Dissipative energy loss within the left ventricle detected using vector flow mapping technology in hypertension_Journal of Biomedical Engineering

Authors：

ZHANG Wen ¹ , ZHANG Yanmei ² , LIU Zhiyue ³ ,  HUANG He ¹

Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;

Corresponding author：

HUANG He, Email: xhehuang@yahoo.com

Keywords：

vector flow mapping; left ventricular energy loss; hypertension; cardiac function

DOI：

10.7507/1001-5515.201607026

Video：

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We have tried to explore the energy loss (EL) within the left ventricle in hypertension by using vector flow mapping (VFM) to detect left ventricular hemodynamic changes in hypertensive patients as early as possible and reflect changes of left ventricular function in hypertension by using EL. Twenty-one hypertensive patients with increased left ventricle mass index (LVMI), 14 hypertensive patients with normal LVMI and 22 control subjects were enrolled in this study. Systolic and diastolic EL derived from VFM within the left ventricle and E/e' by dual Doppler were recorded and analyzed. Compared with those of the controls, diastolic and systolic EL were significantly increased in hypertensive group (P<0.05). In diastole, EL=0.439×SBP (systolic blood pressure)–8.349; in systole, EL=0.385×SBP+0.644×LVMI–10.854. And the EL was positively correlated with E/e', but there was no significant correlation between EL and ejection fraction (EF) in the pooled population. The study shows that the increased EL can help us detect changes of left ventricular hemodynamic in hypertensive patients. It needs further investigation to prove whether EL within the left ventricle could be a new parameter to evaluate diastolic function. SBP and LVMI are the independent predictors for systolic EL, while SBP is the independent predictor for diastolic EL.

Citation： ZHANG Wen, ZHANG Yanmei, LIU Zhiyue, HUANG He. Dissipative energy loss within the left ventricle detected using vector flow mapping technology in hypertension. Journal of Biomedical Engineering, 2017, 34(2): 260-264. doi: 10.7507/1001-5515.201607026 Copy

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2.	程康安, 吴宁. 中国部分地区1980、1990、2000年慢性心力衰竭住院病例回顾性调查. 中华心血管病杂志, 2002, 30(8): 450-454.
3.	Rodriguez Muñoz D, Markl M, Moya Mur J L, et al. Intracardiac flow visualization: current status and future directions. Eur Heart J Cardiovasc Imaging, 2013, 14(11): 1029-1038.
4.	Zhang Haibin, Liu Liwen, Chen Lulu, et al. The evolution of intraventricular vortex during ejection studied by using vector flow mapping. Echocardiography, 2013, 30(1): 27-36.
5.	Marwick T H, Gillebert T C, Aurigemma G, et al. Recommendations on the use of echocardiography in adult hypertension: a report from the European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE)†. Eur Heart J Cardiovasc Imaging, 2015, 16(6): 577-605.
6.	Hayashi T, Itatani K, Inuzuka R, et al. Dissipative energy loss within the left ventricle detected by vector flow mapping in children: Normal values and effects of age and heart rate. J Cardiol, 2015, 66(5/6): 403-410.
7.	Garcia D, Pibarot P, Dumesnil J G, et al. Assessment of aortic valve stenosis severity: A new index based on the energy loss concept. Circulation, 2000, 101(7): 765-771.
8.	Garcia D, Del Alamo J C, Tanne D, et al. Two-dimensional intraventricular flow mapping by digital processing conventional color-Doppler echocardiography images. IEEE Trans Med Imaging, 2010, 29(10): 1701-1713.
9.	Rodríguez Muñoz D, Moya Mur J L, Fernández-Golfín C, et al. Left ventricular vortices as observed by vector flow mapping: main determinants and their relation to left ventricular filling. Echocardiography, 2015, 32(1): 96-105.
10.	Nogami Y, Ishizu T, Atsumi A, et al. Abnormal early diastolic intraventricular flow 'kinetic energy index' assessed by vector flow mapping in patients with elevated filling pressure. Eur Heart J Cardiovasc Imaging, 2013, 14(3): 253-260.
11.	Nagueh S F, Appleton C P, Gillebert T C, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr, 2009, 10(2): 165-193.
12.	Palmon L C, Reichek N, Yeon S B, et al. Intramural myocardial shortening in hypertensive left ventricular hypertrophy with normal pump function. Circulation, 1994, 89 (1): 122-131.
13.	Taler S J, Textor S C, Augustine J E. Resistant hypertension: comparing hemodynamic management to specialist care. Hypertension, 2002, 39(5): 982-988.

1. Krzesinski J M, Saint-Remy A. Essential hypertension, a complex trait. Rev Med Liege, 2012, 67(5/6): 279-285.
2. 程康安, 吴宁. 中国部分地区1980、1990、2000年慢性心力衰竭住院病例回顾性调查. 中华心血管病杂志, 2002, 30(8): 450-454.
3. Rodriguez Muñoz D, Markl M, Moya Mur J L, et al. Intracardiac flow visualization: current status and future directions. Eur Heart J Cardiovasc Imaging, 2013, 14(11): 1029-1038.
4. Zhang Haibin, Liu Liwen, Chen Lulu, et al. The evolution of intraventricular vortex during ejection studied by using vector flow mapping. Echocardiography, 2013, 30(1): 27-36.
5. Marwick T H, Gillebert T C, Aurigemma G, et al. Recommendations on the use of echocardiography in adult hypertension: a report from the European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE)†. Eur Heart J Cardiovasc Imaging, 2015, 16(6): 577-605.
6. Hayashi T, Itatani K, Inuzuka R, et al. Dissipative energy loss within the left ventricle detected by vector flow mapping in children: Normal values and effects of age and heart rate. J Cardiol, 2015, 66(5/6): 403-410.
7. Garcia D, Pibarot P, Dumesnil J G, et al. Assessment of aortic valve stenosis severity: A new index based on the energy loss concept. Circulation, 2000, 101(7): 765-771.
8. Garcia D, Del Alamo J C, Tanne D, et al. Two-dimensional intraventricular flow mapping by digital processing conventional color-Doppler echocardiography images. IEEE Trans Med Imaging, 2010, 29(10): 1701-1713.
9. Rodríguez Muñoz D, Moya Mur J L, Fernández-Golfín C, et al. Left ventricular vortices as observed by vector flow mapping: main determinants and their relation to left ventricular filling. Echocardiography, 2015, 32(1): 96-105.
10. Nogami Y, Ishizu T, Atsumi A, et al. Abnormal early diastolic intraventricular flow 'kinetic energy index' assessed by vector flow mapping in patients with elevated filling pressure. Eur Heart J Cardiovasc Imaging, 2013, 14(3): 253-260.
11. Nagueh S F, Appleton C P, Gillebert T C, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr, 2009, 10(2): 165-193.
12. Palmon L C, Reichek N, Yeon S B, et al. Intramural myocardial shortening in hypertensive left ventricular hypertrophy with normal pump function. Circulation, 1994, 89 (1): 122-131.
13. Taler S J, Textor S C, Augustine J E. Resistant hypertension: comparing hemodynamic management to specialist care. Hypertension, 2002, 39(5): 982-988.

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