ArticlePloS one2017
4D flow MRI assessment of right atrial flow patterns in the normal heart - influence of caval vein arrangement and implications for the patent foramen ovale.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Right heart flow hemodynamic assessment using 4D flow CMR: a systematic review.European heart journal. Imaging methods and practice · 2025Review
- Turning the Tide: Unraveling Aortic Dynamics and Patent Foramen Ovale in Platypnea-Orthodeoxia Syndrome.JACC. Case reports · 2025Article
- Treatment of patent foramen ovale.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Review
- Performance of respiratory gated 4D flow MRI with adaptive k-space reordering in healthy controls and aortic dissection: reproducibility and agreement with 2D phase contrast MRI.The international journal of cardiovascular imaging · 2025Article
- Understanding Right Heart Flow: Implications for Interatrial Shunt Device Therapy in Heart Failure.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Review
- MRI in the Evaluation of Cryptogenic Stroke and Embolic Stroke of Undetermined Source.Radiology · 2024Review
- Elevated thrombin generation levels in the left atrial appendage in patients with atrial fibrillation.Research and practice in thrombosis and haemostasis · 2023Article
- Cannulation configuration and recirculation in venovenous extracorporeal membrane oxygenation.Scientific reports · 2022Article
- Impact of altered vena cava flow rates on right atrium flow characteristics.Journal of applied physiology (Bethesda, Md. : 1985) · 2022Article
- Computational fluid dynamics of the right atrium: Assessment of modelling criteria for the evaluation of dialysis catheters.PloS one · 2021Article
- Histological properties of oscillating intracardiac masses associated with cardiac implantable electric devices.Journal of arrhythmia · 2020Article
- Age-related changes of right atrial morphology and inflow pattern assessed using 4D flow cardiovascular magnetic resonance: results of a population-based study.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2018Observational
- Investigation of Atrial Vortices Using a Novel Right Heart Model and Possible Implications for Atrial Thrombus Formation.Scientific reports · 2017Article
- Patent Foramen Ovale Closure for Nonstroke Indications.Journal of the Society for Cardiovascular Angiography & InterventionsReview
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
aimTo investigate atrial flow patterns in the normal adult heart, to explore whether caval vein arrangement and patency of the foramen ovale (PFO) may be associated with flow pattern. MATERIALS AND
methodsTime-resolved, three-dimensional velocity encoded magnetic resonance imaging (4D flow) was employed to assess atrial flow patterns in thirteen healthy subjects (6 male, 40 years, range 25-50) and thirteen subjects (6 male, 40 years, range 21-50) with cryptogenic stroke and patent foramen ovale (CS-PFO). Right atrial flow was defined as vortical, helico-vortical, helical and multiple vortices. Time-averaged and peak systolic and diastolic flows in the caval and pulmonary veins and their anatomical arrangement were compared.
resultsA spectrum of right atrial flow was observed across the four defined categories. The right atrial flow patterns were strongly associated with the relative position of the caval veins. Right atrial flow patterns other than vortical were more common (p = 0.015) and the separation between the superior and inferior vena cava greater (10±5mm versus 3±3mm, p = 0.002) in the CS-PFO group. In the left atrium all subjects except one had counter-clockwise vortical flow. Vortex size varied and was associated with left lower pulmonary vein flow (systolic r = 0.61, p = 0.001, diastolic r = 0.63 p = 0.002). A diastolic vortex was less common and time-averaged left atrial velocity was greater in the CS-PFO group (17±2cm/sec versus 15±1, p = 0.048). One CS-PFO subject demonstrated vortical retrograde flow in the descending aortic arch; all other subjects had laminar descending aortic flow.
conclusionRight atrial flow patterns in the normal heart are heterogeneous and are associated with the relative position of the caval veins. Patterns, other than 'typical' vortical flow, are more prevalent in the right atrium of those with cryptogenic stroke in the context of PFO. Left atrial flow patterns are more homogenous in normal hearts and show a relationship with flow arising from the left pulmonary veins.
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