- Poster presentation
- Open Access
Vortex ring mixing in the left ventricle of the human heart
© Toger et al; licensee BioMed Central Ltd. 2013
- Published: 30 January 2013
- Left Ventricle
- Mitral Valve
- Cardiovascular Magnetic Resonance
- Vortex Ring
- Water Tank
Nine healthy volunteers and four patients with dilated ischemic cardiomyopathy underwent cardiovascular magnetic resonance including 4D PC-MRI. Particle tracing was used to track blood flowing into the left ventricle during rapid filling (Figure 1). Lagrangian Coherent Structures (LCS) were used to define the boundary of the vortex ring. The entrained volume was defined as the volume of blood from the ventricle (Figure 1, colored blue) inside the vortex ring (Figure 1B, yellow line). The mixing fraction was computed as the entrained volume divided by the total vortex ring volume. Differences between patients and healthy volunteers were tested using the Mann-Whitney U test.
VFR was computed as follows: End-systolic volume (ESV) and the volume of the left ventricle at diastasis (diastatic volume, DV) were measured by manual delineations in short-axis cine images. E-wave volume (EWV) was computed as DV-ESV. The diameter of the mitral valve D was measured as the average of the diameters in the three-chamber view and perpendicular to the three-chamber view in the short-axis view. VFR was computed as VFR = 4/π×EWV/D3.
The mixing fraction was significantly higher in the patients compared to the volunteers (35±7% vs. 19±8%, p=0.006). In contrast to previous studies in water tanks, there was no significant correlation between VFR and the mixing ratio in either group (Figure 2B).
We found a higher mixing ratio in the patients compared to the healthy volunteers. The absence of a significant correlation between VFR and mixing fraction suggests that vortex ring formation in the left ventricle of the human heart is subject to additional complexity and asymmetry compared to experimental studies in water tanks.
This study was supported by Swedish Research Council grants VR 621-2005-3129, VR 621-2008-2949 and VR K2009-65X-14599-07-3, National Visualization Program and Knowledge Foundation grant 2009-0080, the Medical Faculty at Lund University, Sweden, the Region of Scania, Sweden and the Swedish Heart-Lung Foundation.
SJK is supported in part by the Alan A. and Edith L. Wolff Charitable Trust, St. Louis, MO, USA, and the Barnes-Jewish Hospital Foundation, St Louis, MO, USA.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.