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

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.