Peak flow measurements in patients with severe aortic stenosis: a prospective comparative study between cardiovascular magnetic resonance 2D and 4D flow and transthoracic echocardiography

Abstract Background Aortic valve stenosis (AS) is the most prevalent valvular disease in the developed countries. Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) is an emerging imaging technique, which has been suggested to improve the evaluation of AS severity compared to two-dim...

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Autores principales:	Reetta Hälvä, Satu M. Vaara, Juha I. Peltonen, Touko T. Kaasalainen, Miia Holmström, Jyri Lommi, Satu Suihko, Helena Rajala, Minna Kylmälä, Sari Kivistö, Suvi Syväranta
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Aortic valve stenosis 4D flow 2D flow Cardiovascular magnetic resonance Valvular heart disease Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/19122bbd15184aa584c9f18cd6330af0
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spelling	oai:doaj.org-article:19122bbd15184aa584c9f18cd6330af02021-11-21T12:08:59ZPeak flow measurements in patients with severe aortic stenosis: a prospective comparative study between cardiovascular magnetic resonance 2D and 4D flow and transthoracic echocardiography10.1186/s12968-021-00825-11532-429Xhttps://doaj.org/article/19122bbd15184aa584c9f18cd6330af02021-11-01T00:00:00Zhttps://doi.org/10.1186/s12968-021-00825-1https://doaj.org/toc/1532-429XAbstract Background Aortic valve stenosis (AS) is the most prevalent valvular disease in the developed countries. Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) is an emerging imaging technique, which has been suggested to improve the evaluation of AS severity compared to two-dimensional (2D) flow and transthoracic echocardiography (TTE). We investigated the reliability of CMR 2D flow and 4D flow techniques in measuring aortic transvalvular peak systolic flow in patients with severe AS. Methods We prospectively recruited 90 patients referred for aortic valve replacement due to severe AS (73.3 ± 11.3 years, aortic valve area 0.7 ± 0.1 cm2, and 54/36 tricuspid/bicuspid), and 10 non-valvular disease controls. All the patients underwent echocardiography and 2D flow and 4D flow CMR. Peak flow velocity measurements were compared using Wilcoxon signed rank sum test and Bland–Altman analysis. Results 4D flow underestimated peak flow velocity in the AS group when compared with TTE (bias − 1.1 m/s, limits of agreement ± 1.4 m/s) and 2D flow (bias − 1.2 m/s, limits of agreement ± 1.6 m/s). The differences between values obtained by TTE (median 4.3 m/s, range 2.7–6.1 m/s) and 2D flow (median 4.5 m/s, range 2.9–6.5 m/s) compared to 4D flow (median 3.1 m/s, range 1.7–5.1 m/s) were significant (p < 0.001). The difference between 2D flow and TTE were insignificant (bias 0.07 m/s, limits of agreement ± 1.5 m/s). In non-valvular disease controls, peak flow velocity was measured higher by 4D flow than 2D flow (1.4 m/s, 1.1–1.7 m/s and 1.3 m/s, 1.1–1.5 m/s, respectively; bias 0.2 m/s, limits of agreement ± 0.16 m/s). Conclusions CMR 4D flow significantly underestimates systolic peak flow velocity in patients with severe AS. 2D flow, in turn, estimated the AS velocity accurately, with measured peak flow velocities comparable to TTE.Reetta HälväSatu M. VaaraJuha I. PeltonenTouko T. KaasalainenMiia HolmströmJyri LommiSatu SuihkoHelena RajalaMinna KylmäläSari KivistöSuvi SyvärantaBMCarticleAortic valve stenosis4D flow2D flowCardiovascular magnetic resonanceValvular heart diseaseDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of Cardiovascular Magnetic Resonance, Vol 23, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Aortic valve stenosis 4D flow 2D flow Cardiovascular magnetic resonance Valvular heart disease Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Aortic valve stenosis 4D flow 2D flow Cardiovascular magnetic resonance Valvular heart disease Diseases of the circulatory (Cardiovascular) system RC666-701 Reetta Hälvä Satu M. Vaara Juha I. Peltonen Touko T. Kaasalainen Miia Holmström Jyri Lommi Satu Suihko Helena Rajala Minna Kylmälä Sari Kivistö Suvi Syväranta Peak flow measurements in patients with severe aortic stenosis: a prospective comparative study between cardiovascular magnetic resonance 2D and 4D flow and transthoracic echocardiography
description	Abstract Background Aortic valve stenosis (AS) is the most prevalent valvular disease in the developed countries. Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) is an emerging imaging technique, which has been suggested to improve the evaluation of AS severity compared to two-dimensional (2D) flow and transthoracic echocardiography (TTE). We investigated the reliability of CMR 2D flow and 4D flow techniques in measuring aortic transvalvular peak systolic flow in patients with severe AS. Methods We prospectively recruited 90 patients referred for aortic valve replacement due to severe AS (73.3 ± 11.3 years, aortic valve area 0.7 ± 0.1 cm2, and 54/36 tricuspid/bicuspid), and 10 non-valvular disease controls. All the patients underwent echocardiography and 2D flow and 4D flow CMR. Peak flow velocity measurements were compared using Wilcoxon signed rank sum test and Bland–Altman analysis. Results 4D flow underestimated peak flow velocity in the AS group when compared with TTE (bias − 1.1 m/s, limits of agreement ± 1.4 m/s) and 2D flow (bias − 1.2 m/s, limits of agreement ± 1.6 m/s). The differences between values obtained by TTE (median 4.3 m/s, range 2.7–6.1 m/s) and 2D flow (median 4.5 m/s, range 2.9–6.5 m/s) compared to 4D flow (median 3.1 m/s, range 1.7–5.1 m/s) were significant (p < 0.001). The difference between 2D flow and TTE were insignificant (bias 0.07 m/s, limits of agreement ± 1.5 m/s). In non-valvular disease controls, peak flow velocity was measured higher by 4D flow than 2D flow (1.4 m/s, 1.1–1.7 m/s and 1.3 m/s, 1.1–1.5 m/s, respectively; bias 0.2 m/s, limits of agreement ± 0.16 m/s). Conclusions CMR 4D flow significantly underestimates systolic peak flow velocity in patients with severe AS. 2D flow, in turn, estimated the AS velocity accurately, with measured peak flow velocities comparable to TTE.
format	article
author	Reetta Hälvä Satu M. Vaara Juha I. Peltonen Touko T. Kaasalainen Miia Holmström Jyri Lommi Satu Suihko Helena Rajala Minna Kylmälä Sari Kivistö Suvi Syväranta
author_facet	Reetta Hälvä Satu M. Vaara Juha I. Peltonen Touko T. Kaasalainen Miia Holmström Jyri Lommi Satu Suihko Helena Rajala Minna Kylmälä Sari Kivistö Suvi Syväranta
author_sort	Reetta Hälvä
title	Peak flow measurements in patients with severe aortic stenosis: a prospective comparative study between cardiovascular magnetic resonance 2D and 4D flow and transthoracic echocardiography
title_short	Peak flow measurements in patients with severe aortic stenosis: a prospective comparative study between cardiovascular magnetic resonance 2D and 4D flow and transthoracic echocardiography
title_full	Peak flow measurements in patients with severe aortic stenosis: a prospective comparative study between cardiovascular magnetic resonance 2D and 4D flow and transthoracic echocardiography
title_fullStr	Peak flow measurements in patients with severe aortic stenosis: a prospective comparative study between cardiovascular magnetic resonance 2D and 4D flow and transthoracic echocardiography
title_full_unstemmed	Peak flow measurements in patients with severe aortic stenosis: a prospective comparative study between cardiovascular magnetic resonance 2D and 4D flow and transthoracic echocardiography
title_sort	peak flow measurements in patients with severe aortic stenosis: a prospective comparative study between cardiovascular magnetic resonance 2d and 4d flow and transthoracic echocardiography
publisher	BMC
publishDate	2021
url	https://doaj.org/article/19122bbd15184aa584c9f18cd6330af0
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Peak flow measurements in patients with severe aortic stenosis: a prospective comparative study between cardiovascular magnetic resonance 2D and 4D flow and transthoracic echocardiography

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