Left ventricular four-dimensional blood flow distribution, energetics, and vorticity in chronic myocardial infarction patients with/without left ventricular thrombus

Intra-Ventricular Diastolic Hemodynamics under Pharmacological Stress in Patients with Ischemic Heart Disease: Analysis of 4D-Flow and Myocardial Flow Reserve using hybrid13N-ammonia Positron Emission Tomography/Magnetic Resonance

“…The intra-LV 4D flow analysis including healthy controls has been extensively validated 8,19 . Numerous studies have confirmed that intra-LV blood flow is closely related to the LV morphology, wall kinetics, and diastolic compliance in patients with heart failure and previous myocardial infarction, suggesting that 4D-flow CMR is the reference for non-invasive assessment of intra-LV blood flow hemodynamics 8,9,11,19,20 . These initial studies reported that the average KE in early diastole was significantly increased in patients with disease such as dilated cardiomyopathy or myocardial infarction compared to healthy controls 11,21 .…”

“…Subsequently, kinetic energy (KE) and vorticity map was created to estimate energy volume passing through the mitral annulus and LV; the curve for averaged and accumulated KE, peak E to A wave, and vorticity through cardiac cycle were obtained and automatically calculated using GTF ® (Figure 2C right). Diastolic average KE, peak E-to A-wave, and vorticity were normalized by end-diastolic volume for rest and stress study as previously described 9,11,18 . In visual analysis, abnormal flow was visualized as color-coded in stream-line images during early-to-mid diastole phase.…”

“…In addition, four-dimensional (4D) flow MR imaging has been developed to simulate and quantify blood flow in vivo. Its utility has been initially validated for visualization and quantification of blood flow in great arteries, and the flow analysis using computational fluid dynamics provide novel hemodynamic markers such as the energy loss and the wall share stress [8][9][10] . More recently, several studies have employed 4D flow MR to visualize and quantify intra LV blood flow to assess hemodynamic abnormality associated with various cardiac diseases including cardiomyopathy and structural heart disease, utilizing the quantification of the multi-directional blood stream computed as kinetic energy 11,12 .…”

Machine Learning and the Conundrum of Stroke Risk Prediction

“…Studies using cardiac MRI and echocardiography show that flow imaging can map intracardiac stasis and predict mural thrombosis and cerebral microembolism. 28,29,[76][77][78][79] However, these studies have been largely limited to the left ventricle and sinus rhythm, given that flow imaging in the fibrillating atrium is challenging. Patient-specific computational fluid dynamics (CFD) analysis has been shown to outperform traditional functional imaging for coronary ischaemia diagnosis and could be a promising tool to assess atrial thrombosis risk.…”

Validation of Left Ventricular High Frame Rate Echo-Particle Image Velocimetry against 4D Flow MRI in Patients

“…Such information may help risk assessment, including predicting thrombus formation and gauging treatment effectiveness, as well as informing potential future treatment options. Recent studies suggested that cardiac hemodynamics are correlated to different types of cardiomyopathy [1, 2, 3, 4], including dilated cardiomyopathy[5][6]. At present, 4D flow MRI is the gold standard of intracardiac flow imaging, offering detailed 3D velocity vectors throughout the cardiac cycle for comprehensive quantification and visualization of cardiac blood flow patterns.…”