Heart 2001;86:448-455 ( October )

Basic research

Three dimensional flow in the human left atrium A Fyrenius^a, L Wigström^a, T Ebbers^b, M Karlsson^b, J Engvall^a, A F Bolger^c

^a Department of Medicine and Care, Clinical Physiology, Linköping University, Linköping, Sweden, ^b Department of Biomedical Engineering, Linköping University, Linköping, Sweden, ^c Department of Medicine, University of California, San Francisco, 1001 Potrero Avenue 5G1, San Francisco, California 94110, USA

Correspondence to: Dr Bolger abolger{at}medsfgh.ucsf.edu

Accepted 13 June 2001

BACKGROUNDAbnormal flow patterns in the left atrium in atrial fibrillation or mitral stenosis are associated with an increased risk of thrombosis and systemic embolisation; the characteristics of normal atrial flow that avoid stasis have not been well defined.
OBJECTIVESTo present a three dimensional particle trace visualisation of normal left atrial flow in vivo, constructed from flow velocities in three dimensional space.
METHODSParticle trace visualisation of time resolved three dimensional magnetic resonance imaging velocity measurements was used to provide a display of intracardiac flow without the limitations of angle sensitivity or restriction to imaging planes. Global flow patterns of the left atrium were studied in 11 healthy volunteers.
RESULTSIn all subjects vortical flow was observed in the atrium during systole and diastolic diastasis (mean (SD) duration of systolic vortex, 280 (77) ms; and of diastolic vortex, 256 (118) ms). The volume incorporated and recirculated within the vortices originated predominantly from the left pulmonary veins. Inflow from the right veins passed along the vortex periphery, constrained between the vortex and the atrial wall.
CONCLUSIONSGlobal left atrial flow in the normal human heart comprises consistent patterns specific to the phase of the cardiac cycle. Separate paths of left and right pulmonary venous inflow and vortex formation may have beneficial effects in avoiding left atrial stasis in the normal subject in sinus rhythm.


Keywords: atrium; blood flow; magnetic resonance imaging; haemodynamics

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© 2001 by Heart
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