Left ventricular blood flow kinetic energy is associated with the six-minute walk test and left ventricular remodelling post valvular intervention in aortic stenosis

Left ventricular (LV) kinetic energy (KE) assessment by four-dimensional flow cardiovascular magnetic resonance (4D flow CMR) may offer incremental value over routine assessment in aortic stenosis (AS). The main objective of this study is to investigate the LV KE in patients with AS before and after...

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Veröffentlicht in:Quantitative imaging in medicine and surgery 2021-04, Vol.11 (4), p.1470-1482
Hauptverfasser: Elhawaz, Alaa, Archer, Gareth T, Zafar, Hamza, Fidock, Benjamin, Barker, Natasha, Jones, Rachel, Rothman, Alexander, Hose, Rod, Al-Mohammad, Abdallah, Briffa, Norman, Hunter, Steven, Braidley, Peter, Hall, Ian R, Grech, Ever, van der Geest, Rob J, Gunn, Julian P, Swift, Andrew J, Wild, James M, Garg, Pankaj
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container_issue 4
container_start_page 1470
container_title Quantitative imaging in medicine and surgery
container_volume 11
creator Elhawaz, Alaa
Archer, Gareth T
Zafar, Hamza
Fidock, Benjamin
Barker, Natasha
Jones, Rachel
Rothman, Alexander
Hose, Rod
Al-Mohammad, Abdallah
Briffa, Norman
Hunter, Steven
Braidley, Peter
Hall, Ian R
Grech, Ever
van der Geest, Rob J
Gunn, Julian P
Swift, Andrew J
Wild, James M
Garg, Pankaj
description Left ventricular (LV) kinetic energy (KE) assessment by four-dimensional flow cardiovascular magnetic resonance (4D flow CMR) may offer incremental value over routine assessment in aortic stenosis (AS). The main objective of this study is to investigate the LV KE in patients with AS before and after the valve intervention. In addition, this study aimed to investigate if LV KE offers incremental value for its association to the six-minute walk test (6MWT) or LV remodelling post-intervention. We recruited 18 patients with severe AS. All patients underwent transthoracic echocardiography for mean pressure gradient (mPG), CMR including 4D flow and 6MWT. Patients were invited for post-valve intervention follow-up CMR at 3 months and twelve patients returned for follow-up CMR. KE assessment of LV blood flow and the components (direct, delayed, retained and residual) were carried out for all cases. LV KE parameters were normalised to LV end-diastolic volume (LVEDV). For LV blood flow KE assessment, the metrics including time delay (TD) for peak E-wave from base to mid-ventricle (14±48 2.5±9.75 ms, P=0.04), direct (4.91±5.07 1.86±1.72 µJ, P=0.01) and delayed (2.46±3.13 1.38±1.15 µJ, P=0.03) components of LV blood flow demonstrated a significant change between pre- and post-valve intervention. Only LV KEi (r=-0.53, P
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The main objective of this study is to investigate the LV KE in patients with AS before and after the valve intervention. In addition, this study aimed to investigate if LV KE offers incremental value for its association to the six-minute walk test (6MWT) or LV remodelling post-intervention. We recruited 18 patients with severe AS. All patients underwent transthoracic echocardiography for mean pressure gradient (mPG), CMR including 4D flow and 6MWT. Patients were invited for post-valve intervention follow-up CMR at 3 months and twelve patients returned for follow-up CMR. KE assessment of LV blood flow and the components (direct, delayed, retained and residual) were carried out for all cases. LV KE parameters were normalised to LV end-diastolic volume (LVEDV). For LV blood flow KE assessment, the metrics including time delay (TD) for peak E-wave from base to mid-ventricle (14±48 2.5±9.75 ms, P=0.04), direct (4.91±5.07 1.86±1.72 µJ, P=0.01) and delayed (2.46±3.13 1.38±1.15 µJ, P=0.03) components of LV blood flow demonstrated a significant change between pre- and post-valve intervention. Only LV KEi (r=-0.53, P&lt;0.01), diastolic KEi (r=-0.53, P&lt;0.01) and E KEi (r=-0.38, P=0.04) demonstrated association to the 6MWT. However, Pre-operative LV KEi (r=0.67, P=0.02) demonstrated association to LV remodelling post valve intervention. LV blood flow KE is associated with 6MWT and LV remodelling in patients with AS. 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The main objective of this study is to investigate the LV KE in patients with AS before and after the valve intervention. In addition, this study aimed to investigate if LV KE offers incremental value for its association to the six-minute walk test (6MWT) or LV remodelling post-intervention. We recruited 18 patients with severe AS. All patients underwent transthoracic echocardiography for mean pressure gradient (mPG), CMR including 4D flow and 6MWT. Patients were invited for post-valve intervention follow-up CMR at 3 months and twelve patients returned for follow-up CMR. KE assessment of LV blood flow and the components (direct, delayed, retained and residual) were carried out for all cases. LV KE parameters were normalised to LV end-diastolic volume (LVEDV). 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title Left ventricular blood flow kinetic energy is associated with the six-minute walk test and left ventricular remodelling post valvular intervention in aortic stenosis
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