| Sumario: | Aims: The purpose of this study was to assess the evolution of intraventricular vortex during left ventricular ( LV) ejection. Methods: Vector flow mapping was performed in 51 patients with coronary artery disease and LV ejection fraction ( EF) >50%, 70 patients with EF <50% (13 with coronary artery disease and 57 with dilated cardiomyopathy), and 62 healthy volunteers. Results: In normals and patients with EF >50%, the intraventricular vortex dissipated quickly during early ejection. In patients with EF <50%, the vortex stayed mainly at apex and persisted for a significantly longer time. The evolution of vortex during ejection was significantly correlated with QRS width, EF, fractional shortening, LV outflow velocity time integral, wall motion score index ( WMSI), LV dimensions, left atrial diameter, and diastolic mitral annular velocities. LV end-diastolic short diameter and WMSI were the independent determinants of the duration of vortex (R2 = 0.482, P < 0.001). End-systolic short diameter and apical WMSI were the independent determinants of duration of vortex corrected for ejection time (R2 = 0.565, P < 0.001). End-systolic short diameter was the independent determinant of percentage change in vortex area during early ejection (R2 = 0.355, P < 0.001). End-systolic short diameter and ejection time were the independent determinants of percentage change in vortex flow volume (R2 = 0.415, P < 0.001). Conclusions: In patients with LV systolic dysfunction, the vortex persists during ejection and stays mainly at apex. The vortex evolution during ejection is closely associated with LV dimensions and functions.
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