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. 2006 Apr 18;103(16):6305-8.
doi: 10.1073/pnas.0600520103. Epub 2006 Apr 10.

Optimal vortex formation as an index of cardiac health

Morteza Gharib  1 , Edmond Rambod, Arash Kheradvar, David J Sahn, John O Dabiri
Affiliations

Optimal vortex formation as an index of cardiac health

Morteza Gharib et al. Proc Natl Acad Sci U S A. .

Abstract

Heart disease remains a leading cause of death worldwide. Previous research has indicated that the dynamics of the cardiac left ventricle (LV) during diastolic filling may play a critical role in dictating overall cardiac health. Hence, numerous studies have aimed to predict and evaluate global cardiac health based on quantitative parameters describing LV function. However, the inherent complexity of LV diastole, in its electrical, muscular, and hemodynamic processes, has prevented the development of tools to accurately predict and diagnose heart failure at early stages, when corrective measures are most effective. In this work, it is demonstrated that major aspects of cardiac function are reflected uniquely and sensitively in the optimization of vortex formation in the blood flow during early diastole, as measured by a dimensionless numerical index. This index of optimal vortex formation correlates well with existing measures of cardiac health such as the LV ejection fraction. However, unlike existing measures, this previously undescribed index does not require patient-specific information to determine numerical index values corresponding to normal function. A study of normal and pathological cardiac health in human subjects demonstrates the ability of this global index to distinguish disease states by a straightforward analysis of noninvasive LV measurements.

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Conflict of interest statement

Conflict of interest statement: No conflicts declared.

Figures

Fig. 1.
Fig. 1.
Vortex ring formation in vivo and in vitro. (a and b) Map of in vivo blood flow velocity vectors and vorticity (rotation and shear) contours in the LV of a human heart during diastole. Images were obtained by magnetic resonance imaging of a healthy adult (courtesy of the Vascular Imaging Research Center, Department of Radiology, Veterans Affairs Medical Center/University of California, San Francisco). For emphasis, the LV boundary is indicated by a white line. Vortical patterns are indicated by the orientation of velocity vectors and by vorticity contours. Blue and yellow contours indicate clockwise and counterclockwise fluid rotation, respectively. (c) Fluorescent dye images of in vitro vortex ring formation in fluid jets with increasing vortex formation time. (Top) T = 2.0. (Middle) T = 3.8. (Bottom) T = 14.5. For T > 4, vortex ring growth terminates and fluid is subsequently ejected in a trailing jet. Figure is adapted from ref. .
Fig. 2.
Fig. 2.
Quantitative relationship between LV geometry parameter (α), LV ejection fraction, and approximate vortex formation time (T). Horizontal gray band indicates normal range of LV geometry parameter (α). Solid curved line, LV ejection fraction = 0.65 (i.e., normal LV function); dashed curved line, LV ejection fraction = 0.3 (e.g., DCM). The vortex formation time (T) corresponding to normal LV function (i.e., values bounded by vertical dashed lines) is consistent with the range of optimal vortex formation found in previous in vitro experiments (14, 21). The vortex formation time corresponding to a reduced LV ejection fraction (i.e., values bounded by vertical dotted lines) is lower than the optimal range.
Fig. 3.
Fig. 3.
Vortex formation time in adult humans from blind test and those with DCM. Blue circles, blind test; red squares, DCM. Least-squares linear fit to blind test data are indicated by dashed black line. Dotted black lines indicate one standard deviation from the linear fit (SD = 1.03). (Inset) Histogram of vortex formation time data from blind test and DCM populations.
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