Pressure drop mapping using 4D flow MRI in patients with bicuspid aortic valve disease: A novel marker of valvular obstruction
Pressure drop mapping using 4D flow MRI in patients with bicuspid aortic valve disease: A novel marker of valvular obstruction
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DOI：
10.1016/j.mri.2019.11.011
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发表时间：
2020-01-01
影响因子：
2.5
通讯作者：
Garcia, Julio
中科院分区：
文献类型：
--
作者：
Hassanabad, Ali Fatehi;Burns, Fiona;Garcia, Julio
背景资料：复杂的二叶式主动脉瓣（BAV）血流模式对腔内净主动脉压的影响，无论是否有明显的主动脉瓣狭窄，都是未知的。压降（PD），估计由4D Flow MRI，可以量化前与瓣后压力在多个levels.Methods：在这项前瞻性临床研究中，32例BAV患者不同程度的主动脉瓣狭窄和反流和11名健康受试者。在9个预定义的胸主动脉节段处理和分析4D flow MRI。相对于位于左心室流出道内的参考，计算每个平面的PD。常规二维相位对比成像作为血流动力学阻塞的参考。使用Kruskal-Wallis H检验和Mann-Whitney U检验比较健康受试者与BAV患者之间的PD。相关性研究采用斯皮尔曼的rank-order correlations.Results：BAV患者和健康受试者都表现出进行性升高的PD从主动脉根部到远端降主动脉。然而，BAV患者的PD高于健康受试者（p <40 mm Hg），降主动脉段的PD高于无BAV的受试者（p <0.05）。
Background: The influence of complex bicuspid aortic valve (BAV) flow patterns on net intraluminal aortic pressure, both among patients with and without significant aortic stenosis, is unknown. Pressure drop (PD), as estimated by 4D Flow MRI, can quantify pre- vs post-valvular pressure at multiple levels simultaneously.Methods: In this prospective clinical study, 32 patients with BAV with varying degrees of aortic stenosis and regurgitation and 11 healthy subjects were enrolled. 4D flow MRI was processed and analyzed at 9 pre-defined thoracic aortic levels. PD was calculated at each plane relative to a reference located within the left ventricular outflow tract. Conventional 2D phase-contrast imaging was used as reference of hemodynamic obstruction. PD was compared between healthy subjects versus BAV patients using Kruskal-Wallis H test and Mann-Whitney U. Correlation studies were conducted using Spearman's rank-order correlation.Results: Both BAV patients and healthy subjects showed progressive elevation in PD from the aortic root to the distal descending thoracic aorta. However, BAV patients showed higher PD than healthy subjects (p 40 mm Hg) showed higher PD than those without in the descending aortic segments (p