
作者：
Nakaji, Kosuke;Itatani, Keiichi;Yamada, Kei
背景：双心室生理相互作用仍然是心脏病学中的一个具有挑战性的问题。我们开发了一种四维（4D）流动磁共振成像（MRI）扫描和临床可用的分析协议，该协议基于心血管腔的搏动跟踪，无需造影剂，通过计算流动能量损失（EL）来测量双心室血液动力学和能量性能。和动能（KE）。方法：对19例健康志愿者（男11例，女8例）进行4D Flow MRI检查，观察左、右心室系统的血流模式和能量动力学变化，并与正常对照组比较。结果：在左心室（LV）内，在舒张末期和收缩早期，沿纵向沿着可观察到一个大的旋涡。在收缩早期，涡流似乎有助于顺利射血，EL很小。相反，在右心室（RV）中，在舒张期充盈期，在短轴和长轴上的游离壁附近都有漩涡。在单个心动周期内，右心和左心系统的平均EL指数分别为0.63 +/- 0.16（0.42-0.99）mW/m2和1.02 +/- 0.26（0.58-1.58）mW/m2。左室射血分数（EL）是左、右心室功能正常的涡流所造成的不可避免的损失，左室射血分数与心率、右室每搏输出量呈正相关。主动脉瓣处的动能受LV舒张末期容积/每搏输出量的影响。无性别差异observed.Conclusions：RV似乎作为LV系统的能量动力学的调节器的功能。(C)2021年日本心脏病学院。由爱思唯尔有限公司出版。保留所有权利。
Background: Biventricular physiological interaction remains a challenging problem in cardiology. We developed a four-dimensional (4D) flow magnetic resonance imaging (MRI) scan and clinically available analysis protocol based on beat tracking of the cardiovascular lumen without contrast medium, which enabled measurement of the biventricular hemodynamics and energetic performance by calculating flow energy loss (EL) and kinetic energy (KE). The aim of this study was to observe the flow patterns and energy dynamics to reveal the physiology of the right and left ventricular systems.Methods: 4D flow MRI studies were performed in 19 healthy volunteers including 11 male and 8 female. The right and left ventricular systems were segmented to visualize the flow patterns and to quantify the hemodynamics and energy dynamics.Results: A large vortex was observed in the left ventricle (LV), along the longitudinal axis, during end diastole and early systole. At early systole, the vortex appeared to facilitate smooth ejection with little EL. In contrast, in the right ventricle (RV), there were vortices near the free wall in both the short and long axes during the diastolic filling phase. Mean EL index during a single cardiac cycle in the right and left heart systems was 0.63 +/- 0.16 (0.42-0.99) mW/m(2), and 1.02 +/- 0.26 (0.58-1.58) mW/m(2), respectively. EL is inevitable loss caused by the vortex flow to facilitate smooth right and left ventricular function and left-sided EL tended to correlate positively with heart rate and right ventricular stroke volume. Kinetic energy at the aortic valve was influenced by LV end-diastolic volume/stroke volume. No gender difference was observed.Conclusions: The RV appears to function as a regulator of the energy dynamics of the LV system. (C) 2021 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.