Stress increases intracardiac 4D flow cardiovascular magnetic resonance -derived energetics and vorticity and relates to VO2max in Fontan patients View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-07-25

AUTHORS

Vivian P. Kamphuis, Mohammed S. M. Elbaz, Pieter J. van den Boogaard, Lucia J. M. Kroft, Hildo J. Lamb, Mark G. Hazekamp, Monique R. M. Jongbloed, Nico A. Blom, Willem A. Helbing, Arno A. W. Roest, Jos J. M. Westenberg

ABSTRACT

BACKGROUND: We hypothesize that dobutamine-induced stress impacts intracardiac hemodynamic parameters and that this may be linked to decreased exercise capacity in Fontan patients. Therefore, the purpose of this study was to assess the effect of pharmacologic stress on intraventricular kinetic energy (KE), viscous energy loss (EL) and vorticity from four-dimensional (4D) Flow cardiovascular magnetic resonance (CMR) imaging in Fontan patients and to study the association between stress response and exercise capacity. METHODS: Ten Fontan patients underwent whole-heart 4D flow CMR before and during 7.5 μg/kg/min dobutamine infusion and cardiopulmonary exercise testing (CPET) on the same day. Average ventricular KE, EL and vorticity were computed over systole, diastole and the total cardiac cycle (vorticity_volavg cycle, KEavg cycle, ELavg cycle). The relation to maximum oxygen uptake (VO2 max) from CPET was tested by Pearson's correlation or Spearman's rank correlation in case of non-normality of the data. RESULTS: Dobutamine stress caused a significant 88 ± 52% increase in KE (KEavg cycle: 1.8 ± 0.5 vs 3.3 ± 0.9 mJ, P < 0.001), a significant 108 ± 49% increase in EL (ELavg cycle: 0.9 ± 0.4 vs 1.9 ± 0.9 mW, P < 0.001) and a significant 27 ± 19% increase in vorticity (vorticity_volavg cycle: 3441 ± 899 vs 4394 ± 1322 mL/s, P = 0.002). All rest-stress differences (%) were negatively correlated to VO2 max (KEavg cycle: r = - 0.83, P = 0.003; ELavg cycle: r = - 0.80, P = 0.006; vorticity_volavg cycle: r = - 0.64, P = 0.047). CONCLUSIONS: 4D flow CMR-derived intraventricular kinetic energy, viscous energy loss and vorticity in Fontan patients increase during pharmacologic stress and show a negative correlation with exercise capacity measured by VO2 max. More... »

PAGES

43

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12968-019-0553-4

DOI

http://dx.doi.org/10.1186/s12968-019-0553-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1119798603

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31340834


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    "description": "BACKGROUND: We hypothesize that dobutamine-induced stress impacts intracardiac hemodynamic parameters and that this may be linked to decreased exercise capacity in Fontan patients. Therefore, the purpose of this study was to assess the effect of pharmacologic stress on intraventricular kinetic energy (KE), viscous energy loss (EL) and vorticity from four-dimensional (4D) Flow cardiovascular magnetic resonance (CMR) imaging in Fontan patients and to study the association between stress response and exercise capacity.\nMETHODS: Ten Fontan patients underwent whole-heart 4D flow CMR before and during 7.5\u2009\u03bcg/kg/min dobutamine infusion and cardiopulmonary exercise testing (CPET) on the same day. Average ventricular KE, EL and vorticity were computed over systole, diastole and the total cardiac cycle (vorticity_volavg cycle, KEavg cycle, ELavg cycle). The relation to maximum oxygen uptake (VO2 max) from CPET was tested by Pearson's correlation or Spearman's rank correlation in case of non-normality of the data.\nRESULTS: Dobutamine stress caused a significant 88\u2009\u00b1\u200952% increase in KE (KEavg cycle: 1.8\u2009\u00b1\u20090.5 vs 3.3\u2009\u00b1\u20090.9\u2009mJ, P\u2009<\u20090.001), a significant 108\u2009\u00b1\u200949% increase in EL (ELavg cycle: 0.9\u2009\u00b1\u20090.4 vs 1.9\u2009\u00b1\u20090.9\u2009mW, P\u2009<\u20090.001) and a significant 27\u2009\u00b1\u200919% increase in vorticity (vorticity_volavg cycle: 3441\u2009\u00b1\u2009899 vs 4394\u2009\u00b1\u20091322\u2009mL/s, P\u2009=\u20090.002). All rest-stress differences (%) were negatively correlated to VO2 max (KEavg cycle: r\u2009=\u2009-\u20090.83, P\u2009=\u20090.003; ELavg cycle: r\u2009=\u2009-\u20090.80, P\u2009=\u20090.006; vorticity_volavg cycle: r\u2009=\u2009-\u20090.64, P\u2009=\u20090.047).\nCONCLUSIONS: 4D flow CMR-derived intraventricular kinetic energy, viscous energy loss and vorticity in Fontan patients increase during pharmacologic stress and show a negative correlation with exercise capacity measured by VO2 max.", 
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34 schema:description BACKGROUND: We hypothesize that dobutamine-induced stress impacts intracardiac hemodynamic parameters and that this may be linked to decreased exercise capacity in Fontan patients. Therefore, the purpose of this study was to assess the effect of pharmacologic stress on intraventricular kinetic energy (KE), viscous energy loss (EL) and vorticity from four-dimensional (4D) Flow cardiovascular magnetic resonance (CMR) imaging in Fontan patients and to study the association between stress response and exercise capacity. METHODS: Ten Fontan patients underwent whole-heart 4D flow CMR before and during 7.5 μg/kg/min dobutamine infusion and cardiopulmonary exercise testing (CPET) on the same day. Average ventricular KE, EL and vorticity were computed over systole, diastole and the total cardiac cycle (vorticity_vol<sub>avg cycle</sub>, KE<sub>avg cycle,</sub> EL<sub>avg cycle</sub>). The relation to maximum oxygen uptake (VO<sub>2</sub> max) from CPET was tested by Pearson's correlation or Spearman's rank correlation in case of non-normality of the data. RESULTS: Dobutamine stress caused a significant 88 ± 52% increase in KE (KE<sub>avg cycle</sub>: 1.8 ± 0.5 vs 3.3 ± 0.9 mJ, P &lt; 0.001), a significant 108 ± 49% increase in EL (EL<sub>avg cycle</sub>: 0.9 ± 0.4 vs 1.9 ± 0.9 mW, P &lt; 0.001) and a significant 27 ± 19% increase in vorticity (vorticity_vol<sub>avg cycle</sub>: 3441 ± 899 vs 4394 ± 1322 mL/s, P = 0.002). All rest-stress differences (%) were negatively correlated to VO<sub>2</sub> max (KE<sub>avg cycle</sub>: r = - 0.83, P = 0.003; EL<sub>avg cycle</sub>: r = - 0.80, P = 0.006; vorticity_vol<sub>avg cycle</sub>: r = - 0.64, P = 0.047). CONCLUSIONS: 4D flow CMR-derived intraventricular kinetic energy, viscous energy loss and vorticity in Fontan patients increase during pharmacologic stress and show a negative correlation with exercise capacity measured by VO<sub>2</sub> max.
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42 Average ventricular KE
43 CMR-derived intraventricular kinetic energy
44 Fontan patients
45 Pearson correlation
46 Spearman rank correlation
47 VO
48 VO2max
49 association
50 capacity
51 cardiac cycle
52 cardiopulmonary exercise testing
53 cardiovascular magnetic resonance
54 cardiovascular magnetic resonance -derived energetics
55 cases
56 correlation
57 cycle
58 data
59 days
60 diastole
61 differences
62 dobutamine infusion
63 dobutamine stress
64 dobutamine-induced stress
65 effect
66 energetics
67 energy
68 energy loss
69 exercise capacity
70 exercise testing
71 flow CMR-derived intraventricular kinetic energy
72 flow cardiovascular magnetic resonance
73 flow cardiovascular magnetic resonance -derived energetics
74 hemodynamic parameters
75 increase
76 infusion
77 intracardiac hemodynamic parameters
78 intraventricular kinetic energy
79 kinetic energy
80 loss
81 magnetic resonance
82 magnetic resonance -derived energetics
83 max
84 maximum oxygen uptake
85 min dobutamine infusion
86 negative correlation
87 oxygen uptake
88 parameters
89 patients
90 pharmacologic stress
91 purpose
92 rank correlation
93 relation
94 resonance
95 resonance -derived energetics
96 response
97 rest-stress differences
98 same day
99 stress
100 stress increases
101 stress response
102 study
103 systole
104 testing
105 total cardiac cycle
106 uptake
107 ventricular kinetic energy
108 viscous energy loss
109 vorticity
110 whole-heart 4D flow CMR
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