PURPOSE: Valve mediated hemodynamics have been postulated to contribute to pathology of the ascending aorta (AAo). The objective of this study is to assess the association of aortic valve morphology and hemodynamics with downstream AAo size in subjects with bicuspid aortic valve (BAV) disease. MATERIALS AND METHODS: Four-dimensional flow MRI at 1.5 or 3 Tesla was used to evaluate the hemodynamics in the proximal AAo of 52 subjects: size-matched controls with tricuspid aortic valves (n = 24, mid ascending aorta [MAA] diameter = 38.0 ± 4.9 mm) and BAV patients with aortic dilatation (n = 14 right and left coronary leaflet fusion [RL]-BAV, MAA diameter = 38.1 ± 5.3 mm; n = 14 right and noncoronary leaflet fusion [RN]-BAV, MAA diameter = 36.5 ± 6.6 mm). A validated semi-automated technique was used to evaluate hemodynamic metrics (flow angle, flow displacement, and jet quadrant) and valve morphology (orifice circularity) for all subjects. Regression analysis of these metrics to AAo diameter was performed. RESULTS: RN-BAV subjects displayed a stronger correlation between hemodynamic metrics in the proximal AAo with diameter in the distal AAo compared with size-matched tricuspid aortic valve (TAV) controls and RL-BAV subjects. The distal AAo diameter was found to be strongly correlated to the upstream flow displacement (R2adjusted = 0.75) and flow angle (R2adjusted = 0.66) measured at the sino-tubular junction (STJ). Orifice circularity was also strongly correlated (R2adjusted = 0.53) to the distal AAo diameter in RN-BAV subjects. For TAV controls and RL-BAV subjects, correlations were weaker (R2adjusted < 0.2). CONCLUSION: Hemodynamics in the STJ were strongly correlated to the distal AAo diameter for the RN-BAV subjects. Hemodynamic metrics were more strongly correlated to the downstream aortic size when compared with valve morphology metrics. LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:246-254.
PURPOSE: Valve mediated hemodynamics have been postulated to contribute to pathology of the ascending aorta (AAo). The objective of this study is to assess the association of aortic valve morphology and hemodynamics with downstream AAo size in subjects with bicuspid aortic valve (BAV) disease. MATERIALS AND METHODS: Four-dimensional flow MRI at 1.5 or 3 Tesla was used to evaluate the hemodynamics in the proximal AAo of 52 subjects: size-matched controls with tricuspid aortic valves (n = 24, mid ascending aorta [MAA] diameter = 38.0 ± 4.9 mm) and BAV patients with aortic dilatation (n = 14 right and left coronary leaflet fusion [RL]-BAV, MAA diameter = 38.1 ± 5.3 mm; n = 14 right and noncoronary leaflet fusion [RN]-BAV, MAA diameter = 36.5 ± 6.6 mm). A validated semi-automated technique was used to evaluate hemodynamic metrics (flow angle, flow displacement, and jet quadrant) and valve morphology (orifice circularity) for all subjects. Regression analysis of these metrics to AAo diameter was performed. RESULTS:RN-BAV subjects displayed a stronger correlation between hemodynamic metrics in the proximal AAo with diameter in the distal AAo compared with size-matched tricuspid aortic valve (TAV) controls and RL-BAV subjects. The distal AAo diameter was found to be strongly correlated to the upstream flow displacement (R2adjusted = 0.75) and flow angle (R2adjusted = 0.66) measured at the sino-tubular junction (STJ). Orifice circularity was also strongly correlated (R2adjusted = 0.53) to the distal AAo diameter in RN-BAV subjects. For TAV controls and RL-BAV subjects, correlations were weaker (R2adjusted < 0.2). CONCLUSION: Hemodynamics in the STJ were strongly correlated to the distal AAo diameter for the RN-BAV subjects. Hemodynamic metrics were more strongly correlated to the downstream aortic size when compared with valve morphology metrics. LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:246-254.
Authors: Julio Garcia; Alex J Barker; Ian Murphy; Kelly Jarvis; Susanne Schnell; Jeremy D Collins; James C Carr; S Chris Malaisrie; Michael Markl Journal: Eur Heart J Cardiovasc Imaging Date: 2015-09-15 Impact factor: 6.875
Authors: Evaldas Girdauskas; Mina Rouman; Kushtrim Disha; Beatrix Fey; Georg Dubslaff; Bernhard Theis; Iver Petersen; Matthias Gutberlet; Michael A Borger; Thomas Kuntze Journal: J Am Coll Cardiol Date: 2016-04-19 Impact factor: 24.094
Authors: S Chris Malaisrie; James Carr; Issam Mikati; Vera Rigolin; Byron K Yip; Brittany Lapin; Patrick M McCarthy Journal: J Thorac Cardiovasc Surg Date: 2011-12-10 Impact factor: 5.209
Authors: Michael D Hope; Thomas A Hope; Alison K Meadows; Karen G Ordovas; Thomas H Urbania; Marcus T Alley; Charles B Higgins Journal: Radiology Date: 2010-04 Impact factor: 11.105
Authors: Malenka M Bissell; Aaron T Hess; Luca Biasiolli; Steffan J Glaze; Margaret Loudon; Alex Pitcher; Anne Davis; Bernard Prendergast; Michael Markl; Alex J Barker; Stefan Neubauer; Saul G Myerson Journal: Circ Cardiovasc Imaging Date: 2013-06-14 Impact factor: 7.792
Authors: Zhenglun Alan Wei; Connor Huddleston; Phillip M Trusty; Shelly Singh-Gryzbon; Mark A Fogel; Alessandro Veneziani; Ajit P Yoganathan Journal: Ann Biomed Eng Date: 2019-06-24 Impact factor: 3.934