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- Title
Evaluation of 3D blood flow patterns and wall shear stress in the normal and dilated thoracic aorta using flow-sensitive 4D CMR.
- Authors
Brk, Jonas; Blanke, Philipp; Stankovic, Zoran; Barker, Alex; Russe, Maximilian; Geiger, Julia; Frydrychowicz, Alex; Langer, Mathias; Markl, Michael
- Abstract
Background: The purpose of this study was to investigate 3D flow patterns and vessel wall parameters in patients with dilated ascending aorta, age-matched subjects, and healthy volunteers. Methods: Thoracic time-resolved 3D phase contrast CMR with 3-directional velocity encoding was applied to 33patients with dilated ascending aorta (diameter ≥40 mm, age=60±16 years), 15 age-matched normal controls (diameter ≤37 mm, age=68±7.5 years) and 15 young healthy volunteers (diameter ≤30 mm, age=23±2 years). 3D blood flow was visualized and flow patterns were graded regarding presence of supra-physiologic-helix and vortex flow using a semi-quantitative 3-point grading scale. Blood flow velocities, regional wall shear stress (WSS), and oscillatory shear index (OSI) were quantified. Results: Incidence and strength of supra-physiologic-helix and vortex flow in the ascending aorta (AAo) was significantly higher in patients with dilated AAo (16/33 and 31/33, grade 0.9±1.0 and 1.5±0.6) than in controls (2/15 and 7/15, grade 0.2 ± 0.6 and 0.6 ± 0.7, P<.05) or healthy volunteers (1/15 and 0/15, grade 0.1 ± 0.3 P<.05). Greater strength of the ascending aortic helix and vortex flow were associated with significant differences in AAo diameters (P<.05). Peak systolic WSS in the ascending aorta and aortic arch was significantly lower in patients with dilated AAo (P<.0157-.0488). AAo diameter positively correlated to time to peak systolic velocities (r=0.30-0.53, P<.04), OSI (r=0.33-0.49, P<0.02) and inversely correlated to peak systolic WSS (r=0.32-0.40, P<.03). Peak systolic WSS was significantly lower in AAo aneurysms at the right and outer curvature within the AAo and proximal arch (P<.01-.05). Conclusions: Increase in AAo diameter is significantly correlated with the presence and strength of supra-physiologic-helix and vortex formation in the AAo, as well with decrease in systolic WSS and increase in OSI.
- Subjects
BLOOD flow; BLOOD circulation; BODY fluid flow; AORTA; ARTERIES; AORTIC aneurysms; CORONARY arteries; CORONARY circulation; CARDIAC contraction; MAGNETIC resonance imaging; PROBABILITY theory; PHYSIOLOGICAL stress; THREE-dimensional imaging; DESCRIPTIVE statistics; THORACIC aorta
- Publication
Journal of Cardiovascular Magnetic Resonance (BioMed Central), 2012, Vol 14, Issue 1, p84
- ISSN
1532-429X
- Publication type
Article
- DOI
10.1186/1532-429X-14-84