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

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.

Open Access

This is an open access article distributed under the CC BY-NC license.

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  -