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The vortex—an early predictor of cardiovascular outcome?

Nature Reviews Cardiology volume 11, pages 545–553 (2014)Cite this article

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Abstract

Blood motion in the heart features vortices that accompany the redirection of jet flows towards the outlet tracks. Vortices have a crucial role in fluid dynamics. The stability of cardiac vorticity is vital to the dynamic balance between rotating blood and myocardial tissue and to the development of cardiac dysfunction. Moreover, vortex dynamics immediately reflect physiological changes to the surrounding system, and can provide early indications of long-term outcome. However, the pathophysiological relevance of cardiac fluid dynamics is still unknown. We postulate that maladaptive intracardiac vortex dynamics might modulate the progressive remodelling of the left ventricle towards heart failure. The evaluation of blood flow presents a new paradigm in cardiac function analysis, with the potential for sensitive risk identification of cardiac abnormalities. Description of cardiac flow patterns after surgery or device therapy provides an intrinsic qualitative evaluation of therapeutic procedures, and could enable early risk stratification of patients vulnerable to adverse cardiac remodelling.

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Figure 1: Blood flow in the healthy left ventricle.
Figure 2: Time profile of pressure in healthy left cardiac chambers.
Figure 3: Echocardiographic recordings of intraventricular swirling flow in healthy individuals.
Figure 4: Echocardiographic recordings of intraventricular flow.
Figure 5: The vortex in left ventricular remodelling.
Figure 6: Echocardiographic recordings of postsurgical intraventricular flow.
Figure 7: Longitudinally directed intraventricular pressure gradients are markers of normal left ventricular function.

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Acknowledgements

The authors thank Michael John of the Vita-Salute San Raffaele University in Milan, Italy for his support in the preparation of this paper.

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Authors and Affiliations

  1. Department of Engineering and Architecture, University of Trieste, Piazzale Europa, 1, Trieste, 34127, Italy

    Gianni Pedrizzetti

  2. Echocardiography Unit, San Raffaele Scientific Institute, Via Olgettina, 58, 20132, Milan, Italy

    Giovanni La Canna

  3. Cardiac Surgery Department, San Raffaele Scientific Institute, Via Olgettina, 58, 20132, Milan, Italy

    Ottavio Alfieri

  4. Cardiology Division, G. d'Annunzio University, Via dei Vestini, 31, Chieti, 66100, Italy

    Giovanni Tonti

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Correspondence to Giovanni La Canna.

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Pedrizzetti, G., La Canna, G., Alfieri, O. et al. The vortex—an early predictor of cardiovascular outcome?. Nat Rev Cardiol 11, 545–553 (2014). https://doi.org/10.1038/nrcardio.2014.75

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