Carlsson M, Heiberg E, Toger J, Arheden H. Quantification of left and right ventricular kinetic energy using four-dimensional intracardiac magnetic resonance imaging flow measurements. Am J Physiol Heart Circ Physiol 302: H893-H900, 2012. First published December 16, 2011; doi:10.1152/ajpheart.00942.2011.-We aimed to quantify kinetic energy (KE) during the entire cardiac cycle of the left ventricle (LV) and right ventricle (RV) using four-dimensional phasecontrast magnetic resonance imaging (MRI). KE was quantified in healthy volunteers (n ϭ 9) using an in-house developed software. Mean KE through the cardiac cycle of the LV and the RV were highly correlated (r 2 ϭ 0.96). Mean KE was related to end-diastolic volume (r 2 ϭ 0.66 for LV and r 2 ϭ 0.74 for RV), end-systolic volume (r 2 ϭ 0.59 and 0.68), and stroke volume (r 2 ϭ 0.55 and 0.60), but not to ejection fraction (r 2 Ͻ 0.01, P ϭ not significant for both). Three KE peaks were found in both ventricles, in systole, early diastole, and late diastole. In systole, peak KE in the LV was lower (4.9 Ϯ 0.4 mJ, P ϭ 0.004) compared with the RV (7.5 Ϯ 0.8 mJ). In contrast, KE during early diastole was higher in the LV (6.0 Ϯ 0.6 mJ, P ϭ 0.004) compared with the RV (3.6 Ϯ 0.4 mJ). The late diastolic peaks were smaller than the systolic and early diastolic peaks (1.3 Ϯ 0.2 and 1.2 Ϯ 0.2 mJ). Modeling estimated the proportion of KE to total external work, which comprised ϳ0.3% of LV external work and 3% of RV energy at rest and 3 vs. 24% during peak exercise. The higher early diastolic KE in the LV indicates that LV filling is more dependent on ventricular suction compared with the RV. RV early diastolic filling, on the other hand, may be caused to a higher degree of the return of the atrioventricular plane toward the base of the heart. The difference in ventricular geometry with a longer outflow tract in the RV compared with the LV explains the higher systolic KE in the RV.four-dimensional phase-contrast magnetic resonance imaging; cardiovascular magnetic resonance; energy; cardiac function; heart failure CARDIAC PUMPING DELIVERS A pressurized blood volume to the systemic and the pulmonary circulation. The amount of external work required to deliver the volume and pressure can be divided into kinetic energy (KE) and stroke work. Total work of the heart also includes internal work not delivered to the system. Stroke work stands for the vast majority (99%) of the external energy at rest in the left ventricle (LV) (29, 31) and somewhat less in the right ventricle (RV, 94%) (31). The structure of the looped heart has been proposed to direct the momentum or KE of the inflowing blood toward the aorta (18), which may be of specific importance during exercise (17). The magnitude and significance of maintenance of KE of blood in the looped heart has recently been under debate (16, 39 -40). KE is linked to inertia, an important physiological concept (37,41). Inertia is a physical concept describing the maintenance of the forward velocity of a medium (e.g., blood) after a force has...