Time-resolved three-dimensional magnetic resonance velocity mapping of cardiovascular flow paths in volunteers and patients with Fontan circulation

Markl, Michael; Geiger, Julia; Kilner, Philip J.; Föll, Daniela; Stiller, Brigitte; Beyersdorf, Friedhelm; Arnold, Raoul; Frydrychowicz, Alex

doi:10.1016/j.ejcts.2010.05.026

Cited by 81 publications

(63 citation statements)

References 25 publications

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“…In this study, the feasibility of whole heart flow-sensitive 4D-MRI [13,14] for the visualisation of 3D flow characteristics and flexible retrospective flow quantification was evaluated in ten paediatric patients after repair of TOF. It was the aim to visualise and understand changes in blood flow characteristics in the pulmonary arteries after complex surgical repair.…”

Section: Introductionmentioning

confidence: 99%

4D-MR flow analysis in patients after repair for tetralogy of Fallot

et al. 2011

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Section: Introductionmentioning

confidence: 99%

4D-MR flow analysis in patients after repair for tetralogy of Fallot

et al. 2011

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“…Five patients were excluded because of obstructive airway disease, two patients were excluded because of coexisting autoimmune diseases, and three patients were excluded because of poor MRI quality. Twenty patients (13 …”

Section: Subjectsmentioning

confidence: 99%

Flow characteristics of the proximal pulmonary arteries and vena cava in patients with chronic thromboembolic pulmonary hypertension: correlation between 3.0 T phase-contrast MRI and right heart catheterization

Guo

Liu²,

Ma³

et al. 2014

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSEWe aimed to determine the correlation between flow characteristics of the proximal pulmonary arteries and vena cava obtained by 3.0 T phase-contrast magnetic resonance imaging (MRI) and hemodynamic characteristics by right heart catheterization in patients with chronic thromboembolic pulmonary hypertension. MATERIALS AND METHODSTwenty consecutive patients with chronic thromboembolic pulmonary hypertension and 20 sex-and age-matched healthy volunteers were included prospectively. All patients and controls underwent phase-contrast MRI to determine the flow characteristics including peak velocity, mean velocity, and mean blood flow of the proximal pulmonary artery and vena cava. All patients underwent right heart catheterization to determine the hemodynamics. RESULTSPeak velocity and mean velocity of the proximal pulmonary artery were significantly lower in the patient group. In patients, both peak velocity and mean blood flow were sequentially decreased in the main pulmonary artery, left and right pulmonary arteries, and left and right interlobar pulmonary arteries. Inferior vena cava had higher peak velocity, mean velocity, and mean blood flow than superior vena cava. Peak velocity of the main pulmonary artery correlated with mean and diastolic pulmonary artery pressure. Peak velocity of both inferior and superior vena cava strongly correlated with the pulmonary vascular resistance index (PVRI) (r=-0.68, P < 0.001 and r=-0.74, P < 0.001, respectively). Mean velocity of the main pulmonary artery and right pulmonary artery strongly correlated with PVRI and mean pulmonary artery pressure. Mean velocity of the superior vena cava and mean blood flow of the main pulmonary artery strongly correlated with PVRI and right cardiac work index. CONCLUSIONBlood flow in the proximal pulmonary artery and vena cava evaluated by phase-contrast MRI correlate with hemodynamic parameters of right heart catheterization and can be used to noninvasively evaluate the severity of chronic thromboembolic pulmonary hypertension and, potentially, to follow up the treatment response.

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“…Three-dimensional, timeresolved phase-contrast MRI (3DcinePC-MRI) allows visualization and quantification of multidimensional intracardiac blood flow (1,9,19,27). Recently, time-varying and complex 3-D (time ϩ 3-D ϭ 4-D) flow within the beating LV has been analyzed and separated into different functional flow components (1,4,(7)(8).…”

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4-D blood flow in the human right ventricle

Fredriksson

Zajac²,

Eriksson³

et al. 2011

American Journal of Physiology-Heart and Circulatory Physiology

114

115

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Right ventricular (RV) function is a powerful prognostic indicator in many forms of heart disease, but its assessment remains challenging and inexact. RV dysfunction may alter the normal patterns of RV blood flow, but those patterns have been incompletely characterized. We hypothesized that, based on anatomic differences, the proportions and energetics of RV flow components would differ from those identified in the left ventricle (LV) and that the portion of the RV inflow passing directly to outflow (Direct Flow) would be prepared for effective systolic ejection as a result of preserved kinetic energy (KE) compared with other RV flow components. Three-dimensional, time-resolved phase-contrast velocity, and balanced steady-state freeprecession morphological data were acquired in 10 healthy subjects using MRI. A previously validated method was used to separate the RV and LV end-diastolic volumes into four flow components and measure their volume and KE over the cardiac cycle. The RV Direct Flow: 1) followed a smoothly curving route that did not extend into the apical region of the ventricle; 2) had a larger volume and possessed a larger presystolic KE (0.4 Ϯ 0.3 mJ) than the other flow components (P Ͻ 0.001 and P Ͻ 0.01, respectively); and 3) represented a larger part of the end-diastolic blood volume compared with the LV Direct Flow (P Ͻ 0.01). These findings suggest that diastolic flow patterns distinct to the normal RV create favorable conditions for ensuing systolic ejection of the Direct Flow component. These flowspecific aspects of RV diastolic-systolic coupling provide novel perspectives on RV physiology and may add to the understanding of RV pathophysiology. cardiac disease; interventricular function; kinetic energy; phase-contrast magnetic resonance imaging; pump physiology RIGHT VENTRICULAR (RV) FUNCTION has important prognostic impact on both acquired and congenital cardiac diseases (10). The RV may be affected by primary right-sided pathological conditions, such as pulmonary hypertension, congenital heart disease, or cardiomyopathy, or secondarily involved in states with left ventricular (LV) dysfunction (5, 28).Accurate measurement of RV volume and function is the focus of investigations using many modalities (14,18,(23)(24). The most widely employed clinical technique for RV morphological and functional assessment is two-dimensional echocardiography (14, 23), but its accuracy is limited by the complex crescent shaped geometry of the RV and by its location behind the sternum (14, 18). Magnetic resonance imaging (MRI) offers more detailed, three-dimensional (3-D) anatomy and can improve RV volume assessment (11). The dynamic functional status of the RV, which is significantly impacted by respiratory events and loading conditions, remains challenging and inexact (11).The anatomic structures of the heart and the intracardiac blood flow are highly interdependent, and changes in flow due to altered cardiac shape or function may in turn influence structural remodeling (13,21,29). Three-dimensional, timereso...

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Time-resolved three-dimensional magnetic resonance velocity mapping of cardiovascular flow paths in volunteers and patients with Fontan circulation

Cited by 81 publications

References 25 publications

4D-MR flow analysis in patients after repair for tetralogy of Fallot

4D-MR flow analysis in patients after repair for tetralogy of Fallot

Flow characteristics of the proximal pulmonary arteries and vena cava in patients with chronic thromboembolic pulmonary hypertension: correlation between 3.0 T phase-contrast MRI and right heart catheterization

4-D blood flow in the human right ventricle

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