Sotelo Julio, Valverde Israel, Martins Duarte, Bonnet Damien, Boddaert Nathalie, Pushparajan Kuberan, Uribe Sergio, Raimondi Francesca
School of Biomedical Engineering, Universidad de Valparaíso, General Cruz 222, 236-2905 Valparaíso, Chile.
Biomedical Imaging Center, Pontificia Universidad Católica de Chile, Avenida Vicuña Mackenna 4869, Macul, Santiago 832-0000, Chile.
Eur Heart J Cardiovasc Imaging. 2022 Feb 22;23(3):402-411. doi: 10.1093/ehjci/jeaa416.
In this study, we will describe a comprehensive haemodynamic analysis and its relationship to the dilation of the aorta in transposition of the great artery (TGA) patients post-arterial switch operation (ASO) and controls using 4D-flow magnetic resonance imaging (MRI) data.
Using 4D-flow MRI data of 14 TGA young patients and 8 age-matched normal controls obtained with 1.5 T GE-MR scanner, we evaluate 3D maps of 15 different haemodynamics parameters in six regions; three of them in the aortic root and three of them in the ascending aorta (anterior-left, -right, and posterior for both cases) to find its relationship with the aortic arch curvature and root dilation. Differences between controls and patients were evaluated using Mann-Whitney U test, and the relationship with the curvature was accessed by unpaired t-test. For statistical significance, we consider a P-value of 0.05. The aortic arch curvature was significantly different between patients 46.238 ± 5.581 m-1 and controls 41.066 ± 5.323 m-1. Haemodynamic parameters as wall shear stress circumferential (WSS-C), and eccentricity (ECC), were significantly different between TGA patients and controls in both the root and ascending aorta regions. The distribution of forces along the ascending aorta is highly inhomogeneous in TGA patients. We found that the backward velocity (B-VEL), WSS-C, velocity angle (VEL-A), regurgitation fraction (RF), and ECC are highly correlated with the aortic arch curvature and root dilatation.
We have identified six potential biomarkers (B-VEL, WSS-C, VEL-A, RF, and ECC), which may be helpful for follow-up evaluation and early prediction of aortic root dilatation in this patient population.
在本研究中，我们将使用四维血流磁共振成像（MRI）数据，描述大动脉转位（TGA）患者动脉调转手术（ASO）后主动脉扩张的全面血流动力学分析及其关系，并与对照组进行比较。
使用1.5 T GE-MR扫描仪获得的14例TGA年轻患者和8例年龄匹配的正常对照的四维血流MRI数据，我们评估了六个区域中15个不同血流动力学参数的三维图；其中三个在主动脉根部，三个在升主动脉（两种情况均为前-左、-右和后），以发现其与主动脉弓曲率和根部扩张的关系。使用Mann-Whitney U检验评估对照组和患者之间的差异，并通过不成对t检验评估与曲率的关系。为了具有统计学意义，我们考虑P值为0.05。患者的主动脉弓曲率为46.238±5.581 m-1，与对照组的41.066±5.323 m-1有显著差异。血流动力学参数，如壁面切应力周向（WSS-C）和偏心率（ECC），在TGA患者和对照组的根部和升主动脉区域均有显著差异。TGA患者升主动脉沿线的力分布极不均匀。我们发现，向后速度（B-VEL）、WSS-C、速度角（VEL-A）、反流分数（RF）和ECC与主动脉弓曲率和根部扩张高度相关。
我们确定了六种潜在的生物标志物（B-VEL、WSS-C、VEL-A、RF和ECC），这可能有助于对该患者群体进行主动脉根部扩张的随访评估和早期预测。
