TABLE 5.
Four-dimensional flow CMR studies assessing eft ventricular diastolic function using flow component analysis.
| Reference | N | Disease/subject | 4D diastolic parameters | Comparison vs. conventional diastolic parameters | Relevant findings |
| Healthy controls | |||||
| Sundin et al. (77) | 12 controls | Dobutamine stress | Flow component volumes Flow component diastolic KE* |
− | Improved flow efficiency (↑ DF%, ↓RV%) with dobutamine stress ↑ mean ED KE of all flow components with dobutamine stress |
| Stoll et al. (76) | 45 controls | Test-retest variability | Flow component volumes Flow component diastolic KE* |
− | DF was the largest component, followed by RV, DEF and RI. DF had greatest mean ED KE, followed by RI, DEF, and RV. |
| Eriksson et al. (72) | 12 controls 1 DCM patient |
Normal blood flow | Flow component volumes Flow component diastolic KE |
− | Reduced flow efficiency (↓DF%, ↑ RI + RV%) in DCM patient ↓mean ED KE of DF, ↑ overall diastolic KE of non-inflow volume (DEF + RV) in DCM patient |
| Bolger et al. (71) | 17 controls 1 DCM patient |
Normal blood flow | Flow component volumes Flow component diastolic KE |
− | Reduced flow efficiency (↓DF%, ↑ RI + RV%) in DCM patient Similar DF diastolic KE loss in DCM patient, however greater loss of total inflow diastolic KE |
| Cardiovascular disease | |||||
| Stoll et al. (79) | 64 HF patients 36 controls |
HF (mixed etiology) | Flow component volumes Flow component diastolic KE* |
− | Reduced flow efficiency (↓DF%, ↑ RI + RV%) in HF patients ↓mean ED and average KE of DF, ↑ mean ED KE of non-ejected volume (RI + RV) in HF patients. |
| Corrado et al. (73) | 12 MI patients 10 controls |
Post MI | Flow component volumes Flow component diastolic KE* |
− | Reduced flow efficiency (↓DF%, ↑ RI, DEF and RV%) post ant. MI. No significant difference in average KE post ant. MI. |
| Karlsson et al. (78) | 10 AF patients | Post cardioversion | Flow component volumes Flow component diastolic KE |
− | Improved flow efficiency (↑ DF%, ↓RV%) post cardioversion. ↑ mean ED KE of DF, and ↓mean ED KE of RV post cardioversion. |
| Eriksson et al. (28) | 6 controls 3 DCM patients |
Semi-automatic analysis | Flow component volumes | − | The semi-automatic analysis approach used was accurate and had good reproducibility |
| Eriksson et al. (74) | 10 DCM patients 10 controls |
HF (DCM) | Flow component volumes Flow component diastolic KE* |
− | Reduced flow efficiency (↓DF%, ↑ RI, DEF and RV%) in DCM. No significant difference in mean ED KE of DF, but ↑ ED KE of RI, DEF and RV in DCM. |
| Zajac et al. (80) | 22 HF patients (50% with LBBB) |
HF (mixed etiology) Dyssynchrony |
Flow component volumes Flow component diastolic KE* |
− | No significant difference in LVEDV ratio in patients with LBBB. ↓mean ED KE of Direct Flow in patients with LBBB. |
| Svalbring et al. (75) | 26 IHD patients 10 controls |
LV remodeling and dysfunction | Flow component volumes Flow component diastolic KE* |
− | Reduced flow efficiency (↓DF%, ↑ RI + RV%) with increased LV volumes. ↓mean ED KE of Direct Flow, ↑ mean ED KE of non-ejected volume (RI + RV) with increased LV volumes. |
DCM, dilated cardiomyopathy; DF, direct flow; DEF, delayed ejection flow; HF, heart failure; IHD, ischemic heart disease; KE, kinetic energy; LBBB, left bundle branch block; LV, left ventricle; MI, myocardial infarction; RI, retained inflow; RV, residual volume. *Indexed to flow component volume.