Impact of dobutamine stress on diastolic energetic efficiency of healthy left ventricle: an in vivo kinetic energy analysis

Alessandra Riva; Jonatan Eriksson; Federica Viola; Francesco Sturla; Emiliano Votta; Tino Ebbers; Carl-Johan Gustav Carlhäll; Petter Dyverfeldt

doi:10.3389/fcvm.2023.1103751

Impact of dobutamine stress on diastolic energetic efficiency of healthy left ventricle: an in vivo kinetic energy analysis

Front Cardiovasc Med. 2023 Mar 21:10:1103751. doi: 10.3389/fcvm.2023.1103751. eCollection 2023.

Authors

Alessandra Riva^{1

2}, Jonatan Eriksson^{3

4}, Federica Viola⁵, Francesco Sturla^{1

2}, Emiliano Votta^{1

2}, Tino Ebbers^{3

5}, Carl-Johan Gustav Carlhäll^{3

5

6}, Petter Dyverfeldt^{3

5}

Affiliations

¹ Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.
² 3D and Computer Simulation Laboratory, IRCCS, Policlinico San Donato, San Donato Milanese, Italy.
³ Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden.
⁴ Department of Medical Radiation Physics and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
⁵ Unit of Cardiovascular Sciences, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
⁶ Department of Clinical Physiology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.

Abstract

The total kinetic energy (KE) of blood can be decomposed into mean KE (MKE) and turbulent KE (TKE), which are associated with the phase-averaged fluid velocity field and the instantaneous velocity fluctuations, respectively. The aim of this study was to explore the effects of pharmacologically induced stress on MKE and TKE in the left ventricle (LV) in a cohort of healthy volunteers. 4D Flow MRI data were acquired in eleven subjects at rest and after dobutamine infusion, at a heart rate that was ∼60% higher than the one in rest conditions. MKE and TKE were computed as volume integrals over the whole LV and as data mapped to functional LV flow components, i.e., direct flow, retained inflow, delayed ejection flow and residual volume. Diastolic MKE and TKE increased under stress, in particular at peak early filling and peak atrial contraction. Augmented LV inotropy and cardiac frequency also caused an increase in direct flow and retained inflow MKE and TKE. However, the TKE/KE ratio remained comparable between rest and stress conditions, suggesting that LV intracavitary fluid dynamics can adapt to stress conditions without altering the TKE to KE balance of the normal left ventricle at rest.

Keywords: 4D flow MRI; dobutamine stress; flow physiology; hemodynamics; kinetic energy; left ventricle; stress cardiovascular magnetic resonance; turbulent kinetic energy.