| Title |
Transcatheter aortic valve replacement alters ascending aortic blood flow and wall shear stress patterns: A 4D flow MRI comparison with age-matched, elderly controls
|
|---|---|
| Published in |
European Radiology, August 2018
|
| DOI | 10.1007/s00330-018-5672-z |
| Pubmed ID | |
| Authors |
E. S. Farag, J. Vendrik, P. van Ooij, Q. L. Poortvliet, F. van Kesteren, L. W. Wollersheim, A. Kaya, A. H. G. Driessen, J. J. Piek, K. T. Koch, J. Baan, R. N. Planken, J. Kluin, A. J. Nederveen, B. A. J. M. de Mol |
| Abstract |
With the implementation of transcatheter aortic valve replacement (TAVR) in lower-risk patients, evaluation of blood flow characteristics and the effect of TAVR on aortic dilatation becomes of considerable interest. We employed 4D flow MRI in the ascending aorta of patients after TAVR to assess wall shear stress (WSS) and compare blood flow patterns with surgical aortic valve replacement (SAVR) and age- and gender-matched controls. Fourteen post-TAVR patients and ten age- and gender-matched controls underwent kt-PCA accelerated 4D flow MRI of the thoracic aorta at 3.0 Tesla. Velocity and wall shear stress was compared between the two groups. In addition, aortic flow eccentricity and displacement was assessed and compared between TAVR patients, controls and 14 SAVR patients recruited as part of an earlier study. Compared to controls, abnormally elevated WSS was present in 30±10% of the ascending aortic wall in TAVR patients. Increased WSS was present along the posterior mid-ascending aorta and the anterior distal-ascending aorta in all TAVR patients. TAVR results in eccentric and displaced flow in the mid- and distal-ascending aorta, whereas blood flow displacement in SAVR patients occurs only in the distal-ascending aorta. This study shows that TAVR results in increased blood flow velocity and WSS in the ascending aorta compared to age- and gender-matched elderly controls. This finding warrants longitudinal assessment of aortic dilatation after TAVR in the era of potential TAVR in lower-risk patients. Additionally, TAVR results in altered blood flow eccentricity and displacement in the mid- and distal-ascending aorta, whereas SAVR only results in altered blood flow eccentricity and displacement in the distal-ascending aorta. • TAVR results in increased blood flow velocity and WSS in the ascending aorta. • Longitudinal assessment of aortic dilatation after TAVR is warranted in the era of potential TAVR in lower-risk patients. • Both TAVR and SAVR result in altered blood flow patterns in the ascending aorta when compared to age-matched controls. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 50 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 50 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 8 | 16% |
| Researcher | 8 | 16% |
| Professor > Associate Professor | 5 | 10% |
| Other | 4 | 8% |
| Student > Doctoral Student | 3 | 6% |
| Other | 9 | 18% |
| Unknown | 13 | 26% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 19 | 38% |
| Engineering | 5 | 10% |
| Mathematics | 2 | 4% |
| Nursing and Health Professions | 1 | 2% |
| Economics, Econometrics and Finance | 1 | 2% |
| Other | 3 | 6% |
| Unknown | 19 | 38% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 August 2018.
All research outputs
#20,530,891
of 23,100,534 outputs
Outputs from European Radiology
#3,363
of 4,183 outputs
Outputs of similar age
#290,862
of 333,760 outputs
Outputs of similar age from European Radiology
#60
of 71 outputs
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