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

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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.

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Acknowledgments

This work was supported by the 2013 Yeungnam University research grant.

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Authors and Affiliations

  1. Division of Cardiology, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea

    Jang-Won Son

  2. Division of Cardiology, Department of Internal Medicine, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine, 250 Seungsanno, Seodaemun-gu, Seoul, 120-752, Korea

    Geu-Ru Hong & Namsik Chung

  3. New York University, New York, NY, USA

    Woosol Hong

  4. School of Medicine, University of Queensland, Herston, QLD, Australia

    Minji Kim

  5. Siemens Medical Solutions, Mountain View, CA, USA

    Helene Houle

  6. Department of Cardiovascular Imaging, Piedmont Heart Institute, Atlanta, GA, USA

    Mani A. Vannan

  7. Department of Engineering and Architecture, University of Trieste, Trieste, Italy

    Gianni Pedrizzetti

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  1. Jang-Won Son
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Correspondence to Geu-Ru Hong.

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The research of Geu-Ru Hong is supported by Siemens Medical Solution.

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Son, JW., Hong, GR., Hong, W. et al. Differences in aortic vortex flow pattern between normal and patients with stroke: qualitative and quantitative assessment using transesophageal contrast echocardiography. Int J Cardiovasc Imaging 32 (Suppl 1), 45–52 (2016). https://doi.org/10.1007/s10554-015-0818-4

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  • DOI: https://doi.org/10.1007/s10554-015-0818-4

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