scholarly journals Decreased rotational flow and circumferential wall shear stress as early markers of descending aorta dilation in Marfan syndrome: a 4D flow CMR study

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
A. Guala ◽  
G. Teixido-Tura ◽  
L. Dux-Santoy ◽  
C. Granato ◽  
A. Ruiz-Muñoz ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Pulse Wave Velocity ◽  
Marfan Syndrome ◽  
Pulse Wave ◽  
Rotational Flow ◽  
4D Flow ◽  
Descending Aorta ◽  
Early Markers ◽  
Wall Shear

Abstract Background Diseases of the descending aorta have emerged as a clinical issue in Marfan syndrome following improvements in proximal aorta surgical treatment and the consequent increase in life expectancy. Although a role for hemodynamic alterations in the etiology of descending aorta disease in Marfan patients has been suggested, whether flow characteristics may be useful as early markers remains to be determined. Methods Seventy-five Marfan patients and 48 healthy subjects were prospectively enrolled. In- and through-plane vortexes were computed by 4D flow cardiovascular magnetic resonance (CMR) in the thoracic aorta through the quantification of in-plane rotational flow and systolic flow reversal ratio, respectively. Regional pulse wave velocity and axial and circumferential wall shear stress maps were also computed. Results In-plane rotational flow and circumferential wall shear stress were reduced in Marfan patients in the distal ascending aorta and in proximal descending aorta, even in the 20 patients free of aortic dilation. Multivariate analysis showed reduced in-plane rotational flow to be independently related to descending aorta pulse wave velocity. Conversely, systolic flow reversal ratio and axial wall shear stress were altered in unselected Marfan patients but not in the subgroup without dilation. In multivariate regression analysis proximal descending aorta axial (p = 0.014) and circumferential (p = 0.034) wall shear stress were independently related to local diameter. Conclusions Reduced rotational flow is present in the aorta of Marfan patients even in the absence of dilation, is related to aortic stiffness and drives abnormal circumferential wall shear stress. Axial and circumferential wall shear stress are independently related to proximal descending aorta dilation beyond clinical factors. In-plane rotational flow and circumferential wall shear stress may be considered as an early marker of descending aorta dilation in Marfan patients.

scholarly journals Measurements of wall shear stress and aortic pulse wave velocity in swine with familial hypercholesterolemia

2014 ◽  
Vol 41 (5) ◽  
pp. 1475-1485 ◽  
Author(s):  
Andrew L. Wentland ◽  
Oliver Wieben ◽  
Dhanansayan Shanmuganayagam ◽  
Christian G. Krueger ◽  
Jennifer J. Meudt ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Pulse Wave Velocity ◽  
Familial Hypercholesterolemia ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Aortic Pulse Wave Velocity ◽  
Wall Shear

scholarly journals Simultaneous measurements of 3D wall shear stress and pulse wave velocity in the murine aortic arch

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Patrick Winter ◽  
Kristina Andelovic ◽  
Thomas Kampf ◽  
Jan Hansmann ◽  
Peter Michael Jakob ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Pulse Wave Velocity ◽  
Aortic Arch ◽  
Spatial Resolution ◽  
Temporal Resolution ◽  
Pulse Wave ◽  
High Spatial Resolution ◽  
High Temporal Resolution ◽  
4D Flow

Abstract Purpose Wall shear stress (WSS) and pulse wave velocity (PWV) are important parameters to characterize blood flow in the vessel wall. Their quantification with flow-sensitive phase-contrast (PC) cardiovascular magnetic resonance (CMR), however, is time-consuming. Furthermore, the measurement of WSS requires high spatial resolution, whereas high temporal resolution is necessary for PWV measurements. For these reasons, PWV and WSS are challenging to measure in one CMR session, making it difficult to directly compare these parameters. By using a retrospective approach with a flexible reconstruction framework, we here aimed to simultaneously assess both PWV and WSS in the murine aortic arch from the same 4D flow measurement. Methods Flow was measured in the aortic arch of 18-week-old wildtype (n = 5) and ApoE−/− mice (n = 5) with a self-navigated radial 4D-PC-CMR sequence. Retrospective data analysis was used to reconstruct the same dataset either at low spatial and high temporal resolution (PWV analysis) or high spatial and low temporal resolution (WSS analysis). To assess WSS, the aortic lumen was labeled by semi-automatically segmenting the reconstruction with high spatial resolution. WSS was determined from the spatial velocity gradients at the lumen surface. For calculation of the PWV, segmentation data was interpolated along the temporal dimension. Subsequently, PWV was quantified from the through-plane flow data using the multiple-points transit-time method. Reconstructions with varying frame rates and spatial resolutions were performed to investigate the influence of spatiotemporal resolution on the PWV and WSS quantification. Results 4D flow measurements were conducted in an acquisition time of only 35 min. Increased peak flow and peak WSS values and lower errors in PWV estimation were observed in the reconstructions with high temporal resolution. Aortic PWV was significantly increased in ApoE−/− mice compared to the control group (1.7 ± 0.2 versus 2.6 ± 0.2 m/s, p < 0.001). Mean WSS magnitude values averaged over the aortic arch were (1.17 ± 0.07) N/m2 in wildtype mice and (1.27 ± 0.10) N/m2 in ApoE−/− mice. Conclusion The post processing algorithm using the flexible reconstruction framework developed in this study permitted quantification of global PWV and 3D-WSS in a single acquisition. The possibility to assess both parameters in only 35 min will markedly improve the analyses and information content of in vivo measurements.

scholarly journals Towards quantitative evaluation of wall shear stress from 4D flow imaging

2020 ◽  
Vol 74 ◽  
pp. 232-243
Author(s):  
Sébastien Levilly ◽  
Marco Castagna ◽  
Jérôme Idier ◽  
Félicien Bonnefoy ◽  
David Le Touzé ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Quantitative Evaluation ◽  
Flow Imaging ◽  
4D Flow ◽  
Wall Shear ◽  
4D Flow Imaging

scholarly journals Volumetric segmentation-free method for rapid visualization of vascular wall shear stress using 4D flow MRI

2018 ◽  
Vol 80 (2) ◽  
pp. 748-755 ◽  
Author(s):  
Evan M. Masutani ◽  
Francisco Contijoch ◽  
Espoir Kyubwa ◽  
Joseph Cheng ◽  
Marcus T. Alley ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Vascular Wall ◽  
4D Flow Mri ◽  
4D Flow ◽  
Flow Mri ◽  
Wall Shear ◽  
Volumetric Segmentation

scholarly journals On the ‘cusp’ of clinical feasibility: aortic wall shear stress derived non-invasively with 4D flow MRI

2019 ◽  
Vol 11 (7) ◽  
pp. E96-E97
Author(s):  
Emilie Bollache ◽  
Paul W. M. Fedak ◽  
Michael Markl ◽  
Alex J. Barker
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Aortic Wall ◽  
4D Flow Mri ◽  
4D Flow ◽  
Flow Mri ◽  
Wall Shear

Abstract 14689: Regional Aortic Wall Shear Stress Mapping Implicates Hemodynamics in Human Bicuspid Aortopathy

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
David G Guzzardi ◽  
Pim van Ooij ◽  
Alex J Barker ◽  
Giampaolo Martufi ◽  
Katherine E Olsen ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Aortic Wall ◽  
Transforming Growth Factor ◽  
Patient Specific ◽  
4D Flow Mri ◽  
4D Flow ◽  
Hemodynamic Assessment ◽  
Flow Mri ◽  
Wall Shear

Introduction: A suspected genetic cause for bicuspid aortic valve (BAV) aortopathy has led to aggressive resection strategies. Using 4D flow MRI, we documented increased regional wall shear stress (WSS) in BAV patients. Local hemodynamics may exacerbate extracellular matrix (ECM) degradation leading to disease progression. If validated, preoperative regional hemodynamic assessment could be used to guide more targeted patient-specific aortic resection. For the first time, we correlated regional WSS with aortic tissue remodeling in BAV patients. Methods & Results: BAV patients (N=11) undergoing ascending aortic resection received preoperative 4D flow MRI with regional WSS differences mapped. Paired aortic wall samples (from same-patient with elevated WSS paired to normal WSS regions) were collected during surgery and compared using histology (pentachrome), biomechanics (biaxial mechanical testing), and ECM regulation (protein expression). Patient mean age: 49±18 years; mean aortic diameter: 4.6±0.7cm (range: 3.6 - 6.3cm); 55% had R+L fusion pattern; 36% had severe aortic stenosis. All patients had heterogeneous WSS patterns with regions of elevated WSS adjacent to those of normal WSS. By histology, regions of increased WSS showed greater medial elastin fragmentation, fibrosis, and cystic medial necrosis compared to adjacent areas of normal WSS. Regions of increased WSS showed increased elastic modulus (fold change±SD: 1.53±0.68; P=0.06, N=5) and collagen stiffness (1.37±0.49; P=0.07, N=5) compared to normal WSS regions suggesting altered distensibility. Multiplex protein analyses of ECM regulatory molecules revealed an increase in transforming growth factor β-1 (1.49±0.71, P=0.02), MMP-1 (1.62±0.84; P=0.01), MMP-2 (1.49±1.00; P=0.06), MMP-3 (1.23±0.36; P=0.02), MMP-7 (1.57±0.75; P=0.02), and TIMP-2 (1.26±0.33; P=0.01) in elevated WSS regions suggesting ECM dysregulation consistent with aortic remodeling. Conclusions: In BAV aorta, regional WSS corresponds with local histologic abnormalities, altered biomechanics, and ECM dysregulation. These novel data strongly implicate local hemodynamics as a mediator of BAV aortopathy. With further validation, 4D flow MRI could be used to guide personalized resection strategies.

scholarly journals Quantification and comparison of 4D-flow MRI-derived wall shear stress and MRE-derived wall stiffness of the abdominal aorta

2016 ◽  
Vol 45 (3) ◽  
pp. 771-778 ◽  
Author(s):  
Arunark Kolipaka ◽  
Venkata Sita Priyanka Illapani ◽  
Prateek Kalra ◽  
Julio Garcia ◽  
Xiaokui Mo ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Abdominal Aorta ◽  
4D Flow Mri ◽  
4D Flow ◽  
Wall Stiffness ◽  
Flow Mri ◽  
Wall Shear
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