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• Clinical Article •
Evaluation of the correlation between left ventricular blood flow components and left ventricular function in AMI patients by 4D Flow CMR
WANG Shaozhe  LI Yan  LI Guoce  PAN Zhibin  BIAN Hao  ZHANG Lei  ZHANG Houning  KANG Liqing  ZHANG Bin  LIU Fenghai 

DOI:10.12015/issn.1674-8034.2026.02.011.


[Abstract] Objective To explore the application value of left ventricular flow components based on four-dimensional flow cardiac magnetic resonance (4D Flow CMR) in evaluating left ventricular hemodynamics in patients with acute myocardial infarction (AMI).Materials and Methods A retrospective analysis was performed on 62 AMI patients (AMI group), who were divided into LVEF-impaired subgroup (34 cases) and LVEF-preserved subgroup (28 cases) according to left ventricular ejection fraction (LVEF). Meanwhile, 25 age and gender-matched healthy controls were enrolled during the same period. Clinical data and cardiac magnetic resonance (CMR) data were collected for all subjects, including conventional cardiac function parameters, proportions of left ventricular (LV) functional flow components [direct flow (DF), retained inflow (RIF), delayed ejection flow (DEF), residual volume (RV)] and kinetic energy (KE) values, and inter-group differences were analyzed.Results There were significant differences in the four flow components between AMI group and control group (all P < 0.05), namely DF [(27.4 ± 12.4)% vs. (38.4 ± 6.2)%], RIF [(17.4 ± 4.6)% vs.(15.1 ± 4.3)%], DEF [(20.9 ± 5.0)% vs. (16.5 ± 3.8)%] and RV [(33.9 ± 9.2)% vs. (30.0 ± 5.9)%]. Significant differences were found in LVEF and the four flow components between LVEF-impaired subgroup and LVEF-preserved subgroup, including LVEF [(37.5 ± 10.4)% vs. (60.6 ± 7.8)%, P < 0.001], DF [(22.4 ± 9.9)% vs. (33.4 ± 12.6)%, P < 0.001], RIF [(18.5 ± 3.9)% vs. (16.2 ± 5.2)%, P = 0.048], DEF [(22.7 ± 4.6)% vs. (18.7 ± 4.5)%, P = 0.001] and RV [(36.1 ± 10.3)% vs. (31.2 ± 7.0)%, P = 0.034]. Compared with control group, LVEF-preserved subgroup had lower DF proportion and higher DEF proportion, with statistical significance (P = 0.046, P = 0.014). The peak systolic DF KE and mean KE in AMI group were significantly lower than those in control group [25 (20, 31) μJ/mL vs. 38 (31, 45) μJ/mL, 12 (9, 18) μJ/mL vs.18 (15, 22) μJ/mL, all P < 0.001]. The correlation between left ventricular stroke volume (LVSV) and DF proportion was weaker in AMI group than in control group (r = 0.375 vs. r = 0.668), while no significant correlations were found between other flow components and LVSV in both groups (all P > 0.05).Conclusions Left ventricular flow component parameters derived from 4D Flow CMR have high value in evaluating left ventricular hemodynamics after AMI, which can assist in assessing left ventricular function of AMI patients and provide clues for identifying patients with potential risks after AMI.
[Keywords] acute myocardial infarction；magnetic resonance imaging；four-dimensional flow cardiovascular magnetic resonance imaging；flow components；hemodynamics；left ventricular function

WANG Shaozhe1   LI Yan1   LI Guoce1   PAN Zhibin1   BIAN Hao1   ZHANG Lei1   ZHANG Houning2   KANG Liqing1   ZHANG Bin3   LIU Fenghai1*  

1 Department of Magnetic Resonance Imaging, Cangzhou Central Hospital Affiliated to Hebei Medical University, Cangzhou 061000, China

2 Department of Magnetic Resonance Imaging, Affiliated Hospital of North China University of Science and Technology, Tangshan 063000, China

3 Department of Magnetic Resonance Imaging, First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China

Corresponding author: LIU F H, E-mail: lfh600@126.com

Conflicts of interest   None.

Received  2025-10-13
Accepted  2026-01-04
DOI: 10.12015/issn.1674-8034.2026.02.011
DOI:10.12015/issn.1674-8034.2026.02.011.

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