4D flow MRI derived aortic hemodynamics multi-year follow-up in repaired coarctation with bicuspid aortic valve - 31/08/22
, Michael B Scott a, e, Ashitha Pathrose a, Kelly Jarvis a, Haben Berhane a, e, Bradley Allen a, Ryan Avery a, Alejandro Roldan Alsate d, Cynthia K Rigsby a, c, Michael Markl a, e
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Highlights |
• | In patients with bicuspid aortic valve and coarctation repair, mean wall shear stress, peak velocities, and pulse wave velocity remain stable over a median follow-up time of 3.98 years. |
• | Greater baseline peak velocities at the site of the coarctation correlate with aortic narrowing (follow-up vs. baseline diameter) at the coarctation zone (r = -0.642) and descending aorta (r = -0.530). |
Abstract |
Purpose |
The purpose of this study was to investigate the relationships between hemodynamic parameters and longitudinal changes in aortic dimensions on four-dimensional (4D) flow magnetic resonance imaging (MRI) in patients with bicuspid aortic valve (BAV) and repaired coarctation.
Materials and methods |
The study retrospectively included patients with BAV and childhood coarctation repair who had at least two cardiothoracic MRI examinations including 4D flow MRI at baseline and follow-up. Analysis included the calculation of aortic peak velocities, wall shear stress (WSS), pulse wave velocity (PWV), aortic dimensions and annual growth rates. Differences between examinations were assessed using paired t-test or Wilcoxon signed rank test. Relationships between growth rate and 4D flow metrics were assessed using Pearson or Spearman correlation tests.
Results |
The cohort included 15 patients (mean age 35 ± 8 [SD] years, 9 men) with a median follow-up time of 3.98 years (Q1: 2.10; Q3: 4.96). There were no significant differences in aortic mean WSS, peak velocities, and PWV between baseline and follow-up values. Greater baseline peak velocities at the site of the coarctation were strongly associated with aortic narrowing (follow-up vs. baseline diameter) at coarctation zone (r = -0.64; P = 0.010) and moderately in descending aorta (r = -0.53; P = 0.042). In addition, increased baseline WSS in the aortic arch was strongly related with narrowing of the coarctation zone at follow-up (r = -0.64, P = 0.011).
Conclusion |
Measures of aortic hemodynamics and aortic WSS are stable over time in patients with BAV with coarctation repair. Increased peak velocity was associated with a progressive narrowing at the site of the coarctation repair.
El texto completo de este artículo está disponible en PDF.Keywords : Aortic coarctation, 4D flow magnetic resonance imaging (MRI), Bicuspid aortic valve disease
Abbreviations : 3D, 4D, AAo, AArch, ACo, ARB, BAV, BMI, BSA, DAo, MRI, PWV, Q1, Q3, SD, STJ, WSS
Esquema
Vol 103 - N° 9
P. 418-426 - septembre 2022 Regresar al número
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