Study of evolution of left ventricular intracavitary vortex during ejection using vector flow mapping

  AIM  To investigate the evolution of the left ventricular (LV) intracavitary vortex during LV ejection in healthy subjects and patients with heart failure using vector flow mapping (VFM).

  METHODS  VFM was performed from LV apical long-axis view in 50 healthy volunteers and 63 patients with dilated cardiomyopathy (LV ejection fraction < 50%).

  RESULTS  In healthy subjects, the intraventricular vortex dissipated quickly during early ejection. The vortex decreased and disappeared mainly at the base of LV chamber (e.g., under the closed mitral valve). In patients with heart failure, the vortex stayed or disappeared mainly at LV apex during LV ejection. Compared with controls, patients with heart failure had a significantly longer duration of the vortex during the period of LV ejection and larger area and flow volume of the vortex at the middle of LV ejection (all, P < 0.001).

  CONCLUSIONS  In patients with heart failure, the vortex persists and stays mainly at apex during LV ejection, whereas the vortex dissipates quickly during early ejection under the closed mitral valve in healthy subjects, suggesting that the evolution of the intraventricular vortex during LV ejection is associated with LV dimensions and functions.