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 left ventricle. Magnetic resonance (MR) technique allows three-dimensional quantitative mapping of blood flow velocities. We performed three-dimensional MR velocity mapping in a modified left ventricular long axis plane in 10 patients with previous myocardial infarction and milder reduction of the left ventricular function. The early diastolic inflow pattern did not differ qualitatively from earlier published findings in normal subjects. At systole, a flow pattern similar to that found in normals was observed in 7 of our patients. In the remaining 3 patients two types of abnormal systolic flow patterns were observed resulting in a paradoxical flow directed towards the apex. The location and timing of the abnormal flow allowed a distinction between paradoxical flow into an aneurism and paradoxical flow towards an akinetic apex. Compared with other techniques currently available, three-dimensional MR velocity mapping permits a more detailed description and understanding of abnormal flow patterns caused by wall motion injury in patients with myocardial infarction. This potential of the method suggests that three-dimensional MR phase velocity mapping may become a useful tool in assessment of significance and treatment of regional left ventricular dysfunction.