Emmeline E Calkoen1, Mohammed S M Elbaz2, Jos J M Westenberg2, Lucia J M Kroft3, Mark G Hazekamp4, Arno A W Roest5, Rob J van der Geest2. 1. Department of Paediatric Cardiology, Leiden University Medical Center, Leiden, The Netherlands. 2. Department of Radiology, Division of Image Processing, Leiden University Medical Center, Leiden, The Netherlands. 3. Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands. 4. Department of Thoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands. 5. Department of Paediatric Cardiology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: a.roest@lumc.nl.
Abstract
OBJECTIVES: During normal left ventricular (LV) filling, a vortex ring structure is formed distal to the left atrioventricular valve (LAVV). Vortex structures contribute to efficient flow organization. We aimed to investigate whether LAVV abnormality in patients with a corrected atrioventricular septal defect (AVSD) has an impact on vortex ring formation. METHODS: Whole-heart 4D flow MRI was performed in 32 patients (age: 26 ± 12 years), and 30 healthy subjects (age: 25 ± 14 years). Vortex ring cores were detected at peak early (E-peak) and peak late filling (A-peak). When present, the 3-dimensional position and orientation of the vortex ring was defined, and the circularity index was calculated. Through-plane flow over the LAVV, and the vortex formation time (VFT), were quantified to analyze the relationship of vortex flow with the inflow jet. RESULTS: Absence of a vortex ring during E-peak (healthy subjects 0%, vs patients 19%; P = .015), and A-peak (healthy subjects 10% vs patients 44%; P = .008) was more frequent in patients. In 4 patients, this was accompanied by a high VFT (5.1-7.8 vs 2.4 ± 0.6 in healthy subjects), and in another 2 patients with abnormal valve anatomy. In patients compared with controls, the vortex cores had a more-anterior and apical position, closer to the ventricular wall, with a more-elliptical shape and oblique orientation. The shape of the vortex core closely resembled the valve shape, and its orientation was related to the LV inflow direction. CONCLUSIONS: This study quantitatively shows the influence of abnormal LAVV and LV inflow on 3D vortex ring formation during LV inflow in patients with corrected AVSD, compared with healthy subjects.
OBJECTIVES: During normal left ventricular (LV) filling, a vortex ring structure is formed distal to the left atrioventricular valve (LAVV). Vortex structures contribute to efficient flow organization. We aimed to investigate whether LAVV abnormality in patients with a corrected atrioventricular septal defect (AVSD) has an impact on vortex ring formation. METHODS: Whole-heart 4D flow MRI was performed in 32 patients (age: 26 ± 12 years), and 30 healthy subjects (age: 25 ± 14 years). Vortex ring cores were detected at peak early (E-peak) and peak late filling (A-peak). When present, the 3-dimensional position and orientation of the vortex ring was defined, and the circularity index was calculated. Through-plane flow over the LAVV, and the vortex formation time (VFT), were quantified to analyze the relationship of vortex flow with the inflow jet. RESULTS: Absence of a vortex ring during E-peak (healthy subjects 0%, vs patients 19%; P = .015), and A-peak (healthy subjects 10% vs patients 44%; P = .008) was more frequent in patients. In 4 patients, this was accompanied by a high VFT (5.1-7.8 vs 2.4 ± 0.6 in healthy subjects), and in another 2 patients with abnormal valve anatomy. In patients compared with controls, the vortex cores had a more-anterior and apical position, closer to the ventricular wall, with a more-elliptical shape and oblique orientation. The shape of the vortex core closely resembled the valve shape, and its orientation was related to the LV inflow direction. CONCLUSIONS: This study quantitatively shows the influence of abnormal LAVV and LV inflow on 3D vortex ring formation during LV inflow in patients with corrected AVSD, compared with healthy subjects.
Authors: Mohammed S M Elbaz; Rob J van der Geest; Emmeline E Calkoen; Albert de Roos; Boudewijn P F Lelieveldt; Arno A W Roest; Jos J M Westenberg Journal: Magn Reson Med Date: 2016-02-28 Impact factor: 4.668
Authors: Vivian P Kamphuis; Jos J M Westenberg; Roel L F van der Palen; Nico A Blom; Albert de Roos; Rob van der Geest; Mohammed S M Elbaz; Arno A W Roest Journal: Int J Cardiovasc Imaging Date: 2016-11-25 Impact factor: 2.357
Authors: Vivian P Kamphuis; Mohammed S M Elbaz; Pieter J van den Boogaard; Lucia J M Kroft; Hildo J Lamb; Mark G Hazekamp; Monique R M Jongbloed; Nico A Blom; Willem A Helbing; Arno A W Roest; Jos J M Westenberg Journal: J Cardiovasc Magn Reson Date: 2019-07-25 Impact factor: 5.364
Authors: Corina Kräuter; Ursula Reiter; Clemens Reiter; Volha Nizhnikava; Marc Masana; Albrecht Schmidt; Michael Fuchsjäger; Rudolf Stollberger; Gert Reiter Journal: Magn Reson Med Date: 2020-06-18 Impact factor: 4.668
Authors: Jehill D Parikh; Jayant Kakarla; Bernard Keavney; John J O'Sullivan; Gary A Ford; Andrew M Blamire; Kieren G Hollingsworth; Louise Coats Journal: PLoS One Date: 2017-03-10 Impact factor: 3.240
Authors: Sophie Paddock; Vasiliki Tsampasian; Hosamadin Assadi; Bruno Calife Mota; Andrew J Swift; Amrit Chowdhary; Peter Swoboda; Eylem Levelt; Eva Sammut; Amardeep Dastidar; Jordi Broncano Cabrero; Javier Royuela Del Val; Paul Malcolm; Julia Sun; Alisdair Ryding; Chris Sawh; Richard Greenwood; David Hewson; Vassilios Vassiliou; Pankaj Garg Journal: Front Cardiovasc Med Date: 2021-07-07