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Differences in aortic vortex flow pattern between normal and patients with stroke: qualitative and quantitative assessment using transesophageal contrast echocardiography.

Authors
 Jang-Won Son  ;  Geu-Ru Hong  ;  Woosol Hong  ;  Minji Kim  ;  Helene Houle  ;  Mani A. Vannan  ;  Gianni Pedrizzetti  ;  Namsik Chung 
Citation
 INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, Vol.32(Suppl 1) : 42-52, 2016 
Journal Title
 INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 
ISSN
 1569-5794 
Issue Date
2016
MeSH
Adult ; Aged ; Aorta, Thoracic/diagnostic imaging* ; Aorta, Thoracic/physiopathology ; Brain Ischemia/diagnostic imaging* ; Brain Ischemia/physiopathology ; Case-Control Studies ; Contrast Media/administration & dosage* ; Echocardiography, Transesophageal* ; Feasibility Studies ; Female ; Fluorocarbons/administration & dosage* ; Hemodynamics* ; Humans ; Male ; Middle Aged ; Observer Variation ; Predictive Value of Tests ; Prospective Studies ; Pulsatile Flow ; Regional Blood Flow ; Reproducibility of Results ; Stroke/diagnostic imaging* ; Stroke/physiopathology ; Ventricular Function, Left
Keywords
Aorta ; Stroke ; Vortex
Abstract
The flow in the aorta forms a vortex, which is a critical determinant of the flow dynamics in the aorta. Arteriosclerosis can alter the blood flow pattern of the aorta and cause characteristic alterations of the vortex. However, this change in aortic vortex has not yet been studied. This study aimed to characterize aortic vortex flow pattern using transesophageal contrast echocardiography in normal and stroke patients. A total of 85 patients who diagnosed with ischemic stroke and 16 normal controls were recruited for this study. The 16 normal control subjects were designated as the control group, and the 85 ischemic stroke patients were designated as the stroke group. All subjects underwent contrast transesophageal echocardiography (TEE), and particle image velocimetry was used to assess aortic vortex flow. Qualitative and quantitative analyses of vortex flow morphology, location, phasic variation, and pulsatility were undertaken and compared between the groups. In the control group, multiple irregularly-shaped vortices were observed in a peripheral location in the descending thoracic aorta. In contrast, the stroke group had a single, round, merged, and more centrally located aortic vortex flow. In the quantitative analysis of vortex, vortex depth, which represents the location of the major vortex in the aorta, was significantly higher in the control group than in the stroke group (0.599 ± 0.159 vs. 0.522 ± 0.101, respectively, P = 0.013). Vortex relative strength, which is the pulsatility parameter of the vortex itself, was significantly higher in the stroke group than in the control group (0.367 ± 0.148 vs. 0.304 ± 0.087, respectively, P = 0.025). It was feasible to visualize and quantify the characteristic morphology and pulsatility of the aortic vortex flow using contrast TEE, and aortic vortex pattern significantly differed between normal and stroke patients.
Full Text
http://link.springer.com/article/10.1007/s10554-015-0818-4
DOI
10.1007/s10554-015-0818-4
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Chung, Nam Sik(정남식)
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/147161
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