School of Biomedical Engineering and Imaging Sciences, King's College London, 5th Floor Becket House, Lambeth Palace Road, London, SE1 7EU, UK.
Massachusetts Institute of Technology, Cambridge, MA, USA.
J Cardiovasc Transl Res. 2022 Oct;15(5):1075-1085. doi: 10.1007/s12265-022-10221-4. Epub 2022 Feb 23.
Aortic surgeries in congenital conditions, such as hypoplastic left heart syndrome (HLHS), aim to restore and maintain the conduit and reservoir functions of the aorta. We proposed a method to assess these two functions based on 4D flow MRI, and we applied it to study the aorta in pre-Fontan HLHS. Ten pre-Fontan HLHS patients and six age-matched controls were studied to derive the advective pressure difference and viscous dissipation for conduit function, and pulse wave velocity and elastic modulus for reservoir function. The reconstructed neo-aorta in HLHS subjects achieved a good conduit function at a cost of an impaired reservoir function (69.7% increase of elastic modulus). The native descending HLHS aorta displayed enhanced reservoir (elastic modulus being 18.4% smaller) but impaired conduit function (three-fold increase in peak advection). A non-invasive and comprehensive assessment of aortic conduit and reservoir functions is feasible and has potentially clinical relevance in congenital vascular conditions.
先天性主动脉手术，如左心发育不良综合征（HLHS），旨在恢复和维持主动脉的输送和储集功能。我们提出了一种基于 4D 流 MRI 的方法来评估这两种功能，并应用于研究 Fontan 前 HLHS 患者的主动脉。研究了 10 例 Fontan 前 HLHS 患者和 6 名年龄匹配的对照者，以得出输送功能的对流压力差和粘性耗散，以及储集功能的脉搏波速度和弹性模量。HLHS 患者的重建新主动脉实现了良好的输送功能，但代价是储集功能受损（弹性模量增加 69.7%）。HLHS 患者的降主动脉显示出增强的储集功能（弹性模量减小 18.4%），但输送功能受损（峰值对流增加三倍）。非侵入性和全面的主动脉输送和储集功能评估是可行的，并且在先天性血管疾病中具有潜在的临床相关性。
