Abstract 2896: Quantitative Left Ventricular Flow Vortex Analysis is Superior to Conventional Echo-Doppler to Predict Hemodynamics and Symptoms in Patients with Systolic Heart Failure: A Novel Quantitative Vorticity Imaging Study Using Contrast Echocardiography and Particle Image Velocitimetry
Background: We have previously shown that the morphology and location of LV flow vortex is a critical determinant of directed blood flow during ejection. We evaluated whether quantitative LV flow vortex analysis by contrast echocardiography (CE) was superior to conventional echo-Doppler parameters to predict hemodynamics and symptomatic status in patients with systolic heart failure (HF).
Methods: 27 patients had 2-D CE with iv Definity in the apical views. Velocity vector and vorticity of LV flow was measured by Particle Image Velocitimetry (PIV) combined with a Feature Tracking Algorithm (Siemens, CA). Relative and vortex relative strength (RS, VRS), and vortex pulsation correlation (VPC) were measured. LVEDP was measured invasively, and LA volume index (LAVI), E/E’ were measured by echo-Doppler.
Results: RS, VRS, and VPC showed strong correlation with LVEDP (r=-0.927, p<0.001, r=-0.913, p<0.001, r=-0.870, p<0.001), but LAVI and E/E’ showed only modest correlation to LVEDP ( r=0.639, p=0.01, r=0.503, p=0.03 ). Furthermore, RS (1.65 ± 0.3 vs 1.25 ± 0.2, p=0.04), VRS (0.79 ± 0.1 vs 0.59 ± 0.2, p=0.03), and VPC (0.83 ± 0.1 vs 0.67 ± 0.1, p=0.04) were significantly decreased in symptomatic versus asymptomatic HF, respectively. LAVI and E/E’ did not differentiate between symptomatic and asymtomatic HF. Figures A and B⇓ show LV flow vortex in asymptomatic and symptomatic HF respectively: pulsatility is stronger in asymptomatic HF although steady streaming flow is comparable.
Conclusion: The data from this study shows that quantitative LV flow vortex parameters are superior to echo-Doppler measures to predict hemodymics and symptomatic status in patients with systolic HF.