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February 19, 2026Heart and Vessels0 citationsOpen Access

Late-systolic to early-diastolic hemodynamic force analysis in ischemic heart disease using vector flow mapping and invasive pressure measurement

TSTakushi SugiyamaNONaoyuki OtaniHNHaruka Noma

Key Result

Vector Flow Mapping-derived IVPD recoil was significantly reduced to 1.0 mmHg in patients with ischemic heart disease and left ventricular aneurysm compared to 2.5 mmHg in patients without aneurysm, indicating impaired apical suction (P < 0.01).

Key Points

  • To assess late-systolic to early-diastolic hemodynamic force in ischemic heart disease using vector flow mapping.
  • Analyzed apical suction in patients with ischemic heart disease and left ventricular aneurysm using vector flow mapping.
  • Evaluated 37 subjects, including healthy controls and those with ischemic heart disease.
  • Measured intraventricular pressure differences using simultaneous catheter-derived pressures.
  • Patients with left ventricular aneurysm showed reduced apical suction compared to other groups.
  • VFM-derived parameters correlated significantly with transmitral E-wave and simultaneous pressure differences.
  • The combined VFM parameter indicated impaired diastolic suction related to left atrial and left ventricular dynamics.

Study Design

Type

Observational (n=37)

Multicenter

No

Structured PICO

Does vector flow mapping (VFM) accurately assess impaired apical suction and intraventricular pressure differences in patients with ischemic heart disease and left ventricular aneurysm compared to invasive measurements?

P
Population
n=37 participants (11 healthy controls, 11 patients with ischemic heart disease [IHD] without left ventricular aneurysm [LVA], and 15 patients with IHD and LVA). Key inclusion criteria: sinus rhythm, absence of moderate-to-severe valvular heart disease or decompensated heart failure, and no prior coronary artery bypass graft surgery. Japan-based.
I
Intervention
Vector flow mapping (VFM) using echocardiography for noninvasive assessment of intraventricular pressure differences (IVPDs) from late systole to early diastole.
C
Comparator
Invasive left atrial-left ventricular pressure gradient measurement via cardiac catheterization (reference standard), and comparison between IHD patients with versus without LVA.
O
Outcome
Apical suction from late systole to early diastole quantified as IVPD recoil (late systole), IVPD RF (early diastole), and the combined parameter (IVPD VFM recoil + RF), and their correlation with catheter-derived simultaneous pressure differences.surrogate

Vector flow mapping is a feasible noninvasive tool to identify the loss of apical suction and impaired left atrial-left ventricular driving force in patients with post-infarction left ventricular aneurysm.

Main Result

Effect estimate: P-value <0.01

Absolute Event Rate: 1% vs 2.5%

p-value: p=<0.01

Limitations

  • Single-center study with small sample size
  • Invasive measurements only performed in IHD and LV A groups, not in healthy controls
  • Temporal resolution of VFM limited (48 fps)
  • Catheter-derived and VFM-derived pressures measured by different principles and timings, possibly explaining modest correlations
  • Possible physiological status changes within ±4 day window between measurements
  • Infarct size not standardized across MI subtypes due to small numbers
  • Selection bias due to inclusion based on availability of catheterization, image quality, and complete data
  • Underpowered subgroups (e.g. anterior MI without aneurysm) not separately analyzed
  • Small sample size requiring further studies with larger cohorts

Abstract

Abstract Hemodynamic force (HDF) analysis using vector flow mapping (VFM) enables noninvasive assessment of intraventricular pressure differences (IVPDs). In this study, we evaluated the apical suction from late systole to early diastole in patients with ischemic heart disease (IHD) with or without left ventricular aneurysm (LVA), validated against simultaneous left atrial–LV pressure measurements. A total of 37 participants were evaluated: 11 healthy controls, 11 patients with IHD without LVA, and 15 with LVA. VFM-derived IVPDs were quantified as IVPD recoil (late systole) or IVPD RF (early diastole). Patients with LVA showed markedly reduced IVPD recoil and the combined parameter (IVPD VFM recoil + RF) compared with those with IHD, indicating impaired apical suction. IVPD RF and the combined parameter (IVPD VFM recoil + RF) correlated with transmitral E-wave ( r = 0.54, P < 0.01 and r = 0.45, P = 0.03); the combined parameter (IVPD VFM recoil + RF) showed significant correlation with catheter-derived simultaneous pressure differences ( r = 0.40, P < 0.05). These findings demonstrate that VFM identifies loss of apical suction in LVA and reflects impaired LA–LV driving force. VFM offers a practical noninvasive tool for evaluating diastolic suction beyond Doppler indices and may improve physiological assessment in post-infarction LV remodeling.

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Cite This Study

Sugiyama et al. (2026) conducted an observational in Patients with ischemic heart disease with or without left ventricular aneurysm and healthy controls (n=37). Vector Flow Mapping (VFM)-derived Intraventricular Pressure Difference (IVPD) analysis vs. Patients with ischemic heart disease without left ventricular aneurysm (IHD group) and healthy controls was evaluated on IVPD VFM recoil (late systole intraventricular pressure difference reflecting apical suction) and combined IVPD VFM recoil + RF (sum of late systolic recoil and early diastolic rapid filling pressure difference) (P-value <0.01, p=<0.01). Vector Flow Mapping-derived IVPD recoil was significantly reduced to 1.0 mmHg in patients with ischemic heart disease and left ventricular aneurysm compared to 2.5 mmHg in patients without aneurysm, indicating impaired apical suction (P < 0.01).

synapsesocial.com/papers/6996a80aecb39a600b3ee6e0https://doi.org/10.1007/s00380-026-02664-5
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