Left ventricular blood flow patterns in normal subjects: a quantitative analysis by three-dimensional magnetic resonance velocity mapping

J Am Coll Cardiol. 1995 Jul;26(1):224-38. doi: 10.1016/0735-1097(95)00141-l.

Abstract

Objectives: Magnetic resonance velocity mapping was used to investigate the hypothesis of a vortex motion within the left ventricle interacting with mitral valve motion and inflow velocity.

Background: In vitro flow visualization studies have suggested the presence of a large anterior vortex inside the left ventricle during mitral inflow. However, to our knowledge the occurrence of this phenomenon has not been demonstrated in the human left ventricle.

Methods: Magnetic resonance velocity mapping was performed in 26 healthy volunteers using a flow-adjusted gradient sequence for three-dimensional flow velocity acquisition in the long-axis plane of the left ventricle. By computer processing, the flow vectors in the left ventricle were visualized and animated dynamically.

Results: The early diastolic mitral inflow was apically directed, and a large counterclockwise anterior vortex was created within the left ventricle shortly after the onset of the mid-diastolic semiclosure of the anterior mitral leaflet. During mid-diastolic diastasis, mitral inflow ceased until the flow accelerated again at atrial systole. The final closure of the mitral valve was preceded by a smaller vortex seen at the tips of the mitral leaflets. At systolic ejection, all flow vectors were directed toward the left ventricular outflow tract. The anterior vortex had a radius of 1.62 +/- 0.24 cm (mean +/- SD), and the average angular velocity (i.e., the rotation of an element about the center of the vortex within the central core) was 30.08 +/- 9.98 radians/s. The maximal kinetic energy of the anterior vortex was 4.3 x 10(-4) +/- 7.1 x 10(-5) J.

Conclusions: The hypothesis of a diastolic vortex formation in the human left ventricle was confirmed, and its close temporal relation to the motion of the anterior mitral leaflet was demonstrated.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Flow Velocity*
  • Female
  • Heart Ventricles / anatomy & histology
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Mitral Valve / anatomy & histology
  • Mitral Valve / physiology*
  • Regional Blood Flow
  • Reproducibility of Results
  • Ventricular Function*