Blood flow dynamics with four-dimensional flow cardiovascular magnetic resonance in patients with aortic stenosis before and after transcatheter aortic valve replacement
Tóm tắt
Pre- and post-procedural hemodynamic changes which could affect adverse outcomes in aortic stenosis (AS) patients who undergo transcatheter aortic valve replacement (TAVR) have not been well investigated. Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) enables accurate analysis of blood flow dynamics such as flow velocity, flow pattern, wall shear stress (WSS), and energy loss (EL). We sought to examine the changes in blood flow dynamics of patients with severe AS who underwent TAVR. We examined 32 consecutive severe AS patients who underwent TAVR between May 2018 and June 2019 (17 men, 82 ± 5 years, median left ventricular ejection fraction 61%, 6 self-expanding valve), after excluding those without CMR because of a contraindication or inadequate imaging from the analyses. We analyzed blood flow patterns, WSS and EL in the ascending aorta (AAo), and those changes before and after TAVR using 4D flow CMR. After TAVR, semi-quantified helical flow in the AAo was significantly decreased (1.4 ± 0.6 vs. 1.9 ± 0.8, P = 0.002), whereas vortical flow and eccentricity showed no significant changes. WSS along the ascending aortic circumference was significantly decreased in the left (P = 0.038) and left anterior (P = 0.033) wall at the basal level, right posterior (P = 0.011) and left (P = 0.010) wall at the middle level, and right (P = 0.012), left posterior (P = 0.019) and left anterior (P = 0.028) wall at the upper level. EL in the AAo was significantly decreased (15.6 [10.8–25.1 vs. 25.8 [18.6–36.2]] mW, P = 0.012). Furthermore, a significant negative correlation was observed between EL and effective orifice area index after TAVR (r = − 0.38, P = 0.034). In severe AS patients undergoing TAVR, 4D flow CMR demonstrates that TAVR improves blood flow dynamics, especially when a larger effective orifice area index is obtained.
Tài liệu tham khảo
citation_journal_title=Circulation; citation_title=2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines; citation_author=RA Nishimura, CM Otto, RO Bonow, BA Carabello, JP Erwin, LA Fleisher; citation_volume=135; citation_publication_date=2017; citation_pages=e1159-e1195; citation_doi=10.1161/CIR.0000000000000503; citation_id=CR1
citation_journal_title=N Engl J Med; citation_title=Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients; citation_author=MJ Mack, MB Leon, VH Thourani, R Makkar, SK Kodali, M Russo; citation_volume=380; citation_publication_date=2019; citation_pages=1695-1705; citation_doi=10.1056/NEJMoa1814052; citation_id=CR2
citation_journal_title=N Engl J Med; citation_title=Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients; citation_author=JJ Popma, GM Deeb, SJ Yakubov, M Mumtaz, H Gada, D O'Hair; citation_volume=380; citation_publication_date=2019; citation_pages=1706-1715; citation_doi=10.1056/NEJMoa1816885; citation_id=CR3
citation_journal_title=J Cardiol; citation_title=Associations of residual left ventricular and left atrial remodeling with clinical outcomes in patients after aortic valve replacement for severe aortic stenosis; citation_author=T Hatani, T Kitai, R Murai, K Kim, N Ehara, A Kobori; citation_volume=68; citation_publication_date=2016; citation_pages=241-247; citation_doi=10.1016/j.jjcc.2015.09.017; citation_id=CR4
citation_journal_title=J Am Coll Cardiol.; citation_title=Prognostic significance of LGE by CMR in aortic stenosis patients undergoing valve replacement; citation_author=G Barone-Rochette, S Pierard, C De Meester de Ravenstein, S Seldrum, J Melchior, F Maes; citation_volume=64; citation_publication_date=2014; citation_pages=144-154; citation_doi=10.1016/j.jacc.2014.02.612; citation_id=CR5
citation_journal_title=J Am Coll Cardiol; citation_title=Paravalvular leak after transcatheter aortic valve replacement: the new Achilles' heel? A comprehensive review of the literature; citation_author=P Genereux, SJ Head, R Hahn, B Daneault, S Kodali, MR Williams; citation_volume=61; citation_publication_date=2013; citation_pages=1125-1136; citation_doi=10.1016/j.jacc.2012.08.1039; citation_id=CR6
citation_journal_title=Artery Res; citation_title=Ventricular-arterial coupling: invasive and non-invasive assessment; citation_author=JA Chirinos; citation_volume=7; citation_publication_date=2013; citation_pages=2-14; citation_doi=10.1016/j.artres.2012.12.002; citation_id=CR7
citation_journal_title=J Am Coll Cardiol; citation_title=Coupled systolic-ventricular and vascular stiffening with age: implications for pressure regulation and cardiac reserve in the elderly; citation_author=CH Chen, M Nakayama, E Nevo, BJ Fetics, WL Maughan, DA Kass; citation_volume=32; citation_publication_date=1998; citation_pages=1221-1227; citation_doi=10.1016/S0735-1097(98)00374-X; citation_id=CR8
citation_journal_title=Am J Physiol Heart Circ Physiol; citation_title=Left ventricular and proximal aorta coupling in magnetic resonance imaging: aging together?; citation_author=A Redheuil, N Kachenoura, E Bollache, WC Yu, A Opdahl, A Decesare; citation_volume=317; citation_publication_date=2019; citation_pages=H300-H307; citation_doi=10.1152/ajpheart.00694.2018; citation_id=CR9
citation_journal_title=Gen Thorac Cardiovasc Surg; citation_title=New imaging tools in cardiovascular medicine: computational fluid dynamics and 4D flow MRI; citation_author=K Itatani, S Miyazaki, T Furusawa, S Numata, S Yamazaki, K Morimoto; citation_volume=65; citation_publication_date=2017; citation_pages=611-621; citation_doi=10.1007/s11748-017-0834-5; citation_id=CR10
citation_journal_title=Magn Reson Med; citation_title=Quantitative 2D and 3D phase contrast MRI: optimized analysis of blood flow and vessel wall parameters; citation_author=AF Stalder, MF Russe, A Frydrychowicz, J Bock, J Hennig, M Markl; citation_volume=60; citation_publication_date=2008; citation_pages=1218-1231; citation_doi=10.1002/mrm.21778; citation_id=CR11
citation_journal_title=Circulation; citation_title=Helical and retrograde secondary flow patterns in the aortic arch studied by three-directional magnetic resonance velocity mapping; citation_author=PJ Kilner, GZ Yang, RH Mohiaddin, DN Firmin, DB Longmore; citation_volume=88; citation_publication_date=1993; citation_pages=2235-2247; citation_doi=10.1161/01.CIR.88.5.2235; citation_id=CR12
citation_journal_title=Circ Cardiovasc Imaging.; citation_title=Evaluation of aortic blood flow and wall shear stress in aortic stenosis and its association with left ventricular remodeling; citation_author=F Knobelsdorff-Brenkenhoff, A Karunaharamoorthy, RF Trauzeddel, AJ Barker, E Blaszczyk, M Markl; citation_volume=9; citation_publication_date=2016; citation_pages=e004038; citation_doi=10.1161/CIRCIMAGING.115.004038; citation_id=CR13
citation_journal_title=Int J Cardiol; citation_title=Blood flow characteristics in the ascending aorta after aortic valve replacement–a pilot study using 4D-flow MRI; citation_author=F Knobelsdorff-Brenkenhoff, RF Trauzeddel, AJ Barker, H Gruettner, M Markl, J Schulz-Menger; citation_volume=170; citation_publication_date=2014; citation_pages=426-433; citation_doi=10.1016/j.ijcard.2013.11.034; citation_id=CR14
citation_journal_title=Int J Cardiovasc Imaging; citation_title=Blood flow characteristics in the ascending aorta after TAVI compared to surgical aortic valve replacement; citation_author=RF Trauzeddel, U Lobe, AJ Barker, C Gelsinger, C Butter, M Markl; citation_volume=32; citation_publication_date=2016; citation_pages=461-467; citation_doi=10.1007/s10554-015-0792-x; citation_id=CR15
citation_journal_title=Eur Radiol; citation_title=Transcatheter aortic valve replacement alters ascending aortic blood flow and wall shear stress patterns: a 4D flow MRI comparison with age-matched, elderly controls; citation_author=ES Farag, J Vendrik, P Ooij, QL Poortvliet, F Kesteren, LW Wollersheim; citation_volume=29; citation_publication_date=2019; citation_pages=1444-1451; citation_doi=10.1007/s00330-018-5672-z; citation_id=CR16
citation_journal_title=Eur Heart J Cardiovasc Imaging; citation_title=Four-dimensional flow magnetic resonance imaging visualizes significant changes in flow pattern and wall shear stress in the ascending aorta after transcatheter aortic valve implantation in a patient with severe aortic stenosis; citation_author=H Komoriyama, S Tsuneta, N Oyama-Manabe, K Kamiya, T Nagai; citation_volume=21; citation_publication_date=2020; citation_pages=21; citation_id=CR17
citation_journal_title=Magn Reson Med; citation_title=Viscous energy loss in the presence of abnormal aortic flow; citation_author=AJ Barker, P Ooij, K Bandi, J Garcia, M Albaghdadi, P McCarthy; citation_volume=72; citation_publication_date=2014; citation_pages=620-628; citation_doi=10.1002/mrm.24962; citation_id=CR18
citation_journal_title=J Thorac Cardiovasc Surg; citation_title=2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines; citation_author=RA Nishimura, CM Otto, RO Bonow, BA Carabello, JP Erwin, RA Guyton; citation_volume=148; citation_publication_date=2014; citation_pages=e1-e132; citation_doi=10.1016/j.jtcvs.2014.05.014; citation_id=CR19
citation_journal_title=J Am Heart Assoc.; citation_title=How should very severe aortic stenosis be defined in asymptomatic individuals?; citation_author=C Tribouilloy, D Rusinaru, Y Bohbot, S Maréchaux, JL Vanoverschelde, M Enriquez-Sarano; citation_volume=8; citation_publication_date=2019; citation_pages=011724; citation_doi=10.1161/JAHA.118.011724; citation_id=CR20
citation_journal_title=J Am Soc Echocardiogr; citation_title=Recommendations for evaluation of prosthetic valves with echocardiography and doppler ultrasound: a report From the American Society of Echocardiography's Guidelines and Standards Committee and the Task Force on Prosthetic Valves, developed in conjunction with the American College of Cardiology Cardiovascular Imaging Committee, Cardiac Imaging Committee of the American Heart Association, the European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography and the Canadian Society of Echocardiography, endorsed by the American College of Cardiology Foundation, American Heart Association, European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography, and Canadian Society of Echocardiography; citation_author=WA Zoghbi, JB Chambers, JG Dumesnil, E Foster, JS Gottdiener, PA Grayburn; citation_volume=22; citation_publication_date=2009; citation_pages=975-1014; citation_doi=10.1016/j.echo.2009.07.013; citation_id=CR21
citation_journal_title=Heart Vessels; citation_title=Validation of numerical simulation methods in aortic arch using 4D Flow MRI; citation_author=S Miyazaki, K Itatani, T Furusawa, T Nishino, M Sugiyama, Y Takehara; citation_volume=32; citation_publication_date=2017; citation_pages=1032-1044; citation_doi=10.1007/s00380-017-0979-2; citation_id=CR22
citation_journal_title=Interact Cardiovasc Thorac Surg; citation_title=Four-dimensional flow magnetic resonance imaging analysis before and after thoracic endovascular aortic repair of chronic type B aortic dissection; citation_author=Y Takei, K Itatani, S Miyazaki, I Shibasaki, H Fukuda; citation_volume=28; citation_publication_date=2019; citation_pages=413-420; citation_doi=10.1093/icvts/ivy271; citation_id=CR23
citation_journal_title=J Magn Reson Imaging; citation_title=Volumetric arterial wall shear stress calculation based on cine phase contrast MRI; citation_author=WV Potters, P Ooij, H Marquering, E vanBavel, AJ Nederveen; citation_volume=41; citation_publication_date=2015; citation_pages=505-516; citation_doi=10.1002/jmri.24560; citation_id=CR24
citation_journal_title=Eur Heart J Cardiovasc Imaging; citation_title=Energy loss in the left ventricle obtained by vector flow mapping as a new quantitative measure of severity of aortic regurgitation: a combined experimental and clinical study; citation_author=M Stugaard, H Koriyama, K Katsuki, K Masuda, T Asanuma, Y Takeda; citation_volume=16; citation_publication_date=2015; citation_pages=723-730; citation_doi=10.1093/ehjci/jev035; citation_id=CR25
citation_journal_title=Circulation; citation_title=Blood velocity distribution in the human ascending aorta; citation_author=L Segadal, K Matre; citation_volume=76; citation_publication_date=1987; citation_pages=90-100; citation_doi=10.1161/01.CIR.76.1.90; citation_id=CR26
citation_journal_title=Biomech Model Mechanobiol; citation_title=Mechanistic insight into the physiological relevance of helical blood flow in the human aorta: an in vivo study; citation_author=U Morbiducci, R Ponzini, G Rizzo, M Cadioli, A Esposito, FM Montevecchi; citation_volume=10; citation_publication_date=2011; citation_pages=339-355; citation_doi=10.1007/s10237-010-0238-2; citation_id=CR27
citation_journal_title=Int Angiol.; citation_title=Non spiral and spiral (helical) flow patterns in stenosis. In vitro observations using spin and gradient echo magnetic resonance imaging (MRI) and computational fluid dynamic modeling; citation_author=PA Stonebridge, C Buckley, A Thompson, J Dick, G Hunter, JA Chudek; citation_volume=23; citation_publication_date=2004; citation_pages=276-283; citation_id=CR28
citation_journal_title=J Comput Assist Tomogr; citation_title=Time-resolved 3-dimensional velocity mapping in the thoracic aorta: visualization of 3-directional blood flow patterns in healthy volunteers and patients; citation_author=M Markl, MT Draney, MD Hope, JM Levin, FP Chan, MT Alley; citation_volume=28; citation_publication_date=2004; citation_pages=459-468; citation_doi=10.1097/00004728-200407000-00005; citation_id=CR29
citation_journal_title=Sci Rep; citation_title=The influence of the aortic valve angle on the hemodynamic features of the thoracic aorta; citation_author=H Ha, GB Kim, J Kweon, SJ Lee, YH Kim, N Kim; citation_volume=6; citation_publication_date=2016; citation_pages=32316; citation_doi=10.1038/srep32316; citation_id=CR30
citation_journal_title=Eur Radiol; citation_title=Interdependencies of aortic arch secondary flow patterns, geometry, and age analysed by 4-dimensional phase contrast magnetic resonance imaging at 3 Tesla; citation_author=A Frydrychowicz, A Berger, A Munoz Del Rio, MF Russe, J Bock, A Harloff; citation_volume=22; citation_publication_date=2012; citation_pages=1122-1130; citation_doi=10.1007/s00330-011-2353-6; citation_id=CR31
citation_journal_title=JACC Cardiovasc Imaging; citation_title=The role of imaging of flow patterns by 4D flow MRI in aortic stenosis; citation_author=J Garcia, AJ Barker, M Markl; citation_volume=12; citation_publication_date=2019; citation_pages=252-266; citation_doi=10.1016/j.jcmg.2018.10.034; citation_id=CR32
citation_journal_title=Annu Rev Biomed Eng; citation_title=Fluid mechanics of heart valves; citation_author=AP Yoganathan, Z He, JS Casey; citation_volume=6; citation_publication_date=2004; citation_pages=331-362; citation_doi=10.1146/annurev.bioeng.6.040803.140111; citation_id=CR33
citation_journal_title=JACC Cardiovasc Imaging; citation_title=4D flow CMR in assessment of valve-related ascending aortic disease; citation_author=MD Hope, TA Hope, SE Crook, KG Ordovas, TH Urbania, MT Alley; citation_volume=4; citation_publication_date=2011; citation_pages=781-787; citation_doi=10.1016/j.jcmg.2011.05.004; citation_id=CR34
citation_journal_title=J Magn Reson Imaging; citation_title=Aortic valve stenosis and aortic diameters determine the extent of increased wall shear stress in bicuspid aortic valve disease; citation_author=ES Farag, P Ooij, RN Planken, KCP Dukker, F Heer, BJ Bouma; citation_volume=48; citation_publication_date=2018; citation_pages=522-530; citation_doi=10.1002/jmri.25956; citation_id=CR35
citation_journal_title=J Am Coll Cardiol; citation_title=Prosthesis-patient mismatch in patients undergoing transcatheter aortic valve replacement: from the STS/ACC TVT Registry; citation_author=HC Herrmann, SA Daneshvar, GC Fonarow, A Stebbins, S Vemulapalli, ND Desai; citation_volume=72; citation_publication_date=2018; citation_pages=2701-2711; citation_doi=10.1016/j.jacc.2018.09.001; citation_id=CR36
citation_journal_title=J Am Coll Cardiol; citation_title=Comparison of transcatheter and surgical aortic valve replacement in severe aortic stenosis: a longitudinal study of echocardiography parameters in cohort A of the PARTNER trial (placement of aortic transcatheter valves); citation_author=RT Hahn, P Pibarot, WJ Stewart, NJ Weissman, D Gopalakrishnan, MG Keane; citation_volume=61; citation_publication_date=2013; citation_pages=2514-2521; citation_doi=10.1016/j.jacc.2013.02.087; citation_id=CR37
citation_journal_title=Circulation; citation_title=Prognostic value of energy loss index in asymptomatic aortic stenosis; citation_author=E Bahlmann, E Gerdts, D Cramariuc, C Gohlke-Baerwolf, CA Nienaber, K Wachtell; citation_volume=127; citation_publication_date=2013; citation_pages=1149-1156; citation_doi=10.1161/CIRCULATIONAHA.112.078857; citation_id=CR38
citation_journal_title=PLoS ONE; citation_title=The effect of spatial and temporal resolution of cine phase contrast MRI on wall shear stress and oscillatory shear index assessment; citation_author=M Cibis, WV Potters, FJ Gijsen, H Marquering, P Ooij, E vanBavel; citation_volume=11; citation_publication_date=2016; citation_pages=e0163316; citation_doi=10.1371/journal.pone.0163316; citation_id=CR39
citation_journal_title=J Cardiovasc Magn Reson; citation_title=4D flow cardiovascular magnetic resonance consensus statement; citation_author=P Dyverfeldt, M Bissell, AJ Barker, AF Bolger, CJ Carlhall, T Ebbers; citation_volume=17; citation_publication_date=2015; citation_pages=72; citation_doi=10.1186/s12968-015-0174-5; citation_id=CR40
citation_journal_title=J Magn Reson Imaging; citation_title=Assessment of the accuracy of MRI wall shear stress estimation using numerical simulations; citation_author=S Petersson, P Dyverfeldt, T Ebbers; citation_volume=36; citation_publication_date=2012; citation_pages=128-138; citation_doi=10.1002/jmri.23610; citation_id=CR41
citation_journal_title=J Cardiovasc Magn Reson; citation_title=Aortic flow patterns and wall shear stress maps by 4D-flow cardiovascular magnetic resonance in the assessment of aortic dilatation in bicuspid aortic valve disease; citation_author=JF Rodríguez-Palomares, L Dux-Santoy, A Guala, R Kale, G Maldonado, G Teixidó-Turà; citation_volume=20; citation_publication_date=2018; citation_pages=28; citation_doi=10.1186/s12968-018-0451-1; citation_id=CR42
citation_journal_title=J Magn Reson Imaging; citation_title=Venous and arterial flow quantification are equally accurate and precise with parallel imaging compressed sensing 4D phase contrast MRI; citation_author=U Tariq, A Hsiao, M Alley, T Zhang, M Lustig, SS Vasanawala; citation_volume=37; citation_publication_date=2013; citation_pages=1419-1426; citation_doi=10.1002/jmri.23936; citation_id=CR43
citation_journal_title=Magn Reson Med; citation_title=A Bayesian approach for 4D flow imaging of aortic valve in a single breath-hold; citation_author=A Rich, LC Potter, N Jin, Y Liu, OP Simonetti, R Ahmad; citation_volume=81; citation_publication_date=2019; citation_pages=811-824; citation_doi=10.1002/mrm.27386; citation_id=CR44
citation_journal_title=Magn Reson Med; citation_title=Aortic 4D flow MRI in 2 minutes using compressed sensing, respiratory controlled adaptive k-space reordering, and inline reconstruction; citation_author=LE Ma, M Markl, K Chow, H Huh, C Forman, A Vali; citation_volume=81; citation_publication_date=2019; citation_pages=3675-3690; citation_doi=10.1002/mrm.27684; citation_id=CR45
citation_journal_title=Magn Reson Med; citation_title=4D UTE flow: a phase-contrast MRI technique for assessment and visualization of stenotic flows; citation_author=M Kadbi, M Negahdar, JW Cha, M Traughber, P Martin, MF Stoddard; citation_volume=73; citation_publication_date=2015; citation_pages=939-950; citation_doi=10.1002/mrm.25188; citation_id=CR46