Artery Research

Volume 20, Issue C, December 2017, Pages 80 - 81

P127 FLOW DYNAMICS AND ITS RELATION TO BICUSPID AORTOPATHY ASSESSED BY 4D FLOW CMR

Authors
Lydia Dux-Santoy Hurtado, Jose F. Rodriguez-Palomares, Andrea Guala, Raquel Kale, Gisela Teixido-Tura, Filipa Valente, Giuliana Maldonado, David Garcia- Dorado, Artur Evangelista
Hospital Universitari Vall d’Hebron, Department of Cardiology, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
Available Online 6 December 2017.
DOI
10.1016/j.artres.2017.10.109How to use a DOI?
Abstract

Purpose: Different altered flow dynamics may influence ascending aorta (AAo) dilation morphotypes in bicuspid aortic valve (BAV) (1). Using 4D-flow CMR, we aimed to identify flow variables related to root or ascending dilation in BAV.

Methods: One-hundred and one BAV patients (no severe valvular disease, aortic diameters <45 mm) underwent 4D-flow on GE 1.5 T Signa scanner (GE Healthcare, Waukesha, USA). Peak velocity, jet angle, normalized flow displacement, in-plane rotational flow (IRF), systolic flow reversal ratio (SFRR) and wall shear stress (WSS) were evaluated at proximal, mid and distal AAo. Dilation morphotypes were classified as non-dilated, ascending and root (2), using z-score > 2. Univariate and multivariate linear regression were used to identify factors related to dilation. ROC curves were performed to assess the relationship between variables obtained in the multivariate analysis and dilation morphotypes.

Results: Fusion phenotype was right-left (RL) in 78 patients, and right-non coronary (RN) in 23. Dilation morphotype was non-dilated in 24 patients, root in 11 and ascending in 66. On univariate analysis, BAV phenotype (RN), displacement and circumferential WSS presented the highest odds ratios (Table). On multivariate analysis, sex (male), proximal velocity and axial WSS were related to root morphotype (AUC 0.91, P < 0.001), while RN-BAV, distal IRF, and mid-AAo SFRR and circumferential WSS were related to ascending morphotype (AUC 0.81, P < 0.001) (Table and Figure).

Univariate analysis of aortic dilation Multivariate analysis of aortic dilation

Root morphotype Ascending morphotype



Odds Ratio P-value Odds Ratio P-value Odds Ratio P-value
BAV phenotype (RL/RN) 3.23 0.02 1.33 0.008
Sex (Male) 1.10 0.02 4.67 0.005
Prox Peak velocity 1.02 0.028 1.10 0.043
Jet angle 1.05 0.037
Displacement 3.56 0.001 1.11 0.021
IRF 1.01 0.002
WSSaxial 1.20 0.003 7.64 0.008
WSSCireumf 1.65 0.05
Mid Jet angle 1.07 0.006
Displacement 2.46 0.002
IRF 1.01 0.007
SFRR (%) 1.20 0.001 1.2 <0.001
WSSaxial 1.21 0.05
WSSCireumf 2.43 0.02 2.23 0.037
Dist IRF 1.01 0.026 1.10 0.026
WSSCireumf 1.49 0.05
SFRR (%) 1.10 0.005
Table.

Univariate and multivariate factors related to of aortic dilation and dilation morphotypes.

Figure.

ROC curves showing flow variables related to aortic dilation morphotypes.

Conclusions: Different altered flow parameters are related to root and ascending morphotypes in BAV. Further longitudinal studies are warranted to evaluate the impact of these flow parameters in determining the risk for aortopathy.

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Journal
Artery Research
Volume-Issue
20 - C
Pages
80 - 81
Publication Date
2017/12/06
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2017.10.109How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

TY  - JOUR
AU  - Lydia Dux-Santoy Hurtado
AU  - Jose F. Rodriguez-Palomares
AU  - Andrea Guala
AU  - Raquel Kale
AU  - Gisela Teixido-Tura
AU  - Filipa Valente
AU  - Giuliana Maldonado
AU  - David Garcia- Dorado
AU  - Artur Evangelista
PY  - 2017
DA  - 2017/12/06
TI  - P127 FLOW DYNAMICS AND ITS RELATION TO BICUSPID AORTOPATHY ASSESSED BY 4D FLOW CMR
JO  - Artery Research
SP  - 80
EP  - 81
VL  - 20
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2017.10.109
DO  - 10.1016/j.artres.2017.10.109
ID  - Dux-SantoyHurtado2017
ER  -