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MRI-based Protocol to Characterize the Relationship Between Bicuspid Aortic Valve Morphology and Hemodynamics

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Abstract

Bicuspid aortic valve (BAV) is the most common congenital heart defect and can lead to severe complications. Many studies have been conducted to evaluate the potential of geometric and hemodynamic biomarkers to predict BAV-related aortopathy. This work proposes a novel semi-automatic protocol to characterize geometry and hemodynamics of aorta and aortic valve based on 2D cine and 4D flow MRI data. The protocol was applied to 12 BAV and 12 control subjects. Statistical differences between the groups were identified and linear regression models were investigated to elucidate the potential of this protocol to investigate the risk of disease progression. Statistical differences between the groups were found for orifice eccentricity, aorta diameter, velocity, jet angle and flow displacement. Key findings of the regression analysis include the association in the proximal ascending aorta between aorta diameter and mean velocity (negative), jet angle (positive) and flow displacement (positive), in the combined cohort. Positive association between flow displacement in the proximal aorta and orifice jet angle in TAV subjects was found. This study represents a pilot application of a protocol for standardized assessment of aortic geometry and hemodynamics associated with BAV disease. Its limited need for user input is advantageous for large cohort studies.

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Acknowledgments

The authors would like to acknowledge the members of the Cardiovascular Fluid Mechanics Laboratory at Georgia Institute of Technology, for the fruitful discussions on the study and the useful comments provided on the manuscript, and Dr. James Bethel (Westat, Rockville, MD, USA) for his advice on the statistical analysis. This study was funded in part by NHLBI Grant R01HL115828, American Heart Association Scientist Development Grant 13SDG14360004 and K25HL119608 (AJB) and the Wallace H Coulter Distinguished Faculty Chair endowment (APY, LM).

Conflict of interest

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

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Authors and Affiliations

  1. Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Alex J. Barker & Michael Markl

  2. Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Technology Enterprise Park, Suite 200, 387 Technology Circle, Atlanta, GA, 30313-2412, USA

    Lucia Mirabella, Neelakantan Saikrishnan, Daniel J. Mangiameli & Ajit P. Yoganathan

  3. School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA, USA

    Elizabeth R. Coco

  4. Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, IL, USA

    Michael Markl

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  1. Lucia Mirabella
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Correspondence to Ajit P. Yoganathan.

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Associate Editor Peter E. McHugh oversaw the review of this article.

The work performed by Lucia Mirabella was carried out during her appointment at Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.

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Mirabella, L., Barker, A.J., Saikrishnan, N. et al. MRI-based Protocol to Characterize the Relationship Between Bicuspid Aortic Valve Morphology and Hemodynamics. Ann Biomed Eng 43, 1815–1827 (2015). https://doi.org/10.1007/s10439-014-1214-2

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  • DOI: https://doi.org/10.1007/s10439-014-1214-2

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