Left ventricular vortex formation in preterm infants assessed by blood speckle imaging

Background A vortex is a rotational fluid structure formed by shearing of fluid layers. It forms during diastole in the left ventricle (LV) and helps redirect flow to the LV outflow tract for ejection, optimizing energy conservation. The aim of this study was to demonstrate the feasibility of detect...

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Bibliographic Details
Published in:Echocardiography (Mount Kisco, N.Y.) N.Y.), 2019-07, Vol.36 (7), p.1364-1371
Main Authors: Waal, Koert, Crendal, Edward, Boyle, Andrew
Format: Article
Language:English
Subjects:
Blood Flow Velocity
blood speckle imaging
Cross-Sectional Studies
Diastole
echocardiography
Echocardiography, Doppler, Color - methods
Feasibility Studies
Female
Humans
Infant, Newborn
Infant, Premature
intracardiac flow visualization
Male
Reproducibility of Results
speckle tracking
Ventricular Function, Left - physiology
vortex
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Summary:Background A vortex is a rotational fluid structure formed by shearing of fluid layers. It forms during diastole in the left ventricle (LV) and helps redirect flow to the LV outflow tract for ejection, optimizing energy conservation. The aim of this study was to demonstrate the feasibility of detecting and analyzing LV vortices using a new ultrasound technique known as blood speckle imaging (BSI). Methods Conventional and BSI parameters were acquired in preterm infants referred for echocardiography. BSI feasibility and reliability were explored using highest frequency settings and optimized Nyquist limits. Vortex area was determined by tracing the outer vortex ring at maximum area. Peak vortex formation time (PVFT) was determined at time of maximum vortex area relative to the R‐wave, and vortex duration from frame‐by‐frame analysis of first appearance to vortex degradation. Results Left ventricle vortices were detected in 49 of the 50 preterm infants (weight 500–2020 g) with excellent intra‐ and inter‐observer reliability. Mean vortex area indexed to LV area was 0.19 (0.08). Peak vortex formation time was at 87 (7)% of the cardiac cycle, and vortex duration lasted 13 (4)% of the cardiac cycle. Vortex area correlated positively with LV length, end‐diastolic dimension, end‐diastolic volume, mitral annular (R +0.42, +0.50, +0.47, +0.50, all P 
ISSN:0742-2822
1540-8175
DOI:10.1111/echo.14391