Tags

Type your tag names separated by a space and hit enter

Increased systolic vorticity in the left ventricular outflow tract is associated with abnormal aortic flow formations in Tetralogy of Fallot.
Int J Cardiovasc Imaging. 2020 Apr; 36(4):691-700.IJ

Abstract

Aortopathy is a recognized comorbidity of Tetralogy of Fallot (TOF). Aortic flow in children with repaired TOF is abnormal despite normal aortic valve anatomy and early surgical repair that results in aortic size normalization. The purpose of this study was to investigate the flow hemodynamics inside the left ventricle (LV) of children with repaired TOF using 4D-Flow MRI derived vorticity. Vorticity is the spatial derivative of flow velocity and is sensitive to anatomic and geometric variations. Vorticity was calculated inside the LV of children with repaired TOF having normal aortic size (n = 14) and normal controls (n = 10) during systolic ejection phase. All subjects underwent comprehensive biventricular analysis including the MRI based feature-tracking based LV strain analysis and mechanical dyssynchrony. Right ventricular (RV) volumetric indices along with LV mechanical indices were correlated with LV vorticity. All TOF patients had supraphysiologic helical flow in the ascending aorta. The generated peak systolic vorticity integrated over the LV volume was elevated in TOF group compared to control (median: 1344 vs. 858 s-1, P < 0.001). TOF patients had increased LV mechanical dyssynchrony (47 ± 11 vs. 32 ± 7 ms, P < 0.001) and reduced LV global circumferential strain (19 ± 2 vs. 21 ± 2%, P = 0.020). In the TOF group, LV systolic vorticity was independent of RV size and LV mechanical indices. Pathologic aortic flow in children with repaired TOF is associated with abnormal ejection flow patterns inside the LV. Increased systolic vorticity was not associated with LV mechanical dyssynchrony and RV dilation, suggesting that systolic flow inside the LV is independent of impaired LV contractile mechanics and inter-ventricular interactions.

Authors+Show Affiliations

Division of Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA. michal.schafer@cuanschutz.edu.Department of Radiology, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA. Department of Bioengineering, University of Colorado Denver, Anschutz Medical Campus, Aurora, USA.Division of Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.Section of Congenital Heart Surgery, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.Section of Congenital Heart Surgery, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.Department of Radiology, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.Division of Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.Section of Congenital Heart Surgery, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31907684

Citation

Schäfer, Michal, et al. "Increased Systolic Vorticity in the Left Ventricular Outflow Tract Is Associated With Abnormal Aortic Flow Formations in Tetralogy of Fallot." The International Journal of Cardiovascular Imaging, vol. 36, no. 4, 2020, pp. 691-700.
Schäfer M, Barker AJ, Morgan GJ, et al. Increased systolic vorticity in the left ventricular outflow tract is associated with abnormal aortic flow formations in Tetralogy of Fallot. Int J Cardiovasc Imaging. 2020;36(4):691-700.
Schäfer, M., Barker, A. J., Morgan, G. J., Jaggers, J., Stone, M. L., Browne, L. P., Ivy, D. D., & Mitchell, M. B. (2020). Increased systolic vorticity in the left ventricular outflow tract is associated with abnormal aortic flow formations in Tetralogy of Fallot. The International Journal of Cardiovascular Imaging, 36(4), 691-700. https://doi.org/10.1007/s10554-019-01764-w
Schäfer M, et al. Increased Systolic Vorticity in the Left Ventricular Outflow Tract Is Associated With Abnormal Aortic Flow Formations in Tetralogy of Fallot. Int J Cardiovasc Imaging. 2020;36(4):691-700. PubMed PMID: 31907684.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased systolic vorticity in the left ventricular outflow tract is associated with abnormal aortic flow formations in Tetralogy of Fallot. AU - Schäfer,Michal, AU - Barker,Alex J, AU - Morgan,Gareth J, AU - Jaggers,James, AU - Stone,Matthew L, AU - Browne,Lorna P, AU - Ivy,D Dunbar, AU - Mitchell,Max B, Y1 - 2020/01/06/ PY - 2019/10/30/received PY - 2019/12/28/accepted PY - 2020/1/8/pubmed PY - 2020/7/7/medline PY - 2020/1/8/entrez KW - 4D-Flow MRI KW - Left ventricle KW - Tetralogy of fallot SP - 691 EP - 700 JF - The international journal of cardiovascular imaging JO - Int J Cardiovasc Imaging VL - 36 IS - 4 N2 - Aortopathy is a recognized comorbidity of Tetralogy of Fallot (TOF). Aortic flow in children with repaired TOF is abnormal despite normal aortic valve anatomy and early surgical repair that results in aortic size normalization. The purpose of this study was to investigate the flow hemodynamics inside the left ventricle (LV) of children with repaired TOF using 4D-Flow MRI derived vorticity. Vorticity is the spatial derivative of flow velocity and is sensitive to anatomic and geometric variations. Vorticity was calculated inside the LV of children with repaired TOF having normal aortic size (n = 14) and normal controls (n = 10) during systolic ejection phase. All subjects underwent comprehensive biventricular analysis including the MRI based feature-tracking based LV strain analysis and mechanical dyssynchrony. Right ventricular (RV) volumetric indices along with LV mechanical indices were correlated with LV vorticity. All TOF patients had supraphysiologic helical flow in the ascending aorta. The generated peak systolic vorticity integrated over the LV volume was elevated in TOF group compared to control (median: 1344 vs. 858 s-1, P < 0.001). TOF patients had increased LV mechanical dyssynchrony (47 ± 11 vs. 32 ± 7 ms, P < 0.001) and reduced LV global circumferential strain (19 ± 2 vs. 21 ± 2%, P = 0.020). In the TOF group, LV systolic vorticity was independent of RV size and LV mechanical indices. Pathologic aortic flow in children with repaired TOF is associated with abnormal ejection flow patterns inside the LV. Increased systolic vorticity was not associated with LV mechanical dyssynchrony and RV dilation, suggesting that systolic flow inside the LV is independent of impaired LV contractile mechanics and inter-ventricular interactions. SN - 1875-8312 UR - https://www.unboundmedicine.com/medline/citation/31907684/Increased_systolic_vorticity_in_the_left_ventricular_outflow_tract_is_associated_with_abnormal_aortic_flow_formations_in_Tetralogy_of_Fallot_ L2 - https://doi.org/10.1007/s10554-019-01764-w DB - PRIME DP - Unbound Medicine ER -