Blood flow dynamics with four-dimensional flow cardiovascular magnetic resonance in patients with aortic stenosis before and after transcatheter aortic valve replacement

Komoriyama, Hirokazu; Kamiya, Kiwamu; Nagai, Toshiyuki et al.

Journal of Cardiovascular Magnetic Resonance, 2021, 23(1), 81

Permalink : https://hdl.handle.net/2115/82531

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https://doi.org/10.1186/s12968-021-00771-y     15

論文情報

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アクセス権
open access
URI
https://hdl.handle.net/2115/82531
タイトル
Blood flow dynamics with four-dimensional flow cardiovascular magnetic resonance in patients with aortic stenosis before and after transcatheter aortic valve replacement
著者
Komoriyama, Hirokazu ; Kamiya, Kiwamu ; Nagai, Toshiyuki ; Oyama-Manabe, Noriko ; Tsuneta, Satonori ; Kobayashi, Yuta ; Kato, Yoshiya ; Sarashina, Miwa ; Omote, Kazunori ; Konishi, Takao ; Sato, Takuma ; Tsujinaga, Shingo ; Iwano, Hiroyuki ; Shingu, Yasushige ; Wakasa, Satoru ; Anzai, Toshihisa
著者名
Komoriyama, Hirokazu
著者名
Kamiya, Kiwamu
e-Rad_Researcher
00528218
著者名
Nagai, Toshiyuki
著者名
Oyama-Manabe, Noriko
著者名
Tsuneta, Satonori
著者名
Kobayashi, Yuta
著者名
Kato, Yoshiya
著者名
Sarashina, Miwa
著者名
Omote, Kazunori
著者名
Konishi, Takao
著者名
Sato, Takuma
著者名
Tsujinaga, Shingo
著者名
Iwano, Hiroyuki
著者名
Shingu, Yasushige
著者名
Wakasa, Satoru
e-Rad_Researcher
60232089
著者名
Anzai, Toshihisa
言語
英語
キーワード
Four-dimensional flow cardiovascular magnetic resonance
Aortic stenosis
Transcatheter aortic valve replacement
Blood flow dynamics
発行日
2021-06-28
出版者
BioMed Central
収録物名
Journal of Cardiovascular Magnetic Resonance
巻(号)
23(1)
ページ
81
抄録
Background Pre- and post-procedural hemodynamic changes which could affect adverse outcomes in aortic stenosis (AS) patients who undergo transcatheter aortic valve replacement (TAVR) have not been well investigated. Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) enables accurate analysis of blood flow dynamics such as flow velocity, flow pattern, wall shear stress (WSS), and energy loss (EL). We sought to examine the changes in blood flow dynamics of patients with severe AS who underwent TAVR. Methods We examined 32 consecutive severe AS patients who underwent TAVR between May 2018 and June 2019 (17 men, 82 +/- 5 years, median left ventricular ejection fraction 61%, 6 self-expanding valve), after excluding those without CMR because of a contraindication or inadequate imaging from the analyses. We analyzed blood flow patterns, WSS and EL in the ascending aorta (AAo), and those changes before and after TAVR using 4D flow CMR. Results After TAVR, semi-quantified helical flow in the AAo was significantly decreased (1.4 +/- 0.6 vs. 1.9 +/- 0.8, P = 0.002), whereas vortical flow and eccentricity showed no significant changes. WSS along the ascending aortic circumference was significantly decreased in the left (P = 0.038) and left anterior (P = 0.033) wall at the basal level, right posterior (P = 0.011) and left (P = 0.010) wall at the middle level, and right (P = 0.012), left posterior (P = 0.019) and left anterior (P = 0.028) wall at the upper level. EL in the AAo was significantly decreased (15.6 [10.8-25.1 vs. 25.8 [18.6-36.2]] mW, P = 0.012). Furthermore, a significant negative correlation was observed between EL and effective orifice area index after TAVR (r = - 0.38, P = 0.034). Conclusions In severe AS patients undergoing TAVR, 4D flow CMR demonstrates that TAVR improves blood flow dynamics, especially when a larger effective orifice area index is obtained.
資源タイプ
学術雑誌論文
出版タイプ
Version of Record
PISSN
1097-6647
関連情報 (isIdenticalTo)
出版社版DOI
https://doi.org/10.1186/s12968-021-00771-y