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Intuitive visualization and quantification of intraventricular convection in acute ischemic left ventricular failure during early diastole using color Doppler-based echocardiographic vector flow mapping

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Abstract

The aim of this study was to make an intuitive visualization of intraventricular convection (IC) and quantification of intraventricular convection velocity (ICV) in acute ischemic left ventricular (LV) failure of open-chest canines during early diastole contrast to the baseline conditions using color Doppler-based echocardiographic vector flow mapping (VFM). The animal care committee approved this prospective study. In 6 anesthetized open-chest beagle models, the emergence time and the emergence sites of IC in the LV cavity during early diastole were visualized at the standard apical 3-chamber (AP3c) views with the VFM at baseline conditions and after coronary artery ligation. The global ICV and the ICV at the basal, middle and apical levels of LV at the AP3c views at T1, T2, T3, T4, and T5 between both states were compared respectively (T1: the beginning of LV rapid filling period; T2: the middle of LV rapid filling period; T3: the peak of LV rapid filling period; T4: the middle of period of reduced filling; T5: the end of early diastole.). Acute ischemic LV failure with a marked increase in LV end diastolic volume and LV minimal diastolic pressure was induced by coronary artery ligation. The IC appeared only during the period of reduced filling at baseline conditions, and limited to the basal level of LV cavity. But the IC appeared throughout all the early diastole, and was seen almost occupying whole LV cavity during ischemia. The peak of the global ICV for both states appeared at T4. The global ICV at the AP3c views in acute ischemic failure LV cavity increased than those of baseline conditions at the T1 (6.593 ± 0.834 cm2/s vs. 0.000 ± 0.000 cm2/s, P < 0.001), T2 (9.457 ± 0.852 cm2/s vs. 0.000 ± 0.000 cm2/s, P < 0.001), T3 (14.765 ± 1.791 cm2/s vs. 2.030 ± 0.502 cm2/s, P < 0.001), T4 (25.392 ± 4.640 cm2/s vs. 6.688 ± 1.343 cm2/s, P < 0.001), and T5 (15.890 ± 3.159 cm2/s vs. 2.518 ± 0.869 cm2/s, P < 0.001). And the ICV at the basal, middle and apical levels at AP3c views in acute ischemic failure LV cavity also increased than those of baseline conditions at the same phase of early diastole (P < 0.01), except for the ICV at the LV basal level at T1. VFM is a powerful tool for visualization IC and quantification of ICV on profiles of LV flow fields, which can give intriguing insights into the subtle, flow-associated LV fluid dynamics of normal and abnormal cardiac function. It will be of great practical importance to elucidate the accurate physiological and the pathophysiological significance of the IC in further studies, so as to determine whether the cardiac function can be precisely evaluated with IC related index, and to incorporate VFM into clinical routine practice in the future.

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Abbreviations

VFM:

Vector flow mapping

LV:

Left ventricle/ventricular

IC:

Intraventricular convection

ICV:

Intraventricular convection velocity

T1:

The beginning of LV rapid filling period

T2:

The middle of LV rapid filling period

T3:

The peak of LV rapid filling period

T4:

The middle of period of reduced filling

T5:

The end of early diastole

AP3c:

Standard left ventricular apical 3-chamber

HR:

Heart rate

LVEDV:

Left ventricular end diastolic volume

LVESV:

Left ventricular end systolic volume

LVSV:

Left ventricular stroke volume

LVEF:

Left ventricular ejection fraction

LVSPmax :

Left ventricular maximal systolic pressure

LVDPmin :

Left ventricular minimal diastolic pressure

dp/dtmax :

The maximal upstroke velocity of left ventricular systolic pressure

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Acknowledgments

This work was supported by the National Nature Foundation of China (No. 30970698).

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Authors and Affiliations

  1. Department of Cardiovascular Ultrasound and Non-invasive Cardiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, 2nd West Section, 1st Roundway, Chengdu, Sichuan, 610072, China

    Jing Lu, Wenhua Li, Anguo Luo, Shenghua Xie & Lixue Yin

  2. Institute of Ultrasound Image, Chongqing Medical University, Chongqing, China

    Yu Zhong

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  1. Jing Lu
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  2. Wenhua Li
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  3. Yu Zhong
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Correspondence to Lixue Yin.

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Lu, J., Li, W., Zhong, Y. et al. Intuitive visualization and quantification of intraventricular convection in acute ischemic left ventricular failure during early diastole using color Doppler-based echocardiographic vector flow mapping. Int J Cardiovasc Imaging 28, 1035–1047 (2012). https://doi.org/10.1007/s10554-011-9932-0

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  • DOI: https://doi.org/10.1007/s10554-011-9932-0

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