LEFT-VENTRICULAR BLOOD-FLOW PATTERNS ASSESSED BY MAGNETIC-RESONANCE VELOCITY MAPPING IN PATIENTS WITH ISCHEMIC-HEART-DISEASE

Myocardial infarction results in wall motion abnormalities potentially associated with abnormal intracavitary blood flow patterns in the lef t ventricle. Magnetic resonance (MR) technique allows three-dimensiona l quantitative mapping of blood flow velocities. We performed three-di mensional MR velocity mapping in a modified left ventricular long axis plane in 10 patients with previous myocardial infarction and milder r eduction of the left ventricular function. The early diastolic inflow pattern did not differ qualitatively from earlier published findings i n normal subjects. At systole, a flow pattern similar to that found in normals was observed in 7 of our patients. In the remaining 3 patient s two types of abnormal systolic flow patterns were observed resulting in a paradoxical flow directed towards the apex. The location and tim ing of the abnormal flow allowed a distinction between paradoxical flo w into an aneurism and paradoxical flow towards an akinetic apex. Comp ared with other techniques currently available, three-dimensional MR v elocity mapping permits a more detailed description and understanding of abnormal flow patterns caused by wall motion injury in patients wit h myocardial infarction. This potential of the method suggests that th ree-dimensional MR phase velocity mapping may become a useful tool in assessment of significance and treatment of regional left ventricular dysfunction.