Four-dimensional magnetic resonance imaging-derived ascending aortic flow eccentricity and flow compression are linked to aneurysm morphology

Kari, Fabian A.; Kocher, Nadja; Beyersdorf, Friedhelm; Tscheuschler, Anke; Meffert, Philipp; Rylski, Bartosz; Siepe, Matthias; Russe, Maximilian; Hope, Michael D.

doi:10.1093/icvts/ivu446

Cited by 17 publications

(15 citation statements)

References 21 publications

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“…Eccentric aneurysm was associated with a high level of flow compression (low flow compression index) irrespective of the underlining aortic valve morphology and function. These findings may indicate the potential diagnostic value of 4D flow MRI in clinical risk evaluation of patients with TAAs [30].…”

Section: Aortic Aneurysmmentioning

confidence: 70%

“…Aortic dissection [23,28] Thoracic aortic aneurysm [29,30] Endoleak after endovascular aortic repair [31] Retrograde aortic flow as a potential source of embolic stroke [47] Bicuspid aortic valve [32,33,48] Coarctation of the aorta [ aortic diseases…”

Section: Aortamentioning

confidence: 99%

“…Hope et al [29] compared the flow pattern between healthy volunteers and patients with ascending aortic aneurysms; larger helices, vortex, and retrograde flows were found more often in the patients with aortic aneurysms than in the controls. Kari et al [30] calculated the flow compression index as a fraction of the area of high-velocity mid-systolic flow over the complete crosssectional ascending aortic aneurysm according to the ascending aortic aneurysm morphology. Eccentric aneurysm was associated with a high level of flow compression (low flow compression index) irrespective of the underlining aortic valve morphology and function.…”

Section: Aortic Aneurysmmentioning

confidence: 99%

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Four-Dimensional Flow Magnetic Resonance Imaging for Cardiovascular Imaging: from Basic Concept to Clinical Application

Ota

Higuchi

Sun

et al. 2018

Cardiovasc Imaging Asia

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Magnetic resonance imaging (MRI) plays an important role in evaluation of the cardiovascular system. Two-dimensional phase-contrast MRI has been used to assess regional blood flow parameters such as flow velocity and volume and regurgitant fraction. Recently, fourdimensional (4D) flow MRI that acquires three-dimensional (3D) velocity and encodes volume coverage has been developed and applied to various clinical settings. 4D flow MRI allows retrospective flow measurement at any cross-section and 3D flow visualization through postprocessing. More advanced flow parameters based on fluid dynamics have been proposed and applied to 4D flow MRI to further understand flow mechanisms that might be related to the evolution and progression of cardiovascular diseases. The purpose of this review is to introduce the basics of 4D flow image acquisition and postprocessing, and its clinical application to selected cardiovascular diseases.

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Section: Aortic Aneurysmmentioning

confidence: 70%

Section: Aortamentioning

confidence: 99%

Section: Aortic Aneurysmmentioning

confidence: 99%

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Four-Dimensional Flow Magnetic Resonance Imaging for Cardiovascular Imaging: from Basic Concept to Clinical Application

Ota

Higuchi

Sun

et al. 2018

Cardiovasc Imaging Asia

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“…Like Dr Yurekli and colleagues [1], we were also concerned about different blood flow architectures within the tubular ascending aorta; however, when comparing convexity and concavity, the difference between BAV and TAV still remains, in the absence of a significant difference within each group (see Fig 2 in our paper [2]). In 2014, Kari and associates [4] demonstrated that the flow compression index was not significantly different in patients with aortic stenosis or regurgitation. The incidence of valve stenosis and regurgitation are significantly different between the groups, thus reflecting clinical everyday practice.…”

Section: Replymentioning

confidence: 99%

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Haunschild

Schellinger

Etz

2019

The Annals of Thoracic Surgery

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“…MMP-2 protein levels were observed to be higher in aortic regions with enhanced shear stress[18] and adaptive responses to high wall shear stress have been shown to be connected to pro—and activeMMP-2 in an animal mode l[19]. Wall shear stress in ascending aortic aneurysms was shown to increase with aortic diameter [20] and blood flow patterns in ascending aortic aneurysms seem to be associated with aortic morphology [21]. Taken together, these findings suggest that MMP-2 availability plays an important role in aortic wall pathology and that MMP-2 isoforms may serve as indicators of mechanical stress in the aortic wall.…”

Section: Introductionmentioning

confidence: 99%

MMP-2 Isoforms in Aortic Tissue and Serum of Patients with Ascending Aortic Aneurysms and Aortic Root Aneurysms

Tscheuschler¹,

Meffert²,

Beyersdorf³

et al. 2016

PLoS ONE

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ObjectiveThe need for biological markers of aortic wall stress and risk of rupture or dissection of ascending aortic aneurysms is obvious. To date, wall stress cannot be related to a certain biological marker. We analyzed aortic tissue and serum for the presence of different MMP-2 isoforms to find a connection between serum and tissue MMP-2 and to evaluate the potential of different MMP-2 isoforms as markers of high wall stress.MethodsSerum and aortic tissue from n = 24 patients and serum from n = 19 healthy controls was analyzed by ELISA and gelatin zymography. 24 patients had ascending aortic aneurysms, 10 of them also had aortic root aneurysms. Three patients had normally functioning valves, 12 had regurgitation alone, eight had regurgitation and stenosis and one had only stenosis. Patients had bicuspid and tricuspid aortic valves (9/15). Serum samples were taken preoperatively, and the aortic wall specimen collected during surgical aortic repair.ResultsPro-MMP-2 was identified in all serum and tissue samples. Pro-MMP-2 was detected in all tissue and serum samples from patients with ascending aortic/aortic root aneurysms, irrespective of valve morphology or other clinical parameters and in serum from healthy controls. We also identified active MMP-2 in all tissue samples from patients with ascending aortic/aortic root aneurysms. None of the analyzed serum samples revealed signals relatable to active MMP-2. No correlation between aortic tissue total MMP-2 or tissue pro-MMP-2 or tissue active MMP-2 and serum MMP-2 was found and tissue MMP-2/pro-MMP-2/active MMP-2 did not correlate with aortic diameter. This evidence shows that pro-MMP-2 is the predominant MMP-2 species in serum of patients and healthy individuals and in aneurysmatic aortic tissue, irrespective of aortic valve configuration. Active MMP-2 species are either not released into systemic circulation or not detectable in serum. There is no reliable connection between aortic tissue—and serum MMP-2 isoforms, nor any indication that pro-MMP-2 functions as a common marker of high aortic wall stress.

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Four-dimensional magnetic resonance imaging-derived ascending aortic flow eccentricity and flow compression are linked to aneurysm morphology

Abstract: Irrespective of aortic valve morphology and function, ascending aortic blood flow patterns are linked to distinct patterns of ascending aortic aneurysm morphology. Implementation of quantitative local blood flow analyses might help to improve aneurysm risk stratification in the future.

Cited by 17 publications

References 21 publications

Four-Dimensional Flow Magnetic Resonance Imaging for Cardiovascular Imaging: from Basic Concept to Clinical Application

Four-Dimensional Flow Magnetic Resonance Imaging for Cardiovascular Imaging: from Basic Concept to Clinical Application

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MMP-2 Isoforms in Aortic Tissue and Serum of Patients with Ascending Aortic Aneurysms and Aortic Root Aneurysms

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