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Functional significance of intra-left ventricular vortices on energy efficiency in normal, dilated, and hypertrophied hearts
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  • Miwa Sarashina,
  • Hiroyuki Iwano,
  • Kazunori Okada,
  • Kou Motoi,
  • Suguru Ishizaka,
  • Yasuyuki Chiba,
  • Shingo Tsujinaga,
  • Michito Murayama,
  • Masahiro Nakabachi,
  • Shinobu Yokoyama,
  • Hisao Nishino,
  • Sanae Kaga,
  • Toshihisa Anzai
Miwa Sarashina
Faculty of Medicine and Graduate School of Medicine, Hokkaido University
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Hiroyuki Iwano
Faculty of Medicine and Graduate School of Medicine, Hokkaido University
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Kazunori Okada
Division of Health Sciences
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Kou Motoi
Faculty of Medicine and Graduate School of Medicine, Hokkaido University
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Suguru Ishizaka
Faculty of Medicine and Graduate School of Medicine, Hokkaido University
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Yasuyuki Chiba
Faculty of Medicine and Graduate School of Medicine, Hokkaido University
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Shingo Tsujinaga
Faculty of Medicine and Graduate School of Medicine, Hokkaido University
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Michito Murayama
Hokkaido University Hospital
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Masahiro Nakabachi
Hokkaido University Hospital
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Shinobu Yokoyama
Division of Laboratory and Transfusion Medicine
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Hisao Nishino
Division of Laboratory and Transfusion Medicine
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Sanae Kaga
Division of Laboratory and Transfusion Medicine
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Toshihisa Anzai
Faculty of Medicine and Graduate School of Medicine, Hokkaido University
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Abstract

Purpose: To investigate the influence of changes in intra left ventricular (LV) vortices on LV energy efficiency (EE) in normal and diseased hearts. Methods: Vector flow mapping echocardiography was performed in 36 normal subjects (N), 36 patients with dilated cardiomyopathy (D), and 36 patients with LV hypertrophy (H). The circulation of main anterior vortex was measured as a parameter of vortex strength and EE was calculated as energy loss divided by LV stroke work. Results: Circulation increased in the order of N, H, and D (N: 15±4, D: 19±8, H: 17±6 10-3m2/s; analysis of variance [ANOVA], P<0.01). Conversely, EE increased in the order of N, D, and H (N: 0.22±0.07, D: 0.26±0.16, H: 0.30±0.16 10-5J/mmHg·mL·m·s; ANOVA, P=0.04), suggesting worst EE in group H. We found a positive correlation between circulation and stroke work only in group N and positive correlation between circulation and EE only in diseased groups (D: R=0.55, P<0.01; H: R=0.44, P<0.01). Multivariable analyses revealed that circulation was the independent determinant of EE in both of groups D and H. Conclusions: Enhanced vortices could work effectively to increase LV external work without loss of EE in normal hearts, while in failing hearts only to worse EE, regardless of the LV morphology.