Author + information
- Partho P. Sengupta, MD⁎ (, )
- Gianni Pedrizetti, PhD and
- Jagat Narula, MD, PhD
- ↵⁎Address for Correspondence:
Dr. Partho P. Sengupta, Mount Sinai Heart, Mount Sinai Medical Center, One Gustave L. Levy Place, P.O. Box 1030, New York, New York 10029
echocardiographic particle imaging velocimetry (echo-piv) is a noninvasive technique where acoustic reflections from ultrasound contrast agents are tracked frame by frame for characterizing 2-dimensional cardiac and vascular flow fields. Three-dimensional asymmetries in flow sequence can be interpreted by using multiplanar reconstructions of echo-PIV images obtained by biplane echocardiography (Fig. 1,Online Videos 1, 2, and 3). For example, the sequence of flow in a normal left ventricle (LV) (Fig. 2,Online Video 4) is consistent with the formation of asymmetric toroidal vortex ring in early diastole (Online Video 5). The asymmetric vortex is cleared in systole as blood is ejected through a narrow jet in the LV outflow with surrounding shear layers (Fig. 3,Online Video 4). Asymmetry of filling vortex and shear layers during ejection explain previously reported Doppler recordings of skewed velocity distributions in the LV cavity (1). The left atrial (LA) flow (Fig. 4,Online Video 6) illustrates the presence of multiple small circulating vortices. The jet from the right upper pulmonary vein passes peripherally along the wall with minimal entrainment. The vortices in the cavity vanish with the onset of mitral valve opening. The presence of multiple transient vortices in the normal subject may have beneficial effects in avoiding LA stasis in sinus rhythm. Flow in the descending thoracic aorta (Fig. 5,Online Video 7) shows skewed axial velocity profiles. Although high velocity forward motion is underestimated, retrograde streaming in systole is visualized. In addition, strong secondary recirculating flows are seen in diastole. Presence of flow asymmetry and retrograde flow from descending thoracic aorta has been recently identified as a potential pathway for retrograde cerebral embolism of plaques formed in descending thoracic aorta (2).
For supplementary videos and their legends, please see the online version of this article.
All authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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