Noninvasive aortic imaging

Baliyan, Vinit; Verdini, Daniel; Meyersohn, Nandini M.

doi:10.21037/cdt.2018.02.01

Cited by 20 publications

(20 citation statements)

References 95 publications

(116 reference statements)

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“…Our study highlights the data inputs to mathematical models, which can then provide insights and predictions. The availability of quantitative imaging (Dinsmore, 1990; Nienaber et al, 1994; Baliyan et al, 2018) and blood (Vezzoli et al, 2017) data may permit hybrid 0D–3D, or fully 3D physiologically detailed modeling. However, our present qualitative results will be unaffected in potential higher dimensional investigations.…”

Section: Model Limitationsmentioning

confidence: 99%

Arterial Hypertension and Unusual Ascending Aortic Dilatation in a Neonate With Acute Kidney Injury: Mechanistic Computer Modeling

et al. 2019

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BackgroundNeonatal asphyxia caused kidney injury and severe hypertension in a newborn. An unusually dilatated ascending aorta developed. Dialysis and pharmacological treatment led to partial recovery of the ascending aortic diameters. It was hypothesized that the aortic dilatation may be associated with aortic stiffening, peripheral resistance, and cardiovascular changes. Mathematical modeling was used to better understand the potential causes of the hypertension, and to confirm our clinical treatment within the confines of the model’s capabilities.MethodsThe patient’s systolic arterial blood pressure showed hypertension. Echocardiographic exams showed ascending aorta dilatation during hypertension, which partially normalized upon antihypertensive treatment. To explore the underlying mechanisms of the aortic dilatation and hypertension, an existing lumped parameter hemodynamics model was deployed. Hypertension was simulated using realistic literature informed parameter values. It was also simulated using large parameter perturbations to demonstrate effects. Simulations were designed to permit examination of causal mechanisms. The hypertension inducing effects of aortic stiffnesses, vascular resistances, and cardiac hypertrophy on blood flow and pressure were simulated. Sensitivity analysis was used to stratify causes.ResultsIn agreement with our clinical diagnosis, the model showed that an increase of aortic stiffness followed by augmentation of peripheral resistance are the prime causes of realistic hypertension. Increased left ventricular elastance may also cause hypertension. Ascending aortic pressure and flow increased in the simultaneous presence of left ventricle hypertrophy and augmented small vessel resistance, which indicate a plausible condition for ascending aorta dilatation. In case of realistic hypertension, sensitivity analysis showed that the treatment of both the large vessel stiffness and small vessel resistance are more important in comparison to cardiac hypertrophy.Conclusion and DiscussionLarge vessel stiffness was found to be the prime factor in arterial hypertension, which confirmed the clinical treatment. Treatment of cardiac hypertrophy appears to provide significant benefit but may be secondary to treatment of large vessel stiffness. The quantitative grading of pathophysiological mechanisms provided by the modeling may contribute to treatment recommendations. The model was limited due to a lack of data suitable to permit model identification.

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Section: Model Limitationsmentioning

confidence: 99%

Arterial Hypertension and Unusual Ascending Aortic Dilatation in a Neonate With Acute Kidney Injury: Mechanistic Computer Modeling

et al. 2019

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“…The detection of such biomarkers in the plasma (MMPs) currently it is not very promising, and the markers are not anatomically specific for a certain diseased section of the vasculature. However, due to the present advanced imaging capabilities with an excellent resolution and diminution of study time, the combination of the imaging findings with specific molecular metabolic activity shines light on a long route to prediction for AAAs (8)(9)(10). This is currently attempted with positron emission tomography (PET), with fusion techniques with computed tomography (CT) or magnetic resonance imaging (MRI), and recently by using ultra small superparamagnetic particles of iron oxide (USPIOs) with an MRI scan (11,12).…”

Section: Editorialmentioning

confidence: 99%

Predictions and insights for the abdominal aortic aneurysm

Kotsis

2018

J. Thorac. Dis

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“…However, this modality is invasive and introduces considerable discomfort to patients, and not all parts of the thoracic aorta can be visualized due to a limited FOV 6 . Computed tomography angiography is currently the most widely used diagnostic modality due to its near universal availability and rapid acquisition 7,8 . However, CT angiography focuses on the detection of luminal abnormalities, while providing limited information on pathological changes within the aortic vessel wall 9 .…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance multitasking for multidimensional assessment of cardiovascular system: Development and feasibility study on the thoracic aorta

Christodoulou

Wang

et al. 2020

Magnetic Resonance in Med

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Purpose To develop an MR multitasking‐based multidimensional assessment of cardiovascular system (MT‐MACS) with electrocardiography‐free and navigator‐free data acquisition for a comprehensive evaluation of thoracic aortic diseases. Methods The MT‐MACS technique adopts a low‐rank tensor image model with a cardiac time dimension for phase‐resolved cine imaging and a T2‐prepared inversion‐recovery dimension for multicontrast assessment. Twelve healthy subjects and 2 patients with thoracic aortic diseases were recruited for the study at 3 T, and both qualitative (image quality score) and quantitative (contrast‐to‐noise ratio between lumen and wall, lumen and wall area, and aortic strain index) analyses were performed in all healthy subjects. The overall image quality was scored based on a 4‐point scale: 3, excellent; 2, good; 1, fair; and 0, poor. Statistical analysis was used to test the measurement agreement between MT‐MACS and its corresponding 2D references. Results The MT‐MACS images reconstructed from acquisitions as short as 6 minutes demonstrated good or excellent image quality for bright‐blood (2.58 ± 0.46), dark‐blood (2.58 ± 0.50), and gray‐blood (2.17 ± 0.53) contrast weightings, respectively. The contrast‐to‐noise ratios for the three weightings were 49.2 ± 12.8, 20.0 ± 5.8 and 2.8 ± 1.8, respectively. There were good agreements in the lumen and wall area (intraclass correlation coefficient = 0.993, P < .001 for lumen; intraclass correlation coefficient = 0.969, P < .001 for wall area) and strain (intraclass correlation coefficient = 0.947, P < .001) between MT‐MACS and conventional 2D sequences. Conclusion The MT‐MACS technique provides high‐quality, multidimensional images for a comprehensive assessment of the thoracic aorta. Technical feasibility was demonstrated in healthy subjects and patients with thoracic aortic diseases. Further clinical validation is warranted.

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Noninvasive aortic imaging

Cited by 20 publications

References 95 publications

Arterial Hypertension and Unusual Ascending Aortic Dilatation in a Neonate With Acute Kidney Injury: Mechanistic Computer Modeling

Arterial Hypertension and Unusual Ascending Aortic Dilatation in a Neonate With Acute Kidney Injury: Mechanistic Computer Modeling

Predictions and insights for the abdominal aortic aneurysm

Magnetic resonance multitasking for multidimensional assessment of cardiovascular system: Development and feasibility study on the thoracic aorta

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