Table 2 Left ventricular vortex parameters by multimodality imaging
From: Evaluation of intraventricular flow by multimodality imaging: a review and meta-analysis
Parameters | Definition | EPIV | VFM | 4D flow CMR | Clinical implications | Ref. |
|---|---|---|---|---|---|---|
Size and localization of the vortex |  |  |  |  | Increased vortex depth, length, radius and area values in patients with LV systolic dysfunction | [s.1–7] |
Vortex length | Apico-basal diameter indexed to LV length | + | – | + | ||
Vortex width | Mediolateral diameter indexed to LV transverse width | + | – | + | ||
Vortex radius | Maximum or mean radius/diameter of the vortex | – | + | – | ||
Vortex size | Vortex area, absolute value or indexed to LV area | + | + | + | ||
Vortex depth | Distance to the mitral annulus indexed to LV length | + | – | + | ||
Vortex transversal position | Distance of the vortex core to septum, indexed to LV length | + | – | + | ||
Vortex sphericity index | Vortex width indexed to vortex length | + | – | + | ||
Timing and duration of the vortex |  |  |  |  | Delayed diastolic vortex formation, longer duration of persistence of vortex during ejection time despite unchanged total vortex duration in DCM patients | [s.6, 8–10] |
Vortex duration | Duration of vortex in the LV | + | + | – | ||
Time to diastolic vortex formation | Time from mitral valve opening to vortex formation | + | – | – | ||
Vorticity parameters |  |  |  |  | Significant heterogeneity in reported value ranges as well as the direction of change with diseases compared with controls | [s.3, 6, 8, 11–21] |
Vortex circulation | Vorticity over the main diastolic vortex | + | + | + | ||
Vortex strength | Clockwise and counterclockwise vorticity indexed to total LV circulation | + | – | – | ||
Vorticity fluctuation index | Standard deviation of the squared vorticity | + | – | – | ||
Reynolds number | V.D/v, where V is linear velocity, D is the diameter of flow chamber and v is the kinematic viscosity. Higher number indicates increased vortical flow. | – | + | + | Higher mean Reynolds numbers in the LV in patients with heart failure. No difference between controls and patients with Fontan circulation. | [s.8, 21] |
Vortex pulsatility parameters | Â | Â | Â | Â | Â | [s.16, 22, 23] |
Relative strength | Pulsatile/nonpulsatile vorticity over LV | + | – | – | Lower in DCM patients, higher in patients with left bundle branch block compared to healthy controls. | |
Vortex relative strength | Pulsatile/nonpulsatile vorticity over vortex | + | – | – | ||
Vortex Pulsation correlation | Correlation of steady and pulsatile vortex components with zeroeth order vorticity | + | – | – |