| Title: |
Aortic stenosis assessment from the 3-chamber cine: Ratio of balanced steady-state-free-precession (bSSFP) blood signal between the aorta and left ventricle predicts severity |
| Authors: |
Kavitha Vimalesvaran; Sameer Zaman; James P. Howard; Nikoo Aziminia; Marilena Giannoudi; Henry Procter; Marta Varela; Fatmatulzehra Uslu; Ben Ariff; Nick Linton; Eylem Levelt; Anil A. Bharath; Graham D. Cole |
| Source: |
Journal of Cardiovascular Magnetic Resonance, Vol 26, Iss 1, Pp 100005- (2024) |
| Publisher Information: |
Elsevier, 2024. |
| Publication Year: |
2024 |
| Collection: |
LCC:Diseases of the circulatory (Cardiovascular) system |
| Subject Terms: |
Aortic Valve; Aortic Stenosis; Left Ventricle; Balanced Steady-State Free Precession; Magnetic Field Strength; Valvular heart disease; Diseases of the circulatory (Cardiovascular) system; RC666-701 |
| Description: |
Background: Cardiovascular magnetic resonance (CMR) imaging is an important tool for evaluating the severity of aortic stenosis (AS), co-existing aortic disease, and concurrent myocardial abnormalities. Acquiring this additional information requires protocol adaptations and additional scanner time, but is not necessary for the majority of patients who do not have AS. We observed that the relative signal intensity of blood in the ascending aorta on a balanced steady state free precession (bSSFP) 3-chamber cine was often reduced in those with significant aortic stenosis. We investigated whether this effect could be quantified and used to predict AS severity in comparison to existing gold-standard measurements. Methods: Multi-centre, multi-vendor retrospective analysis of patients with AS undergoing CMR and transthoracic echocardiography (TTE). Blood signal intensity was measured in a ∼1 cm2 region of interest (ROI) in the aorta and left ventricle (LV) in the 3-chamber bSSFP cine. Because signal intensity varied across patients and scanner vendors, a ratio of the mean signal intensity in the aorta ROI to the LV ROI (Ao:LV) was used. This ratio was compared using Pearson correlations against TTE parameters of AS severity: aortic valve peak velocity, mean pressure gradient and the dimensionless index. The study also assessed whether field strength (1.5 T vs. 3 T) and patient characteristics (presence of bicuspid aortic valves (BAV), dilated aortic root and low flow states) altered this signal relationship. Results: 314 patients (median age 69 [IQR 57–77], 64% male) who had undergone both CMR and TTE were studied; 84 had severe AS, 78 had moderate AS, 66 had mild AS and 86 without AS were studied as a comparator group. The median time between CMR and TTE was 12 weeks (IQR 4–26). The Ao:LV ratio at 1.5 T strongly correlated with peak velocity (r = −0.796, p = 0.001), peak gradient (r = −0.772, p = 0.001) and dimensionless index (r = 0.743, p = 0.001). An Ao:LV ratio of |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1097-6647 |
| Relation: |
http://www.sciencedirect.com/science/article/pii/S1097664723001709; https://doaj.org/toc/1097-6647 |
| DOI: |
10.1016/j.jocmr.2023.100005 |
| Access URL: |
https://doaj.org/article/e9fa345f152e4e25b40e39f1fb7dd9cb |
| Accession Number: |
edsdoj.9fa345f152e4e25b40e39f1fb7dd9cb |
| Database: |
Directory of Open Access Journals |