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Int J Cardiovasc Imaging. 2017 Dec;33(12):1969-1978. doi: 10.1007/s10554-017-1196-x. Epub 2017 Jun 16.

Association between flow skewness and aortic dilatation in patients with aortic stenosis.

Author information

1
POSTECH Biotech Center, Pohang University of Science and Technology, Pohang, South Korea.
2
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-Gil, Songpa-gu, Seoul, 138-736, South Korea.
3
Asan Institute of Life Science, Seoul, South Korea.
4
Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
5
Department of Mechanical Engineering, Pohang University of Science and Technology, Pohang, South Korea.
6
Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
7
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-Gil, Songpa-gu, Seoul, 138-736, South Korea. donghyun.yang@gmail.com.

Abstract

We investigated association between hemodynamic characteristics and aortic dilatation in patients with severe aortic stenosis (AS). Eighty patients with severe AS (mean age, 67.2 ± 12.5 years) who underwent multi-detector computed tomography and phase-contrast magnetic resonance imaging at the ascending aorta were retrospectively analyzed. Patients with an ascending aorta diameter >4 cm had a significantly higher forward flow rate at systole (28.5 ± 6.0 vs. 36.2 ± 8.6 L min, P < 0.001), and retrograde flow rate at systole (11.3 ± 4.2 vs. 18.8 ± 5.8 L min, P < 0.001), fractional reverse ratio (a ratio of retrograde flow rate to forward flow rate; 34.1 ± 11.9% vs. 43.5 ± 18.0%, P = 0.014), flow skewness Rskewness (a ratio of sum of forward and retrograde systole flow to net systole flow rate; 2.4 ± 0.7 vs. 3.2 ± 1.0, P < 0.001). The presence of bicuspid aortic valve (BAV; odds ratio [OR] 72.01, 95% confidence interval [CI] 10.57-490.46, P < 0.001), Left ventricular mass index (LVMI; OR 1.02 /g/m2; CI 1.00-1.04, P = 0.043) and Rskewness (OR 5.6 per 1, 95% CI 1.8-17.1, P = 0.001) were associated with aortic dilatation. BAV, LVMI, and increased Rskewness in the ascending aorta are associated with aortic dilatation in patients with AS.

KEYWORDS:

2D PC-MRI; Aortic dilatation; Aortic stenosis; Hemodynamics; Phase-contrast magnetic resonance imaging; Wall shear stress

PMID:
28623496
DOI:
10.1007/s10554-017-1196-x
[Indexed for MEDLINE]

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