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Review
. 2020 Sep 10;7(3):37.
doi: 10.3390/jcdd7030037.

Left Ventricular Blood Flow Kinetic Energy Assessment by 4D Flow Cardiovascular Magnetic Resonance: A Systematic Review of the Clinical Relevance

Harjinder Kaur  1 , Hosamadin Assadi  2 , Samer Alabed  1   2 , Donnie Cameron  3 , Vassilios S Vassiliou  3 , Jos J M Westenberg  4 , Rob van der Geest  4 , Liang Zhong  5 , Amardeep Dastidar  6 , Andrew J Swift  1   2 , Pankaj Garg  1   2
Affiliations
Review

Left Ventricular Blood Flow Kinetic Energy Assessment by 4D Flow Cardiovascular Magnetic Resonance: A Systematic Review of the Clinical Relevance

Harjinder Kaur et al. J Cardiovasc Dev Dis. .

Abstract

Background: There is an emerging body of evidence that supports the potential clinical value of left ventricular (LV) intracavity blood flow kinetic energy (KE) assessment using four-dimensional flow cardiovascular magnetic resonance imaging (4D flow CMR). The aim of this systematic review is to summarize studies evaluating LV intracavity blood flow KE quantification methods and its potential clinical significance. Methods: A systematic review search was carried out on Medline, Pubmed, EMBASE and CINAHL. Results: Of the 677 articles screened, 16 studies met eligibility. These included six (37%) studies on LV diastolic function, another six (37%) studies on heart failure or cardiomyopathies, three (19%) studies on ischemic heart disease or myocardial infarction and finally, one (6%) study on valvular heart disease, namely, mitral regurgitation. One of the main strengths identified by these studies is high reproducibility of LV blood flow KE hemodynamic assessment (mean coefficient of variability = 6 ± 2%) for the evaluation of LV diastolic function. Conclusions: The evidence gathered in this systematic review suggests that LV blood flow KE has great promise for LV hemodynamic assessment. Studies showed increased diagnostic confidence at no cost of additional time. Results were highly reproducible with low intraobserver variability.

Keywords: 4D flow CMR; 4D flow MRI; cardiovascular magnetic resonance; four-dimensional; intracardiac; phase contrast; systematic review; time-resolved; velocity encoded.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram demonstrating evidence synthesis for the systematic review, adapted from Moher et al. 2009 [8] using the PRISMA tool.
Figure 2
Figure 2
Left ventricular kinetic energy (KE) mapping. (a) Mapping of left ventricular (LV) KE using endocardial contours. This is a semi-automated method for the quantification of hemodynamically relevant parameters; (b) left ventricular blood flow KE curve for the whole cardiac cycle; green point: end-systolic KE; yellow point: Peak A-wave KE; red point: Peak E-wave KE; (c) mean line of LV E-wave KE with progressive age demonstrates that with age E-wave KE reduces; (d) mean line of LV A-wave KE with progressive age demonstrates that with age E-wave KE increases; (e) mean line of LV KE ratio with progressive age demonstrates that with age KE E/A ratio reduces.
Figure 3
Figure 3
LV blood-flow components KE analysis. LV blood-flow component KE breakdown can give further insight into kinetic energy distribution between different flow components in various cardiovascular disorders. Red: Residual flow component, Blue: Retained flow component, Yellow: Delayed flow component, Green: Direct flow component.
See this image and copyright information in PMC

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