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Erschienen in: The International Journal of Cardiovascular Imaging 2/2019

02.03.2019 | Original Paper

Left ventricular vortex formation time in elite athletes

verfasst von: Gerard King, Nicholas Ngiam, John Clarke, Malissa J. Wood, Kian-Keong Poh

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 2/2019

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Abstract

Vortex formation time (VFT) is a continuous measure of the left ventricular (LV) filling that integrates all phases of diastole. This has been previously studied in patients with heart failure. This study examined the differences in VFT between healthy controls and elite athletes. We compared echocardiographic indices between elite male athletes (n = 41) and age-, weight- and sex-matched sedentary volunteers (n = 22). VFT was obtained using the validated formula: 4 × (1 − β)/π × α3 × LVEF, where β is the fraction of total transmitral diastolic stroke volume contributed by atrial contraction (assessed by time velocity integral of the mitral E- and A-waves) and α is the biplane end-diastolic volume (EDV)1/3 divided by mitral annular diameter during early diastole. Diastolic function was measured by the ratio of mitral peak velocity of early filling (E) to early diastolic mitral annular velocity (e′) (E/e′ ratio) and the ratio of E to mitral peak velocity of late filling (A) (E/A ratio). The heart rate was lower (63 ± 10 vs. 74 ± 6 beats per minute, p < 0.001) and the LV end diastolic diameter was larger in athletes as compared to controls (56 ± 3 vs. 50 ± 4 mm, p < 0.001). The VFT was lower in the sedentary group compared to athletes (3.1 ± 0.4 vs. 4.0 ± 0.8, p < 0.001). Similarly, E/e′ was higher in sedentary controls compared to athletes (7.5 ± 1.8 vs 4.2 ± 1.0, p < 0.001). Furthermore, there was a modest correlation between VFT and E/A (r = 0.47, p < 0.001) as well as E/e′ (r = − 0.33, p = 0.012). In conclusion, the VFT was elevated among elite athletes compared to healthy sedentary controls.
Literatur
1.
Zurück zum Zitat Poh KK, Lee LC, Shen L, Chong E, Tan YL, Chai P, Yeo TC, Wood MJ (2012) Left ventricular fluid dynamics in heart failure: echocardiographic measurement and utilities of vortex formation time. Eur Heart J Cardiovasc Imaging 13(5):385–393CrossRefPubMed Poh KK, Lee LC, Shen L, Chong E, Tan YL, Chai P, Yeo TC, Wood MJ (2012) Left ventricular fluid dynamics in heart failure: echocardiographic measurement and utilities of vortex formation time. Eur Heart J Cardiovasc Imaging 13(5):385–393CrossRefPubMed
2.
Zurück zum Zitat Pelà G, Bruschi G, Montagna L, Manara M, Manca C (2004) Left and right ventricular adaptation assessed by Doppler tissue echocardiography in athletes. J Am Soc Echocardiogr 17(3):205–211CrossRefPubMed Pelà G, Bruschi G, Montagna L, Manara M, Manca C (2004) Left and right ventricular adaptation assessed by Doppler tissue echocardiography in athletes. J Am Soc Echocardiogr 17(3):205–211CrossRefPubMed
3.
Zurück zum Zitat Vinereanu D, Florescu N, Sculthorpe N, Tweddel AC, Stephens MR, Fraser AG (2001) Differentiation between pathologic and physiologic left ventricular hypertrophy by tissue Doppler assessment of long-axis function in patients with hypertrophic cardiomyopathy or systemic hypertension and in athletes. Am J Cardiol 88(1):53–58CrossRefPubMed Vinereanu D, Florescu N, Sculthorpe N, Tweddel AC, Stephens MR, Fraser AG (2001) Differentiation between pathologic and physiologic left ventricular hypertrophy by tissue Doppler assessment of long-axis function in patients with hypertrophic cardiomyopathy or systemic hypertension and in athletes. Am J Cardiol 88(1):53–58CrossRefPubMed
4.
Zurück zum Zitat Rawlins J, Bhan A, Sharma S (2009) Left ventricular hypertrophy in athletes. Eur J Echocardiogr 10(3):350–356CrossRefPubMed Rawlins J, Bhan A, Sharma S (2009) Left ventricular hypertrophy in athletes. Eur J Echocardiogr 10(3):350–356CrossRefPubMed
5.
Zurück zum Zitat Nishimura R, Tajik A (1997) Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocardiography is the clinician’s Rosetta stone. J Am Coll Cardiol 30(1):8–18CrossRefPubMed Nishimura R, Tajik A (1997) Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocardiography is the clinician’s Rosetta stone. J Am Coll Cardiol 30(1):8–18CrossRefPubMed
6.
Zurück zum Zitat Carlhäll CJ1, Bolger A (2010) Passing strange: flow in the failing ventricle. Circ Heart Fail 3(2):326–331CrossRefPubMed Carlhäll CJ1, Bolger A (2010) Passing strange: flow in the failing ventricle. Circ Heart Fail 3(2):326–331CrossRefPubMed
7.
Zurück zum Zitat Belohlavek M (2012) Vortex formation time: an emerging echocardiographic index of left ventricular filling efficiency. Eur Heart J Cardiovasc Imaging 13(5):367–369CrossRefPubMedPubMedCentral Belohlavek M (2012) Vortex formation time: an emerging echocardiographic index of left ventricular filling efficiency. Eur Heart J Cardiovasc Imaging 13(5):367–369CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Gharib M, Rambod E, Shariff K (1998) A universal time-scale of vortex formation time. J Fluid Mech 360:121–140CrossRef Gharib M, Rambod E, Shariff K (1998) A universal time-scale of vortex formation time. J Fluid Mech 360:121–140CrossRef
10.
Zurück zum Zitat Gharib M, Kremers D, Koochesfahani MM, Kemp M (2002) Leonardo’s vision of flow visualization. Exp Fluids 33:219–223CrossRef Gharib M, Kremers D, Koochesfahani MM, Kemp M (2002) Leonardo’s vision of flow visualization. Exp Fluids 33:219–223CrossRef
11.
Zurück zum Zitat Gharib M, Rambod E, Kheradvar A, Sahn DJ, Dabiri JO (2006) Optimal vortex formation as an index of cardiac health. Proc Natl Acad Sci USA 103:6305–6308CrossRefPubMed Gharib M, Rambod E, Kheradvar A, Sahn DJ, Dabiri JO (2006) Optimal vortex formation as an index of cardiac health. Proc Natl Acad Sci USA 103:6305–6308CrossRefPubMed
12.
Zurück zum Zitat Russo C, Jin Z, Homma S, Rundek T, Elkind MS, Sacco RL, Di Tullio MR (2011) Effect of obesity and overweight on left ventricular diastolic function: a community-based study in an elderly cohort. J Am Coll Cardiol 57(12):1368–1374CrossRefPubMedPubMedCentral Russo C, Jin Z, Homma S, Rundek T, Elkind MS, Sacco RL, Di Tullio MR (2011) Effect of obesity and overweight on left ventricular diastolic function: a community-based study in an elderly cohort. J Am Coll Cardiol 57(12):1368–1374CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Zile MR, Brutsaert DL (2002) New concepts in diastolic dysfunction and diastolic heart failure: part I: diagnosis, prognosis, and measurements of diastolic function. Circulation 105(11):1387–1393CrossRefPubMed Zile MR, Brutsaert DL (2002) New concepts in diastolic dysfunction and diastolic heart failure: part I: diagnosis, prognosis, and measurements of diastolic function. Circulation 105(11):1387–1393CrossRefPubMed
14.
Zurück zum Zitat King GJ, Murphy RT, Almuntaser I, Bennett K, Ho E, Brown AS (2008) Alterations in myocardial stiffness in elite athletes assessed by a new Doppler index. Heart 94:1323–1325CrossRefPubMed King GJ, Murphy RT, Almuntaser I, Bennett K, Ho E, Brown AS (2008) Alterations in myocardial stiffness in elite athletes assessed by a new Doppler index. Heart 94:1323–1325CrossRefPubMed
15.
Zurück zum Zitat Waldman LK, Nosan D, Villarreal F, Covell JW (1988) Relationship between transmural deformation and local myofiber direction in canine left ventricle. Circ Res 63:550–562CrossRefPubMed Waldman LK, Nosan D, Villarreal F, Covell JW (1988) Relationship between transmural deformation and local myofiber direction in canine left ventricle. Circ Res 63:550–562CrossRefPubMed
16.
Zurück zum Zitat Hill JC, Palma RA (2005) Doppler tissue imaging for the assessment of left ventricular diastolic function: a systemic approach for the sonographer. J Am Soc Echocardiogr 18:80–90CrossRefPubMed Hill JC, Palma RA (2005) Doppler tissue imaging for the assessment of left ventricular diastolic function: a systemic approach for the sonographer. J Am Soc Echocardiogr 18:80–90CrossRefPubMed
17.
Zurück zum Zitat Pasipoularides A, Vlachos PP, Little WC (2015) Vortex formation time is not an index of ventricular function. J Cardiovasc Transl Res 8(1):54–58CrossRefPubMedPubMedCentral Pasipoularides A, Vlachos PP, Little WC (2015) Vortex formation time is not an index of ventricular function. J Cardiovasc Transl Res 8(1):54–58CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Rademakers FE, Buchalter MB, Rogers WJ, Zerhouni EA, Weisfeldt ML, Weiss JL, Shapiro EP (1992) Dissociation between left ventricular untwisting and filling. Circulation 85(4):1572–1581CrossRefPubMed Rademakers FE, Buchalter MB, Rogers WJ, Zerhouni EA, Weisfeldt ML, Weiss JL, Shapiro EP (1992) Dissociation between left ventricular untwisting and filling. Circulation 85(4):1572–1581CrossRefPubMed
19.
Zurück zum Zitat Krueger P, Gharib M (2003) The significance of vortex ring formation to the impulse and thrust of a starting jet. Phys Fluids 15:1271–1281CrossRef Krueger P, Gharib M (2003) The significance of vortex ring formation to the impulse and thrust of a starting jet. Phys Fluids 15:1271–1281CrossRef
20.
Zurück zum Zitat Mohseni K, Gharib M (1998) A model for universal time scale of vortex ring formation. Phys Fluids 10:2436–2438CrossRef Mohseni K, Gharib M (1998) A model for universal time scale of vortex ring formation. Phys Fluids 10:2436–2438CrossRef
21.
Zurück zum Zitat Hong GR, Pedrizzetti G, Tonti G, Li P, Wei Z, Kim JK, Baweja A, Liu S, Chung N, Houle H, Narula J, Vannan MA (2008) Characterization and quantification of vortex flow in the human left ventricle by contrast echocardiography using vector particle image velocimetry. JACC Cardiovasc Imaging 1(6):705–717CrossRefPubMedPubMedCentral Hong GR, Pedrizzetti G, Tonti G, Li P, Wei Z, Kim JK, Baweja A, Liu S, Chung N, Houle H, Narula J, Vannan MA (2008) Characterization and quantification of vortex flow in the human left ventricle by contrast echocardiography using vector particle image velocimetry. JACC Cardiovasc Imaging 1(6):705–717CrossRefPubMedPubMedCentral
Metadaten
Titel
Left ventricular vortex formation time in elite athletes
verfasst von
Gerard King
Nicholas Ngiam
John Clarke
Malissa J. Wood
Kian-Keong Poh
Publikationsdatum
02.03.2019
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe 2/2019
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-019-01561-5

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