PMID- 27532640
OWN - NLM
STAT- MEDLINE
DCOM- 20170808
LR  - 20240327
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 11
IP  - 8
DP  - 2016
TI  - Altered Diastolic Flow Patterns and Kinetic Energy in Subtle Left Ventricular 
      Remodeling and Dysfunction Detected by 4D Flow MRI.
PG  - e0161391
LID - 10.1371/journal.pone.0161391 [doi]
LID - e0161391
AB  - AIMS: 4D flow magnetic resonance imaging (MRI) allows quantitative assessment of 
      left ventricular (LV) function according to characteristics of the dynamic flow 
      in the chamber. Marked abnormalities in flow components' volume and kinetic 
      energy (KE) have previously been demonstrated in moderately dilated and depressed 
      LV's compared to healthy subjects. We hypothesized that these 4D flow-based 
      measures would detect even subtle LV dysfunction and remodeling. METHODS AND 
      RESULTS: We acquired 4D flow and morphological MRI data from 26 patients with 
      chronic ischemic heart disease with New York Heart Association (NYHA) class I and 
      II and with no to mild LV systolic dysfunction and remodeling, and from 10 
      healthy controls. A previously validated method was used to separate the LV 
      end-diastolic volume (LVEDV) into functional components: direct flow, which 
      passes directly to ejection, and non-ejecting flow, which remains in the LV for 
      at least 1 cycle. The direct flow and non-ejecting flow proportions of 
      end-diastolic volume and KE were assessed. The proportions of direct flow volume 
      and KE fell with increasing LVEDV-index (LVEDVI) and LVESV-index (LVESVI) (direct 
      flow volume r = -0.64 and r = -0.74, both P<0.001; direct flow KE r = -0.48, P = 
      0.013, and r = -0.56, P = 0.003). The proportions of non-ejecting flow volume and 
      KE rose with increasing LVEDVI and LVESVI (non-ejecting flow volume: r = 0.67 and 
      r = 0.76, both P<0.001; non-ejecting flow KE: r = 0.53, P = 0.005 and r = 0.52, P 
      = 0.006). The proportion of direct flow volume correlated moderately to LVEF (r = 
      0.68, P < 0.001) and was higher in a sub-group of patients with LVEDVI >74 ml/m2 
      compared to patients with LVEDVI <74 ml/m2 and controls (both P<0.05). 
      CONCLUSION: Direct flow volume and KE proportions diminish with increased LV 
      volumes, while non-ejecting flow proportions increase. A decrease in direct flow 
      volume and KE at end-diastole proposes that alterations in these novel 4D 
      flow-specific markers may detect LV dysfunction even in subtle or subclinical LV 
      remodeling.
FAU - Svalbring, Emil
AU  - Svalbring E
AUID- ORCID: 0000-0003-3776-0671
AD  - Department of Medical and Health Sciences, Division of Cardiovascular Medicine, 
      Linkoping University, Linkoping, Sweden.
FAU - Fredriksson, Alexandru
AU  - Fredriksson A
AD  - Department of Medical and Health Sciences, Division of Cardiovascular Medicine, 
      Linkoping University, Linkoping, Sweden.
FAU - Eriksson, Jonatan
AU  - Eriksson J
AD  - Department of Medical and Health Sciences, Division of Cardiovascular Medicine, 
      Linkoping University, Linkoping, Sweden.
AD  - Center for Medical Image Science and Visualization (CMIV), Linkoping University, 
      Linkoping, Sweden.
FAU - Dyverfeldt, Petter
AU  - Dyverfeldt P
AD  - Department of Medical and Health Sciences, Division of Cardiovascular Medicine, 
      Linkoping University, Linkoping, Sweden.
AD  - Center for Medical Image Science and Visualization (CMIV), Linkoping University, 
      Linkoping, Sweden.
FAU - Ebbers, Tino
AU  - Ebbers T
AD  - Department of Medical and Health Sciences, Division of Cardiovascular Medicine, 
      Linkoping University, Linkoping, Sweden.
AD  - Center for Medical Image Science and Visualization (CMIV), Linkoping University, 
      Linkoping, Sweden.
FAU - Bolger, Ann F
AU  - Bolger AF
AD  - Department of Medical and Health Sciences, Division of Cardiovascular Medicine, 
      Linkoping University, Linkoping, Sweden.
AD  - Department of Medicine, University of California San Francisco, San Francisco, 
      California, United States of America.
FAU - Engvall, Jan
AU  - Engvall J
AD  - Department of Medical and Health Sciences, Division of Cardiovascular Medicine, 
      Linkoping University, Linkoping, Sweden.
AD  - Center for Medical Image Science and Visualization (CMIV), Linkoping University, 
      Linkoping, Sweden.
AD  - Department of Clinical Physiology, Department of Medical and Health Sciences, 
      Linkoping University, Linkoping, Sweden.
FAU - Carlhall, Carl-Johan
AU  - Carlhall CJ
AD  - Department of Medical and Health Sciences, Division of Cardiovascular Medicine, 
      Linkoping University, Linkoping, Sweden.
AD  - Center for Medical Image Science and Visualization (CMIV), Linkoping University, 
      Linkoping, Sweden.
AD  - Department of Clinical Physiology, Department of Medical and Health Sciences, 
      Linkoping University, Linkoping, Sweden.
LA  - eng
PT  - Journal Article
DEP - 20160817
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Aged
MH  - Blood Flow Velocity/*physiology
MH  - Diastole/physiology
MH  - Female
MH  - Heart Ventricles/*physiopathology
MH  - Humans
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Middle Aged
MH  - Stroke Volume/physiology
MH  - Systole/physiology
MH  - Ventricular Dysfunction, Left/*physiopathology
MH  - Ventricular Function, Left/*physiology
MH  - Ventricular Remodeling/*physiology
PMC - PMC4988651
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2016/08/18 06:00
MHDA- 2017/08/09 06:00
PMCR- 2016/08/17
CRDT- 2016/08/18 06:00
PHST- 2016/02/16 00:00 [received]
PHST- 2016/08/04 00:00 [accepted]
PHST- 2016/08/18 06:00 [entrez]
PHST- 2016/08/18 06:00 [pubmed]
PHST- 2017/08/09 06:00 [medline]
PHST- 2016/08/17 00:00 [pmc-release]
AID - PONE-D-16-06705 [pii]
AID - 10.1371/journal.pone.0161391 [doi]
PST - epublish
SO  - PLoS One. 2016 Aug 17;11(8):e0161391. doi: 10.1371/journal.pone.0161391. 
      eCollection 2016.