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Characterization of complex flow patterns in the ascending aorta in patients with aortic regurgitation using conventional phase-contrast velocity MRI.

Journal article
Authors Odd Bech-Hanssen
Frida Svensson
Christian Lars Polte
Sinsia A Gao
Kerstin M Lagerstrand
Åse (Allansdotter) Johnsson
Published in The international journal of cardiovascular imaging
Volume 34
Issue 3
Pages 419–429
ISSN 1875-8312
Publication year 2018
Published at Institute of Clinical Sciences, Department of Radiation Physics
Institute of Medicine, Department of Molecular and Clinical Medicine
Pages 419–429
Language en
Links dx.doi.org/10.1007/s10554-017-1239-...
www.ncbi.nlm.nih.gov/entrez/query.f...
Subject categories Cardiovascular medicine

Abstract

Ascending aorta (AA) flow displacement (FD) is a surrogate for increased wall shear stress. We prospectively studied the flow profile in the AA in patients with aortic regurgitation (AR), to identify predictors of FD and investigate whether magnetic resonance imaging (MRI) phase-contrast flow rate curves (PC-FRC) contain quantitative information related to FD. Forty patients with chronic moderate (n = 14) or severe (n = 26) AR (21 (53%) with bicuspid aortic valve) and 22 controls were investigated. FD was determined from phase-contrast velocity profiles and defined as the distance between the center of the lumen and the "center of velocity" of the peak systolic forward flow or the peak diastolic negative flow, normalized to the lumen radius. Forward and backward volume flow was determined separately for systole and diastole. Seventy percent had systolic backward flow and 45% had diastolic forward flow in large areas of the vessel. AA dimension was an independent predictor of systolic FD while AA dimension and regurgitant volume were independent predictors of diastolic FD. Valve phenotype was not an independent predictor of systolic or diastolic FD. The linear relationships between systolic backward flow and systolic FD and diastolic forward flow and diastolic FD were strong (R = 0.77 and R = 0.76 respectively). Systolic backward flow and diastolic forward flow identified marked systolic and diastolic FD (≥0.35) with a positive likelihood ratio of 6.0 and 10.8, respectively. In conclusion, conventional PC-FRC data can detect and quantify FD in patients with AR suggesting the curves as a research and screening tool in larger patient populations.

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