Pressure fields by flow-sensitive, 4D, velocity-encoded CMR in patients with aortic coarctation

JACC Cardiovasc Imaging. 2014 Sep;7(9):920-6. doi: 10.1016/j.jcmg.2014.03.017.

Abstract

This study compared pressure fields by 4-dimensional (4D), velocity-encoded cine (VEC) cardiac magnetic resonance imaging (CMR) with pressures measured by the clinical gold standard catheterization. Thirteen patients (n = 7 male, n = 6 female) with coarctation were studied. The 4D-VEC-CMR pressure fields were computed by solving the Pressure-Poisson equation. The agreement between catheterization and CMR-based methods was determined at 5 different measurement sites along the aorta. For all sites, the correlation coefficients between measures varied between 0.86 and 0.97 (p < 0.001). The Bland-Altman test showed good agreement between peak systolic pressure gradients across the coarctation. The nonsignificant (p > 0.2) bias was +2.3 mm Hg (± 6.4 mm Hg, 2 SDs) for calibration with dynamic pressures and +1.5 mm Hg (± 4.6 mm Hg, 2 SDs) for calibration with static pressure. In a clinical setting of coarctation, pressure fields can be accurately computed from 4D-VEC-CMR-derived flows. In patients with coarctation, this noninvasive technique might evolve to an alternative to invasive catheterization.

Keywords: cardiac magnetic resonance; catheterization; coarctation; pressure.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aorta / physiopathology*
  • Aortic Coarctation / diagnosis*
  • Aortic Coarctation / physiopathology
  • Arterial Pressure*
  • Blood Flow Velocity
  • Blood Pressure Determination / methods*
  • Cardiac Catheterization
  • Contrast Media
  • Female
  • Humans
  • Magnetic Resonance Imaging, Cine*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Regional Blood Flow
  • Reproducibility of Results
  • Young Adult

Substances

  • Contrast Media