Noninvasive 4D Pressure Difference Mapping Derived from 4D Flow MRI in Patients with Repaired Aortic Coarctation: Comparison with Young Healthy Volunteers

Rengier, Fabian; Delles, Michael; Yj, Jeong; Tengg‐Kobligk, Hendrik von; Kauczor, HU; Unterhinninghofen, Roland; Ley, Sebastian; Eichhorn, Joachim

doi:10.1055/s-0033-1354532

Cited by 4 publications

(7 citation statements)

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“… Pressure gradient: a useful biomarker for evaluating vessel stenosis (e.g., in the aortic coarctation or in valve stenosis). The colorimetric map shows the pressure modification and distribution in the vessel during the cardiac cycle (24).  Pulse wave velocity: the most useful indicator of vessel wall elasticity and stiffness.…”

Section: Quantitative Assessmentmentioning

confidence: 99%

“…In this condition, the pressure gradient across the stenosis and the post-stenotic pressure loss are the hemodynamic parameters that most guide the treatment (96). According to clinical guidelines, intervention is recommended when the systolic gradient is higher than 20 mmHg (95).…”

Section: Coarctationmentioning

confidence: 99%

“…The pressure gradient is commonly measured directly by invasive catheterization or indirectly estimated by TTE. However the first method does not offer accurate information on the aortic dimensions and the second technique lacks the time-resolved and three-dimensional information for the entire thoracic aorta (96).…”

Section: Coarctationmentioning

confidence: 99%

“…Furthermore, when the anatomical result after surgery is not optimal, 4D flow MRI could be extremely useful to differentiate between not-significant mild residual narrowing, vascular tortuosity generating turbulent flows and hemodynamically relevant recurrent CoA (96). The derived hemodynamic parameters (WSS, TKE) calculated by 4D flow MRI could further characterize the prognosis in these patients and therefore help pinpoint the optimal timing of surgical treatment.…”

Section: Coarctationmentioning

confidence: 99%

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4D flow imaging of the thoracic aorta: is there an added clinical value?

Catapano¹,

Pambianchi²,

Cundari³

et al. 2020

Cardiovasc Diagn Ther

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flow MRI has emerged as a powerful non-invasive technique in cardiovascular imaging, enabling to analyse in vivo complex flow dynamics models by quantifying flow parameters and derived features. Deep knowledge of aortic flow dynamics is fundamental to better understand how abnormal flow patterns may promote or worsen vascular diseases. In the perspective of an increasingly personalized and preventive medicine, growing interest is focused on identifying those quantitative functional features which are early predictive markers of pathological evolution. The thoracic aorta and its spectrum of diseases, as the first area of application and development of 4D flow MRI and supported by an extensive experimental validation, represents the ideal model to introduce this technique into daily clinical practice. The purpose of this review is to describe the impact of 4D flow MRI in the assessment of the thoracic aorta and its most common affecting diseases, providing an overview of the actual clinical applications and describing the potential role of derived advanced hemodynamic measures in tailoring follow-up and treatment.

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Section: Quantitative Assessmentmentioning

confidence: 99%

Section: Coarctationmentioning

confidence: 99%

Section: Coarctationmentioning

confidence: 99%

Section: Coarctationmentioning

confidence: 99%

See 2 more Smart Citations

4D flow imaging of the thoracic aorta: is there an added clinical value?

Catapano¹,

Pambianchi²,

Cundari³

et al. 2020

Cardiovasc Diagn Ther

View full text Add to dashboard Cite

show abstract

“…Gorter et al [47] found that the Pulmonary regurgitant volume is superior to fraction using background-corrected phase contrast Mri in determining the severity of regurgitation in repaired tetralogy of Fallot. noninvasive 4D pressure difference mapping derived from 4D flow MRI enables detection of altered intraluminal aortic pressures and showed significant spatial and temporal changes in patients with repaired aortic coarctation [48]. Myocardial T1 and T2 mapping in diastolic and systolic phase were compared by Tessa et al [49].…”

Section: Several Papers Describe Different Techniques To Assess Hemodmentioning

confidence: 99%

Cardiovascular imaging 2015 in the International Journal of Cardiovascular Imaging

Bezerra

Costa

Reiber

et al. 2016

Int J Cardiovasc Imaging

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a step towards measuring myocardial perfusion using coronary X-ray angiographic images. A total of 28 data sets were tested in seven porcine models. The mean length of the optimal time range was 3.61 ± 1.29 frames or 2.18 ± 1.40 s. This method was confirmed to be robust for assessing blood flow measurements in conventional coronary angiography at 15 fps with hand injection of the contrast agent.

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Assessment of Pulmonary Arteries Hemodynamics and Its Relationship With Cardiac Remodeling and Myocardial Fibrosis in Athletes With Four‐Dimensional Flow MRI

Tang,

Zhang,

Liu

et al. 2023

Magnetic Resonance Imaging

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BackgroundExercise‐induced cardiac remodeling (CR) and myocardial fibrosis (MF) can increase cardiovascular risk in athletes. Early detection of pulmonary arterial hemodynamics parameters among athletes may be beneficial in optimizing the frequency of clinical follow‐ups.PurposeTo analyze the hemodynamics of pulmonary arteries and its relationship with CR and MF in athletes using four‐dimensional (4D) flow MRI.Study TypeProspective.PopulationOne hundred twenty‐one athletes (median age, 24 years; mean exercise per week 10 hours, for mean of 5 years) and twenty‐one sedentary healthy controls (median age, 25 years; exercise per week <3 hours, irregular pattern).Field Strength/SequenceTrue fast imaging with steady state free precession, time‐resolved 3D Cartesian phase‐contrast, and phase sensitive inversion recovery late gadolinium enhancement sequences at 3.0 T.AssessmentCR was defined as any cardiac parameters exceeding the 99th percentile upper reference limits, encompassing ventricular function, bi‐atrium and bi‐ventricle diameters, and ventricular wall thickness. MF was visually evaluated by three independent radiologists. 4D flow parameters were assessed in the main, right, and left pulmonary arteries (MPA, RPA, and LPA, respectively) and compared between different groups. Four machine learning (ML) models were developed to differentiate between athletes with and without CR and/or MF.Statistical TestsUnivariate analysis was used to compare groups. Area under the receiver operating characteristic curve (AUC) was used to assess the performance of the ML models.ResultsAthletes had significantly higher WSSmax in the MPA, RPA, and LPA than controls. Athletes with CR and/or MF (N = 30) had significantly lower RPmax from MPA to RPA than those without (N = 91). Among the ML models, the gradient boosting machine model had the highest performance, with an AUC of 0.90.ConclusionThe pulmonary arterial hemodynamics parameters could differentiate CR and/or MF in athletes, which may be potential to assist in optimizing frequency of follow‐up.Evidence Level1Technical EfficacyStage 2

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Noninvasive 4D Pressure Difference Mapping Derived from 4D Flow MRI in Patients with Repaired Aortic Coarctation: Comparison with Young Healthy Volunteers

Cited by 4 publications

References 0 publications

4D flow imaging of the thoracic aorta: is there an added clinical value?

4D flow imaging of the thoracic aorta: is there an added clinical value?

Cardiovascular imaging 2015 in the International Journal of Cardiovascular Imaging

Assessment of Pulmonary Arteries Hemodynamics and Its Relationship With Cardiac Remodeling and Myocardial Fibrosis in Athletes With Four‐Dimensional Flow MRI

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