Original Research

Hemodynamic aspects of mitral regurgitation assessed by generalized phase-contrast MRI

  1. Petter Dyverfeldt PhD1,2,3,*,
  2. John-Peder Escobar Kvitting MD, PhD3,4,
  3. Carl Johan Carlhäll MD, PhD3,5,
  4. Gabriella Boano MD4,
  5. Andreas Sigfridsson PhD1,3,6,
  6. Ulf Hermansson MD4,
  7. Ann F. Bolger MD1,7,
  8. Jan Engvall MD, PhD1,
  9. Tino Ebbers PhD1,2,3

Article first published online: 24 FEB 2011

DOI: 10.1002/jmri.22407

Issue

Journal of Magnetic Resonance Imaging

Journal of Magnetic Resonance Imaging

Volume 33, Issue 3, pages 582–588, March 2011

Additional Information

How to Cite

Dyverfeldt, P., Kvitting, J.-P. E., Carlhäll, C. J., Boano, G., Sigfridsson, A., Hermansson, U., Bolger, A. F., Engvall, J. and Ebbers, T. (2011), Hemodynamic aspects of mitral regurgitation assessed by generalized phase-contrast MRI. J. Magn. Reson. Imaging, 33: 582–588. doi: 10.1002/jmri.22407

Author Information

  1. 1

    Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden

  2. 2

    Division of Applied Thermodynamics and Fluid Mechanics, Department of Management and Engineering, Linköping University, Linköping, Sweden

  3. 3

    Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden

  4. 4

    Department of Cardiothoracic Surgery, Linköping University Hospital, Linköping, Sweden

  5. 5

    Department of Clinical Physiology, Linköping University Hospital, Linköping, Sweden

  6. 6

    Division of Medical Informatics, Department of Biomedical Engineering, Linköping University, Linköping, Sweden

  7. 7

    Department of Medicine, University of California San Francisco, San Francisco, California, United States

*Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine, SE-581 83 Linköping, Sweden

Publication History

  1. Issue published online: 23 FEB 2011
  2. Article first published online: 24 FEB 2011
  3. Manuscript Accepted: 15 SEP 2010
  4. Manuscript Received: 21 NOV 2009

Funded by

  • Swedish Research Council
  • Swedish Heart-Lung Foundation
  • Heart Foundation at Linköping University

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Keywords:

  • Hemodynamics;
  • mitral valve insufficiency;
  • turbulent flow;
  • phase-contrast MRI;
  • pulmonary veins;
  • blood flow velocity

Abstract

Purpose:

To investigate the utility of MRI measurement of left atrial (LA) flow patterns and turbulent kinetic energy (TKE) in patients with clinically significant mitral regurgitation.

Materials and Methods:

Three-dimensional cine phase-contrast MRI (PC-MRI) data were acquired in five patients with posterior mitral leaflet prolapse and two normal volunteers. LA flow patterns were assessed using particle trace visualization. Specifically, vortices were recognized by closed streamlines. LA flow distortion was assessed by estimation of TKE. In addition, the regurgitant volume was measured.

Results:

Four of the mitral regurgitation patients had eccentric regurgitant jets directed toward the septum; one patient had a central jet. The dominant systolic vortex was located in proximity to the regurgitant jet. The LA flow was highly disturbed with elevated values of TKE; peak LA TKE ranged from 13 to 37 mJ and occurred consistently at late systole. The average LA TKE per cardiac cycle was significantly related to the regurgitant volume (TKE = 0.573 + 0.179·RegVol, R2 = 0.983).

Conclusion:

MRI permits investigations of atrial flow patterns and TKE in significant mitral regurgitation. The degree of LA flow distortion, as measured by the average LA TKE over one cardiac cycle, appears to reflect the severity of regurgitation. J. Magn. Reson. Imaging 2011;33:582–588. © 2011 Wiley-Liss, Inc.

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