{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T21:01:12Z","timestamp":1762981272412,"version":"3.41.2"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,25]],"date-time":"2021-11-25T00:00:00Z","timestamp":1637798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012866","name":"Cumming School of Medicine, University of Calgary","doi-asserted-by":"publisher","award":["URGC SEM #1054341"],"award-info":[{"award-number":["URGC SEM #1054341"]}],"id":[{"id":"10.13039\/100012866","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000038","name":"Natural Sciences and Engineering Research Council of Canada","doi-asserted-by":"publisher","award":["RGPIN-2020-04549 DGECR-2020-00204"],"award-info":[{"award-number":["RGPIN-2020-04549 DGECR-2020-00204"]}],"id":[{"id":"10.13039\/501100000038","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> Four-dimensional (4-D) flow cardiac magnetic resonance imaging can be used to elegantly describe the hemodynamic efficiency of left ventricular (LV) flow throughout the cardiac cycle. Patients with nonvalvular paroxysmal atrial fibrillation (PAF) may have occult LV disease. Flow distribution analysis, based on 4-D flow, may unmask the presence of LV disease by assessing flow components: direct flow, retained flow, delayed ejection, and residual volume. This study aimed to identify LV hemodynamic inefficiencies in patients with PAF and normal systolic function. We hypothesized that the fraction of direct flow to the total end-diastolic volume would be reduced in patients with PAF compared with controls.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> We used 4-D LV flow component analysis to compare hemodynamics in 30 healthy controls and 50 PAF patients in sinus rhythm.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> PAF subjects and healthy controls had similar LV mass, volume, and ejection fraction. Direct flow was lower in the PAF group than in the controls (44.5 \u00b1 11.2% vs. 50.0 \u00b1 12.2%, <jats:italic>p<\/jats:italic> = 0.042) while delayed ejection was higher in the PAF group (21.6 \u00b1 5.6% vs. 18.6 \u00b1 5.7%, <jats:italic>p<\/jats:italic> = 0.022).<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> PAF patients demonstrated a relative reduction in direct flow and elevation in delayed ejection.<\/jats:p>","DOI":"10.3389\/fbioe.2021.725121","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T02:53:23Z","timestamp":1638327203000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Left Ventricular Flow Distribution as a Novel Flow Biomarker in Atrial Fibrillation"],"prefix":"10.3389","volume":"9","author":[{"given":"Hansuk","family":"Kim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hana","family":"Sheitt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen B.","family":"Wilton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James A.","family":"White","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julio","family":"Garcia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 Diseases and Injuries in 204 Countries and Territories, 1990-2019: a Systematic Analysis for the Global Burden of Disease Study 2019","volume":"396","author":"Abbafati","year":"2020","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1080\/10976640701544530","article-title":"Transit of Blood Flow through the Human Left Ventricle Mapped by Cardiovascular Magnetic Resonance","volume":"9","author":"Bolger","year":"2007","journal-title":"J. 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