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Tang M, Zhang F, Liu B, Liu Q, Qi W, Tang M, Luo Y, Chen J. Assessment of Pulmonary Arteries Hemodynamics and Its Relationship With Cardiac Remodeling and Myocardial Fibrosis in Athletes With Four-Dimensional Flow MRI. J Magn Reson Imaging 2024; 60:377-387. [PMID: 37819191 DOI: 10.1002/jmri.29048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Exercise-induced cardiac remodeling (CR) and myocardial fibrosis (MF) can increase cardiovascular risk in athletes. Early detection of pulmonary arterial hemodynamics parameters among athletes may be beneficial in optimizing the frequency of clinical follow-ups. PURPOSE To analyze the hemodynamics of pulmonary arteries and its relationship with CR and MF in athletes using four-dimensional (4D) flow MRI. STUDY TYPE Prospective. POPULATION One hundred twenty-one athletes (median age, 24 years; mean exercise per week 10 hours, for mean of 5 years) and twenty-one sedentary healthy controls (median age, 25 years; exercise per week <3 hours, irregular pattern). FIELD STRENGTH/SEQUENCE True fast imaging with steady state free precession, time-resolved 3D Cartesian phase-contrast, and phase sensitive inversion recovery late gadolinium enhancement sequences at 3.0 T. ASSESSMENT CR was defined as any cardiac parameters exceeding the 99th percentile upper reference limits, encompassing ventricular function, bi-atrium and bi-ventricle diameters, and ventricular wall thickness. MF was visually evaluated by three independent radiologists. 4D flow parameters were assessed in the main, right, and left pulmonary arteries (MPA, RPA, and LPA, respectively) and compared between different groups. Four machine learning (ML) models were developed to differentiate between athletes with and without CR and/or MF. STATISTICAL TESTS Univariate analysis was used to compare groups. Area under the receiver operating characteristic curve (AUC) was used to assess the performance of the ML models. RESULTS Athletes had significantly higher WSSmax in the MPA, RPA, and LPA than controls. Athletes with CR and/or MF (N = 30) had significantly lower RPmax from MPA to RPA than those without (N = 91). Among the ML models, the gradient boosting machine model had the highest performance, with an AUC of 0.90. CONCLUSION The pulmonary arterial hemodynamics parameters could differentiate CR and/or MF in athletes, which may be potential to assist in optimizing frequency of follow-up. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Mingsong Tang
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Fan Zhang
- Department of Gynaecology and Ostetrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Binyao Liu
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Qian Liu
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Wanying Qi
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Min Tang
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Yong Luo
- Department of Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Jing Chen
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
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Curry T, Barrameda ME, Thomas TC, Esfandiarei M. In vivo phenotypic vascular dysfunction extends beyond the aorta in a mouse model for fibrillin-1 (Fbn1) mutation. Sci Rep 2024; 14:5779. [PMID: 38461168 PMCID: PMC10924961 DOI: 10.1038/s41598-024-56438-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/06/2024] [Indexed: 03/11/2024] Open
Abstract
In individuals with Marfan Syndrome (MFS), fibrillin-1 gene (FBN1) mutations can lead to vascular wall weakening and dysfunction. The experimental mouse model of MFS (Fbn1C1041G/+) has been advantageous in investigating MFS-associated life-threatening aortic aneurysms. It is well established that the MFS mouse model exhibits an accelerated-aging phenotype in elastic organs like the aorta, lung, and skin. However, the impact of Fbn1 mutations on the in vivo function and structure of various artery types with the consideration of sex and age, has not been adequately explored in real-time and a clinically relevant context. In this study, we investigate if Fbn1 mutation contributes to sex-dependent alterations in central and cerebral vascular function similar to phenotypic changes associated with normal aging in healthy control mice. In vivo ultrasound imaging of central and cerebral vasculature was performed in 6-month-old male and female MFS and C57BL/6 mice and sex-matched 12-month-old (middle-aged) healthy control mice. Our findings confirm aortic enlargement (aneurysm) and wall stiffness in MFS mice, but with exacerbation in male diameters. Coronary artery blood flow velocity (BFV) in diastole was not different but left pulmonary artery BFV was decreased in MFS and 12-month-old control mice regardless of sex. At 6 months of age, MFS male mice show decreased posterior cerebral artery BFV as compared to age-matched control males, with no difference observed between female cohorts. Reduced mitral valve early-filling velocities were indicated in MFS mice regardless of sex. Male MFS mice also demonstrated left ventricular hypertrophy. Overall, these results underscore the significance of biological sex in vascular function and structure in MFS mice, while highlighting a trend of pre-mature vascular aging phenotype in MFS mice that is comparable to phenotypes observed in older healthy controls. Furthermore, this research is a vital step in understanding MFS's broader implications and sets the stage for more in-depth future analyses, while providing data-driven preclinical justification for re-evaluating diagnostic approaches and therapeutic efficacy.
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Affiliation(s)
- T Curry
- College of Medicine-Phoenix, University of Arizona, Phoenix, AZ, USA
- Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, USA
| | - M E Barrameda
- Biomedical Sciences Program, College of Graduate Studies, Midwestern University, 19555 N 59th Ave., Glendale, AZ, 85308, USA
| | - T Currier Thomas
- College of Medicine-Phoenix, University of Arizona, Phoenix, AZ, USA.
- Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, USA.
- Biomedical Sciences Program, College of Graduate Studies, Midwestern University, 19555 N 59th Ave., Glendale, AZ, 85308, USA.
- Arizona State University, Tempe, AZ, USA.
- Phoenix VA Health Care System, Phoenix, AZ, USA.
| | - M Esfandiarei
- College of Medicine-Phoenix, University of Arizona, Phoenix, AZ, USA.
- Biomedical Sciences Program, College of Graduate Studies, Midwestern University, 19555 N 59th Ave., Glendale, AZ, 85308, USA.
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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Shang Y, Theilenberg S, Gajdošík M, Schreiber LM, Juchem C. High resolution simulation and measurement demonstrate oscillatory spatiotemporal B 0 fluctuations across the human cardiac cycle. Magn Reson Med 2024; 91:91-104. [PMID: 37598417 DOI: 10.1002/mrm.29831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/12/2023] [Accepted: 07/28/2023] [Indexed: 08/22/2023]
Abstract
PURPOSE Functional cardiac MRI scans employing balanced steady-state free precession sequences suffer from dark band artifacts in the myocardium due to B0 inhomogeneity. We recently introduced a novel method for the theoretical derivation of B0 distributions in the human heart. This study aims to simulate the B0 distributions in the heart across the cardiac cycle using structural MR images and validate the simulations via in vivo measured cardiac phase-specific B0 maps on the same subjects at 3T. METHODS Cardiac phase-specific B0 field maps were acquired from eight healthy subjects at 3T. B0 conditions were simulated based on tissue masks created from the cardiac-phase specific structural images from the in vivo B0 map scan and anatomical images from a thoracic MRI scan, adopting our recently published approach. The simulations and in vivo measurements were compared by calculating the spatial correlation of their B0 distributions and temporal correlation of the derived spherical harmonic coefficients throughout the cardiac cycle. RESULTS The spatial comparison of B0 maps between the simulation and in vivo measurement indicates an overall average correlation coefficient of 0.91 across the cardiac cycle in all subjects. Both groups show consistent high-level B0 patterns. Temporal variations of B0 conditions exhibit sinusoidal characteristics and are strongly correlated between simulation and in vivo. CONCLUSION Theoretical simulations employing regional anatomical features were validated by direct in vivo B0 mapping in the same subjects. The spatial B0 condition throughout the cardiac cycle exhibits oscillatory characteristics due to structural distortions of cardiac motion.
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Affiliation(s)
- Yun Shang
- Department of Biomedical Engineering, Columbia University in the City of New York, New York, New York, USA
| | - Sebastian Theilenberg
- Department of Biomedical Engineering, Columbia University in the City of New York, New York, New York, USA
| | - Martin Gajdošík
- Department of Biomedical Engineering, Columbia University in the City of New York, New York, New York, USA
| | - Laura M Schreiber
- Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center, University Hospital Wuerzburg, Wuerzburg, Germany
- Department of Cardiovascular Imaging, Comprehensive Heart Failure Center, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Christoph Juchem
- Department of Biomedical Engineering, Columbia University in the City of New York, New York, New York, USA
- Department of Radiology, Columbia University in the City of New York, New York, New York, USA
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Curry T, Barrameda ME, Currier Thomas T, Esfandiarei M. In Vivo Phenotypic Vascular Dysfunction Extends Beyond the Aorta in a Mouse Model for Fibrillin-1 ( FBN1 ) Mutation. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.18.567641. [PMID: 38014144 PMCID: PMC10680800 DOI: 10.1101/2023.11.18.567641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
In individuals with Marfan Syndrome (MFS), fibrillin-1 gene ( FBN1 ) mutations can lead to vascular wall weakening and dysfunction. The experimental mouse model of MFS ( FBN1 C1041G/+ ) has been advantageous in investigating MFS-associated life-threatening aortic aneurysms. Although the MFS mouse model presents an accelerated-aging phenotype in elastic organs (e.g., lung, skin), the impact of FBN1 mutations on other central and peripheral arteries function and structure with the consideration of the impact of sex remains underexplored. In this study, we investigate if FBN1 mutation contributes to sex-dependent alterations in central and cerebral vascular function similar to phenotypic changes associated with normal aging in healthy control mice. In vivo ultrasound imaging of central and cerebral vasculature was performed in 6-month-old male and female MFS and C57BL/6 mice and sex-matched 12-month-old (middle-aged) healthy control mice. Our findings confirm aortic enlargement (aneurysm) and wall stiffness in MFS mice, but with exacerbation in male diameters. Coronary artery blood flow velocity (BFV) in diastole was not different but left pulmonary artery BFV was decreased in MFS and 12-month-old control mice regardless of sex. At 6 months of age, MFS male mice show decreased posterior cerebral artery BFV as compared to age-matched control males, with no difference observed between female cohorts. Reduced mitral valve early-filling velocities were indicated in MFS mice regardless of sex. Male MFS mice also demonstrated left ventricular hypertrophy. Overall, these results underscore the significance of biological sex in vascular function and structure in MFS mice, while highlighting a trend of pre-mature vascular aging phenotype in MFS mice that is comparable to phenotypes observed in older healthy controls.
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Körperich H, Eckstein J, Atito M, Barth P, Laser KT, Burchert W, Weber OM, Stehning C, Piran M. Assessment of pulmonary artery stiffness by multiparametric cardiac magnetic resonance-surrogate for right heart catheterization. Front Cardiovasc Med 2023; 10:1200833. [PMID: 37692049 PMCID: PMC10485836 DOI: 10.3389/fcvm.2023.1200833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/14/2023] [Indexed: 09/12/2023] Open
Abstract
Background Cardiac magnetic resonance (CMR) imaging allows for multiparametric assessment of healthy pulmonary artery (PA) hemodynamics. Gender- and aging-associated PA stiffness and pressure alterations have remained clinically unestablished, however may demonstrate epidemiological differences in disease development. The aim of this study is to evaluate the role of CMR as a surrogate for catheter examinations by providing a comprehensive CMR assessment of sex- and age-related reference values for PA stiffness, flow, and pressure. Methods and Results PA hemodynamics were studied between gender and age groups (>/<50 years) using phase-contrast CMR. Corresponding correlation analyses were performed. 179 healthy volunteers with a median age of 32.6 years (range 11.3-68.2) were examined. Males demonstrated increased PA compliance (median [interquartile range] or mean ± standard deviation) (20.8 mm2/mmHg [16.6; 25.8] vs. 19.2 ± 7.1 mm2/mmHg; P < 0.033), higher pulse wave velocity (2.00 m/s [1.35; 2.87] vs. 1.73 m/s [1.19; 2.34]; P = 0.018) and a reduced full width half maximum (FWHM) (219 ± 22 ms vs. 235 ± 23 ms; P < 0.001) than females. Mean, systolic, diastolic PA pressure and pulmonary proportional pulse pressure were significantly elevated for males compared to females (P < 0.001). Older subjects (>50 years) exhibited reduced PA elasticity (41.7% [31.0; 52.9] vs. 66.4% [47.7; 83.0]; P < 0.001), reduced PA compliance (15.4 mm2/mmHg [12.3; 20.7] vs. 21.3 ± 6.8 mm2/mmHg; P < 0.001), higher pulse wave velocity (2.59 m/s [1.57; 3.59] vs. 1.76 m/s [1.24; 2.34]; P < 0.001) and a reduced FWHM (218 ± 29 ms vs. 231 ± 21 ms; P < 0.001) than younger subjects. Conclusions Velocity-time profiles are dependent on age and gender. PA stiffness indices deteriorate with age. CMR has potential to serve as a surrogate for right heart catheterization.
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Affiliation(s)
- Hermann Körperich
- Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
| | - Jan Eckstein
- Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
| | - Medhat Atito
- Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
| | - Peter Barth
- Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
| | - Kai Thorsten Laser
- Clinic for Paediatric Cardiology and Congenital Heart Defects, Heart and Diabetes Center North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
| | - Wolfgang Burchert
- Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
| | | | | | - Misagh Piran
- Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany
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Schafstedde M, Jarmatz L, Brüning J, Hüllebrand M, Nordmeyer S, Harloff A, Hennemuth A. Population-based reference values for 4D flow MRI derived aortic blood flow parameters. Physiol Meas 2023; 44. [PMID: 36735968 DOI: 10.1088/1361-6579/acb8fd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 02/03/2023] [Indexed: 02/05/2023]
Abstract
Objective. This study assesses age-related differences of thoracic aorta blood flow profiles and provides age- and sex-specific reference values using 4D flow cardiovascular magnetic resonance (CMR) data.Approach. 126 volunteers (age 20-80 years, female 51%) underwent 4D flow CMR and 12 perpendicular analysis planes in the thoracic aorta were specified. For these planes the following parameters were evaluated: body surface area-adjusted aortic area (A'), normalized flow displacement (NFD), the degree of wall parallelism (WPD), the minimal relative cross-sectional area through which 80% of the volume flow passes (A80) and the angle between flow direction and centerline (α).Main results. Age-related differences in blood flow parameters were seen in the ascending aorta with higher values for NFD and angle and lower values for WPD and A80 in older subjects. All parameters describing blood flow patterns correlated with the cross-sectional area in the ascending aorta. No relevant sex-differences regarding blood flow profiles were found.Significance. These age- and sex-specific reference values for quantitative parameters describing blood flow within the aorta might help to study the clinical relevance of flow profiles in the future.
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Affiliation(s)
- Marie Schafstedde
- Institute of Congenital Heart Disease, German Heart Center Charité, Berlin, Germany.,Department of Congenital Heart Disease, German Heart Center Charité, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany.,Partner Site Berlin, German Centre for Cardiovascular Research (DZHK), Berlin, Germany
| | - Lina Jarmatz
- Institute of Congenital Heart Disease, German Heart Center Charité, Berlin, Germany
| | - Jan Brüning
- Institute of Congenital Heart Disease, German Heart Center Charité, Berlin, Germany.,Partner Site Berlin, German Centre for Cardiovascular Research (DZHK), Berlin, Germany
| | - Markus Hüllebrand
- Institute of Congenital Heart Disease, German Heart Center Charité, Berlin, Germany.,Fraunhofer MEVIS, Bremen, Germany
| | - Sarah Nordmeyer
- Institute of Congenital Heart Disease, German Heart Center Charité, Berlin, Germany.,Department of Congenital Heart Disease, German Heart Center Charité, Berlin, Germany
| | - Andreas Harloff
- Department of Neurology, University Medical Center Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Germany
| | - Anja Hennemuth
- Institute of Congenital Heart Disease, German Heart Center Charité, Berlin, Germany.,Partner Site Berlin, German Centre for Cardiovascular Research (DZHK), Berlin, Germany.,Fraunhofer MEVIS, Bremen, Germany
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Zhang J, Zheng XZ, Wu XC. Pulmonary transit time has close relation with pulmonary pulse wave transit time in normal subjects. Clin Physiol Funct Imaging 2023; 43:78-84. [PMID: 36377619 DOI: 10.1111/cpf.12794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/06/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pulmonary transit time (PTT) and pulmonary pulse wave transit time (pPTT) are useful parameters for the evaluation of cardiopulmonary circulation and vascular alterations, but their relationship remains unknown. The aim of this study was to investigate the correlation between PTT and pPTT. METHODS A total of 60 healthy volunteers were involved in this study. They were divided into two groups (30 participants per group): <50 years and >50 years. They all underwent Doppler echocardiography of pulmonary vein flow and contrast echocardiography with the measurement of pPTT and PTT, respectively. The correlation between PTT and pPTT was deduced. RESULTS Compared with Group of <50 years, there was a significant increment in left atrial volume index, left atrial pressure and pulmonary artery stiffness but a significant reduction in acceleration times of pulmonary artery flow in Group of >50 years (p < 0.05). Group >50 years had longer PTT and but reduced normalized PTT by R-R interval (NPTT), reduced normalized pPTT by R-R interval (NpPTT) than Group <50 years (p < 0.05), while there was no significant difference in pPTT between the two groups (p > 0.05). PTT and NPTT were all negatively correlated with pPTT and NpPTT. The statistically significant strongest correlation was observed between PTT and NpPTT (r = -0.886, p < 0.0001). The regression equation for them was y = 7.4396-13.095x (R2 = 0.785; p < 0.001), where x and y represent NpPTT and PTT, respectively. CONCLUSION PTT had close relation with pPTT in normal subjects. From the regression equation for them, we can get the value of PTT simply and easily by non-invasively measured pPTT.
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Affiliation(s)
- Jun Zhang
- Department of Ultrasound, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, People's Republic of China
| | - Xiao-Zhi Zheng
- Department of Ultrasound, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China
| | - Xu-Chu Wu
- Department of Ultrasound, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China
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Kan H, Mizuno K, Takizawa M, Shimohira M, Kawai T, Aoki T, Tsubokura S, Kasai H. Noncontrast time-resolved pulmonary magnetic resonance angiography with consecutive beam saturation pulse and variable flip angles using three-dimensional fast spin echo: A preliminary study. Magn Reson Imaging 2022; 94:80-88. [PMID: 36122676 DOI: 10.1016/j.mri.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/20/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022]
Abstract
To develop and validate a novel noncontrast time-resolved magnetic resonance angiography (NC TR-MRA) using consecutive beam pulses with variable flip angles for visualizing hemodynamics in the pulmonary artery, we performed phantom and volunteer studies and applied the novel NC TR-MRA to a 51-year-old woman with pulmonary arteriovenous malformation (PAVM).The novel NC TR-MRA sequence utilized consecutive multiple-beam saturation pulses with variable flip angles considering venous blood T1 relaxation to alter the visualized blood signal length. The flowing blood signal length is suppressed according to the number of beam saturation pulses. NC TR-MRA in each flow phase was assessed by subtracting the images with and without beam saturation pulses. In the flow phantom study, three flow velocities were used to simulate physiological pulmonary arterial blood flow. Signal profiles along the flow direction were evaluated in each flow phase. In the volunteer study, five healthy volunteers were recruited, and NC TR-MRA was applied to evaluate relationships between the flow-saturated time and signal enhancement rates. Four regions of interest (ROIs) were determined on the proximal and distal portions of the right basal artery. A patient with PAVM was included to validate whether a PAVM lesion could be visualized using NC TR-MRA. The visualized flow signal lengths extended proportionally with the number of beam saturation pulses in the steady-flow phantom at all velocities. In the volunteer study, NC TR-MRA images showed signal enhancement from the proximal to distal portions of the right basal artery with increase in the flow-saturated time. Signal enhancement rates in all ROIs were significantly positively correlated with the flow-saturated time (p < 0.001 in all ROIs). Further, the lesion and its hemodynamics could be explicitly visualized in the patient with PAVM. Hence, NC TR-MRA using beam saturation pulse can visualize the hemodynamics of the pulmonary artery and may be useful for diagnosing and following patients with PAVM.
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Affiliation(s)
- Hirohito Kan
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, 1-1-20, Daiko-Minami, Higashi-ku, Nagoya, Aichi 461-8673, Japan; Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-ku, Nagoya, Aichi 467-8601, Japan.
| | - Kyosuke Mizuno
- Department of Radiology, Nagoya City University Hospital, 1 Kawasumi, Mizuho-ku, Nagoya, Aichi 467-8601, Japan.
| | - Masahiro Takizawa
- FUJIFILM Healthcare Corporation, 2-1, Shintoyofuta, Kashiwa, Chiba, 277-0804, Japan..
| | - Masashi Shimohira
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-ku, Nagoya, Aichi 467-8601, Japan.
| | - Tatsuya Kawai
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-ku, Nagoya, Aichi 467-8601, Japan.
| | - Toshitaka Aoki
- Department of Radiology, Nagoya City University Hospital, 1 Kawasumi, Mizuho-ku, Nagoya, Aichi 467-8601, Japan.
| | - Satoshi Tsubokura
- Department of Radiology, Nagoya City University Hospital, 1 Kawasumi, Mizuho-ku, Nagoya, Aichi 467-8601, Japan.
| | - Harumasa Kasai
- Department of Radiology, Nagoya City University Hospital, 1 Kawasumi, Mizuho-ku, Nagoya, Aichi 467-8601, Japan.
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Deux JF, Crowe LA, Genecand L, Hachulla AL, Glessgen CG, Noble S, Beghetti M, Ning J, Giese D, Lador F, Vallée JP. Correlation between Pulmonary Artery Pressure and Vortex Duration Determined by 4D Flow MRI in Main Pulmonary Artery in Patients with Suspicion of Chronic Thromboembolic Pulmonary Hypertension (CTEPH). J Clin Med 2022; 11:jcm11175237. [PMID: 36079178 PMCID: PMC9457422 DOI: 10.3390/jcm11175237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/23/2022] [Accepted: 09/01/2022] [Indexed: 11/16/2022] Open
Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) is one of the causes of pulmonary hypertension (PH) and requires invasive measurement of the mean pulmonary artery pressure (mPAP) during right heart catheterisation (RHC) for the diagnosis. 4D flow MRI could provide non-invasive parameters to estimate the mPAP. Twenty-five patients with suspected CTEPH underwent cardiac MRI. Mean vortex duration (%), pulmonary distensibility, right ventricular volumes and function were measured using 4D flow MRI and cine sequences, and compared with the mPAP measured by RHC. The mPAP measured during RHC was 33 ± 16 mmHg (10−66 mmHg). PH (defined as mPAP > 20 mmHg) was present in 19 of 25 patients (76%). A vortical flow was observed in all but two patients (92%) on 4D flow images, and vortex duration showed good correlation with the mPAP (r = 0.805; p < 0.0001). Youden index analysis showed that a vortex duration of 8.6% of the cardiac cycle provided a 95% sensitivity and an 83% specificity to detect PH. Reliability for the measurement of vortex duration was excellent for both intra-observer ICC = 0.823 and inter-observer ICC = 0.788. Vortex duration could be a useful parameter to non-invasively estimate mPAP in patients with suspected CTEPH.
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Affiliation(s)
- Jean-François Deux
- Division of Radiology, Diagnostic Department Geneva University Hospitals, 1205 Geneva, Switzerland
- Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
- Pulmonary Hypertension Program, Geneva University Hospitals, 1205 Geneva, Switzerland
- Correspondence: ; Tel.: +41-66-145-41-73
| | - Lindsey A. Crowe
- Division of Radiology, Diagnostic Department Geneva University Hospitals, 1205 Geneva, Switzerland
- Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Léon Genecand
- Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
- Pulmonary Hypertension Program, Geneva University Hospitals, 1205 Geneva, Switzerland
- Division of Pulmonary Medicine, Department of Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Anne-Lise Hachulla
- Division of Radiology, Diagnostic Department Geneva University Hospitals, 1205 Geneva, Switzerland
- Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
- Pulmonary Hypertension Program, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Carl G. Glessgen
- Division of Radiology, Diagnostic Department Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Stéphane Noble
- Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
- Pulmonary Hypertension Program, Geneva University Hospitals, 1205 Geneva, Switzerland
- Division of Cardiology, Department of Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Maurice Beghetti
- Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
- Pulmonary Hypertension Program, Geneva University Hospitals, 1205 Geneva, Switzerland
- Paediatric Cardiology Unit, Geneva University Hospitals, 1205 Geneva, Switzerland
- Centre Universitaire Romand de Cardiologie et Chirurgie Cardiaque Pédiatrique, University of Geneva and Lausanne, 1205 Geneva, Switzerland
| | - Jin Ning
- Siemens Medical Solutions USA Inc., Cleveland, OH 44125, USA
| | - Daniel Giese
- Magnetic Resonance, Siemens Healthcare GmbH, 91052 Erlangen, Germany
| | - Frédéric Lador
- Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
- Pulmonary Hypertension Program, Geneva University Hospitals, 1205 Geneva, Switzerland
- Division of Pulmonary Medicine, Department of Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Jean-Paul Vallée
- Division of Radiology, Diagnostic Department Geneva University Hospitals, 1205 Geneva, Switzerland
- Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
- Pulmonary Hypertension Program, Geneva University Hospitals, 1205 Geneva, Switzerland
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Kamada H, Nakamura M, Ota H, Higuchi S, Takase K. Blood flow analysis with computational fluid dynamics and 4D-flow MRI for vascular diseases. J Cardiol 2022; 80:386-396. [PMID: 35718672 DOI: 10.1016/j.jjcc.2022.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 05/16/2022] [Indexed: 10/31/2022]
Abstract
Both computational fluid dynamics (CFD) and time-resolved, three-dimensional, phase-contrast, magnetic resonance imaging (4D-flow MRI) enable visualization of time-varying blood flow structures and quantification of blood flow in vascular diseases. However, they are totally different. CFD is a method to calculate blood flow by solving the governing equations of fluid mechanics, so the obtained flow field is somewhat virtual. On the other hand, 4D-flow MRI measures blood flow in vivo, thus the flow is real. Recently, with the development and enhancement of computers, medical imaging techniques, and related software, blood flow analysis has become more accessible to clinicians and its usefulness in vascular diseases has been demonstrated. In this review, we have outlined the methods and characteristics of CFD and 4D-flow MRI, respectively. We have discussed the differences in the characteristics between both methods; reviewed the milestones achieved by blood flow analysis in various vascular diseases; and discussed the usefulness, challenges, and limitations of blood flow analysis. We have discussed the difficulties and limitations of current blood flow analysis. We have also discussed our views on future directions.
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Affiliation(s)
- Hiroki Kamada
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan.
| | - Masanori Nakamura
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya, Japan
| | - Hideki Ota
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Satoshi Higuchi
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Kei Takase
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
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Ota H, Kamada H, Higuchi S, Takase K. Clinical Application of 4D Flow MR Imaging to Pulmonary Hypertension. Magn Reson Med Sci 2022; 21:309-318. [PMID: 35185084 PMCID: PMC9680544 DOI: 10.2463/mrms.rev.2021-0111] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/19/2021] [Indexed: 10/14/2023] Open
Abstract
Pulmonary hypertension (PH) is characterized by elevated pulmonary arterial pressure (PAP). Although right-heart catheterization is the gold standard method for the diagnosis of PH by definition, various less-invasive imaging tests have been used for screening, detection of underlying diseases-causing PH, and monitoring of diseases. Among them, 4D flow MRI is an emerging and unique imaging test that allows for comprehensive visualization of blood flow in the right heart and proximal pulmonary arteries. The characteristic blood flow pattern observed in patients with PH is vortical flow formation in the main pulmonary artery. Recent studies have proposed the use of these findings to determine not only the presence of PH but also estimate the mean PAP. Other applications of 4D flow MRI for PH include measurement of wall shear stress, helicity, and 3D flow balance in the pulmonary arteries. It is worth noting that 4D flow has also the potential for longitudinal follow-ups. In this review, the clinical definition of PH, summary of conventional imaging tests, characteristics of pulmonary arterial flow as shown by 4D flow MRI, and clinical application of 4D flow MRI in the management of patients with PH will be discussed.
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Affiliation(s)
- Hideki Ota
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Miyagi, Japan
- Department of Advanced MRI Collaboration Research, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Hiroki Kamada
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Satoshi Higuchi
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Kei Takase
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Miyagi, Japan
- Department of Advanced MRI Collaboration Research, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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Abnormal pulmonary flow is associated with impaired right ventricular coupling in patients with COPD. Int J Cardiovasc Imaging 2021; 37:3039-3048. [PMID: 34021434 DOI: 10.1007/s10554-021-02285-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/10/2021] [Indexed: 01/31/2023]
Abstract
Cor Pulmonale or right ventricular (RV) dysfunction due to pulmonary disease is an expected complication of COPD resulting primarily from increased afterload mediated by chronic alveolar hypoxemia and resulting hypoxic pulmonary vasoconstriction. Early detection of elevated RV afterload has been previously demonstrated by visualization of abnormal flow patterns in the proximal pulmonary arteries. Prior analysis of helicity in the pulmonary arteries in pulmonary hypertension patients has demonstrated a strong association between helicity and increased RV afterload. However, these flow hemodynamics have yet to be fully explored in patients with COPD. We hypothesized that patients with COPD will have abnormal pulmonary flow as evaluated by 4D-Flow MRI and associated with RV function and pulmonary arterial stiffness. Patients with COPD (n = 15) (65 years ± 6) and controls (n = 10) (58 years ± 9) underwent 4D-Flow MRI to calculate helicity. The helicity was calculated in the main pulmonary artery (MPA) and along the RV outflow tract (RVOT)-MPA axis. Main pulmonary arterial stiffness was measured using the relative area change (RAC). We found COPD patients had decreased helicity relative to healthy controls in the MPA (19.4 ± 7.8vs 32.8 ± 15.9, P = 0.007) and reduced helicity along the RVOT-MPA axis (33.2 ± 9.0 vs 43.5 ± 8.3, P = 0.010). Our investigation indicates a strong association between helicity along the MPA-RV outflow tract axis and RV function and suggests that 4D-Flow MRI might be a sensitive tool in evaluating RV-pulmonary arterial coupling in COPD.
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Gbinigie H, Coats L, Parikh JD, Hollingsworth KG, Gan L. A 4D flow cardiovascular magnetic resonance study of flow asymmetry and haemodynamic quantity correlations in the pulmonary artery. Physiol Meas 2021; 42:025005. [PMID: 33482652 DOI: 10.1088/1361-6579/abdf3b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE In this paper we elucidate the asymmetric flow pattern and the haemodynamic quantity distributions and correlations in the pulmonary artery (PA) vasculature in healthy adults having structurally normal hearts, to provide reference on the flow characteristics in the PA and the right ventricle. APPROACH Velocity data are acquired non-invasively from 18 healthy volunteers by 4D flow magnetic resonance imaging, resolved to 20 phases with spatial resolution 3 × 3 × 3 mm3. Interpolation is applied to improve the accuracy in quantifying haemodynamic quantities including kinetic energy, rotational energy, helicity and energy dissipation rate. These quantities are volumetrically normalised to remove size dependency, representing densities or local intensity. MAIN RESULTS Flow asymmetry in the PA is quantified in terms of all the flow dynamic quantities and their correlations. The right PA has larger diameter and higher peak stroke velocity than the left PA. It also has the highest rotational energy intensity. Counter-rotating helical streams in the main PA appear to be associated with the unidirectional helical flow noticed in the left and the right PA near the peak systole. SIGNIFICANCE This study provides a fundamental basis of normal flow in the PA. It implies the validity to use these flow pattern-related quantitative measures to aid with the identification of abnormal PA flow non-invasively, specifically for detecting abnormalities in the pulmonary circulation and response to therapy, where haemodynamic flow is commonly characterised by increased vortical and helical formations.
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Affiliation(s)
- Henrike Gbinigie
- Department of Engineering, Durham University, Durham, DH1 3LE, United Kingdom
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14
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Intracardiac and Vascular Hemodynamics with Cardiovascular Magnetic Resonance in Heart Failure. Heart Fail Clin 2021; 17:135-147. [PMID: 33220882 DOI: 10.1016/j.hfc.2020.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In heart failure (HF), the impaired heart loses its ability to competently eject blood during systole or fill with blood during diastole, manifesting in multifaceted abnormal intracardiac or intravascular flow dynamics. Conventional imaging techniques are limited in their ability to evaluate multidirectional multidimensional flow alterations in HF. Four-dimensional (4-D) flow magnetic resonance imaging (MRI) has emerged as a promising technique to comprehensively visualize and quantify changes in 3-dimensional blood flow dynamics in complex cardiovascular diseases. This article reviews emerging applications of 4-D flow MRI hemodynamic markers in HF and etiologies at risk of progressing to HF.
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Horvat D, Zlibut A, Orzan RI, Cionca C, Muresan ID, Mocan T, Revnic R, Agoston-Coldea L. Aging influences pulmonary artery flow and stiffness in healthy individuals: non-invasive assessment using cardiac MRI. Clin Radiol 2020; 76:161.e19-161.e28. [PMID: 33109351 DOI: 10.1016/j.crad.2020.09.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/16/2020] [Indexed: 11/19/2022]
Abstract
AIM To investigate age-related changes of the pulmonary artery (PA) using cardiac magnetic resonance imaging (cMRI) in healthy subjects. MATERIALS AND METHODS A cross-sectional observational study was conducted on apparently healthy subjects who underwent PA velocity-encoded cMRI. cMRI was used to determine PA stiffness parameters such as PA elasticity, relative area change (PA-RAC) and pulse-wave velocity (PA-PWV), and PA flow parameters by subtracting simultaneous forward flow (FF) and backward flow (BF) velocity across the PA cross-section. Data were presented in five age and sex matched groups. RESULTS One hundred and fifty subjects (20-70 years, 75 men) met the enrolment criteria. PA elasticity and PA-RAC significantly decreased with age (p<0.001), while PA-PWV, regurgitant volume (Vreg) and backward flow volume (VBF) increased in the elderly (p<0.001). Linear regression analysis indicated that PA elasticity (r=-0.441, p<0.0001) and PA-RAC (r=-0.484, p<0.0001) were indirectly and negatively associated with advancing age, whereas PAmin (r=0.331, p<0.0001), PA-PWV (r=0.490, p<0.0001), VReg (r=0.335, p<0.0001) and VBF (r=0.349, p<0.0001) were directly associated with age. Multivariate analysis indicated that age was independently associated with Vreg and VBF, and the addition of PAmin and PA-PWV marginally increased its predictive capacity. CONCLUSION Aging significantly increases cMRI-based PA flow and stiffness parameters. These could become relevant markers of subclinical changes of the PA geometry in healthy subjects.
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Affiliation(s)
- D Horvat
- Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - A Zlibut
- Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - R I Orzan
- Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - C Cionca
- Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Department of Radiology, Affidea Hiperdia Diagnostic Imaging Center, Cluj-Napoca, Romania
| | - I D Muresan
- Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - T Mocan
- Department of Physiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - R Revnic
- Department of Family Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - L Agoston-Coldea
- Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Department of Radiology, Affidea Hiperdia Diagnostic Imaging Center, Cluj-Napoca, Romania; 2(nd) Department of Internal Medicine, Emergency County Hospital, Cluj-Napoca, Romania
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16
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Schäfer M, Ivy DD, Abman SH, Stenmark K, Browne LP, Barker AJ, Mitchell MB, Morgan GJ, Wilson N, Shah A, Kollengode M, Naresh N, Fonseca B, DiMaria M, Buckner JK, Hunter KS, Kheyfets V, Fenster BE, Truong U. Differences in pulmonary arterial flow hemodynamics between children and adults with pulmonary arterial hypertension as assessed by 4D-flow CMR studies. Am J Physiol Heart Circ Physiol 2019; 316:H1091-H1104. [PMID: 30822118 PMCID: PMC7327229 DOI: 10.1152/ajpheart.00802.2018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Despite different developmental and pathological processes affecting lung vascular remodeling in both patient populations, differences in 4D MRI findings between children and adults with PAH have not been studied. The purpose of this study was to compare flow hemodynamic state, including flow-mediated shear forces, between pediatric and adult patients with PAH matched by severity of pulmonary vascular resistance index (PVRi). Adults (n = 10) and children (n = 10) with PAH matched by pulmonary vascular resistance index (PVRi) and healthy adult (n = 10) and pediatric (n = 10) subjects underwent comprehensive 4D-flow MRI to assess peak systolic wall shear stress (WSSmax) measured in the main (MPA), right (RPA), and left pulmonary arteries (LPA), viscous energy loss (EL) along the MPA-RPA and MPA-LPA tract, and qualitative analysis of secondary flow hemodynamics. WSSmax was decreased in all pulmonary vessels in children with PAH when compared with the same age group (all P < 0.05). Similarly, WSSmax was decreased in all pulmonary vessels in adult PAH patients when compared with healthy adult subjects (all P < 0.01). Average EL was increased in adult patients with PAH when compared with the same age group along both MPA-RPA (P = 0.020) and MPA-LPA (P = 0.025) tracts. There were no differences in EL indices between adults and pediatric patients. Children and adult patients with PAH have decreased shear hemodynamic forces. However, pathological flow hemodynamic formations appear to be more consistent in adult patients, whereas flow hemodynamic abnormalities appear to be more variable in children with PAH for comparable severity of PVRi. NEW & NOTEWORTHY Both children and adult patients with PAH have decreased shear hemodynamic forces inside the pulmonary arteries associated with the degree of vessel dilation and stiffness. These differences also exist between healthy normotensive children and adults. However, pathological flow hemodynamic formations appear to more uniform in adult patients, whereas in children with PAH flow, hemodynamic abnormalities appear to be more variable. Pathological flow formations appear not to have a major effect on viscous energy loss associated with the flow conduction through proximal pulmonary arteries.
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Affiliation(s)
- Michal Schäfer
- Division of Pediatric Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - D Dunbar Ivy
- Division of Pediatric Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Steven H Abman
- Division of Pulmonology, Breathing Institute, University of Colorado Denver Anschutz Medical Campus , Aurora, Colorado
| | - Kurt Stenmark
- Developmental Lung Biology and Cardiovascular Pulmonary Research Laboratories, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Lorna P Browne
- Department of Radiology, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Alex J Barker
- Department of Radiology, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Max B Mitchell
- Department of Surgery, Pediatric Heart Surgery, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Gareth J Morgan
- Division of Pediatric Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Neil Wilson
- Division of Pediatric Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Anar Shah
- Division of Pediatric Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Madhukar Kollengode
- Division of Pediatric Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Nivedita Naresh
- Department of Radiology, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Brian Fonseca
- Division of Pediatric Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Michael DiMaria
- Division of Pediatric Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - J Kern Buckner
- Division of Cardiology, National Jewish Health , Denver, Colorado
| | - Kendall S Hunter
- Division of Pediatric Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Vitaly Kheyfets
- Department of Bioengineering, University of Colorado Denver , Aurora, Colorado
| | - Brett E Fenster
- Division of Cardiology, National Jewish Health , Denver, Colorado
| | - Uyen Truong
- Division of Pediatric Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
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Manning WJ. Journal of Cardiovascular Magnetic Resonance 2017. J Cardiovasc Magn Reson 2018; 20:89. [PMID: 30593280 PMCID: PMC6309095 DOI: 10.1186/s12968-018-0518-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 12/06/2018] [Indexed: 02/07/2023] Open
Abstract
There were 106 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2017, including 92 original research papers, 3 reviews, 9 technical notes, and 1 Position paper, 1 erratum and 1 correction. The volume was similar to 2016 despite an increase in manuscript submissions to 405 and thus reflects a slight decrease in the acceptance rate to 26.7%. The quality of the submissions continues to be high. The 2017 JCMR Impact Factor (which is published in June 2018) was minimally lower at 5.46 (vs. 5.71 for 2016; as published in June 2017), which is the second highest impact factor ever recorded for JCMR. The 2017 impact factor means that an average, each JCMR paper that were published in 2015 and 2016 was cited 5.46 times in 2017.In accordance with Open-Access publishing of Biomed Central, the JCMR articles are published on-line in continuus fashion and in the chronologic order of acceptance, with no collating of the articles into sections or special thematic issues. For this reason, over the years, the Editors have felt that it is useful to annually summarize the publications into broad areas of interest or theme, so that readers can view areas of interest in a single article in relation to each other and other contemporary JCMR articles. In this publication, the manuscripts are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought within the journal. In addition, I have elected to use this format to convey information regarding the editorial process to the readership.I hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your very best, high quality manuscripts to JCMR for consideration. I thank our very dedicated Associate Editors, Guest Editors, and Reviewers for their efforts to ensure that the review process occurs in a timely and responsible manner and that the JCMR continues to be recognized as the forefront journal of our field. And finally, I thank you for entrusting me with the editorship of the JCMR as I begin my 3rd year as your editor-in-chief. It has been a tremendous learning experience for me and the opportunity to review manuscripts that reflect the best in our field remains a great joy and highlight of my week!
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Affiliation(s)
- Warren J Manning
- Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.
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Wehrum T, Lodemann T, Hagenlocher P, Stuplich J, Ngo BTT, Grundmann S, Hennemuth A, Hennig J, Harloff A. Age-related changes of right atrial morphology and inflow pattern assessed using 4D flow cardiovascular magnetic resonance: results of a population-based study. J Cardiovasc Magn Reson 2018; 20:38. [PMID: 29898733 PMCID: PMC6001162 DOI: 10.1186/s12968-018-0456-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 05/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To assess age-related changes of blood flow and geometry of the caval veins and right atrium (RA) using 4D flow cardiovascular magnetic resonance (CMR) data obtained in a population-based study. METHODS An age-stratified sample (n = 126) of the population of the city of Freiburg, Germany, underwent transthoracic echocardiography and electrocardiogram-triggered and navigator-gated 4D flow CMR at 3 Tesla covering the caval veins and right heart. Study participants were divided into three age groups (1:20-39; 2:40-59; and 3:60-80 years of age). Analysis planes were placed in the superior and inferior caval vein. Subsequently, RA morphology and three-dimensional blood inflow pattern was assessed. RESULTS Blood flow of the RA showed a clockwise rotating helix without signs of turbulence in younger subjects. By contrast, such rotation was absent in 12 subjects of group 3 and turbulences were significantly more frequent (p < 0.001). We observed an age-related shift of the caval vein axis. While the outlets of the superior and inferior caval veins were facing each other in group 1, lateralization occurred in older subjects (p < 0.001). A convergence of axes was observed from lateral view with facing axes in older subjects (p = 0.004). Finally, mean and peak systolic blood flow in the caval veins decreased with age (group 3 < 2 < 1). CONCLUSIONS We have provided reference values of 4D CMR blood flow for different age groups and demonstrated the significant impact of age on hemodynamics of the RA inflow tract. This effect of aging should be taken into account when assessing pathologic conditions of the heart in the future.
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Affiliation(s)
- Thomas Wehrum
- Department of Neurology and Neuroscience, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 64, 79106 Freiburg, Germany
| | - Thomas Lodemann
- Department of Neurology and Neuroscience, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 64, 79106 Freiburg, Germany
| | - Paul Hagenlocher
- Department of Neurology and Neuroscience, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 64, 79106 Freiburg, Germany
| | - Judith Stuplich
- Department of Cardiology, University Heart Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ba Thanh Truc Ngo
- Department of Cardiology, University Heart Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sebastian Grundmann
- Department of Cardiology, University Heart Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anja Hennemuth
- Charité – Universitätsmedizin Berlin, Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Berlin, Germany
| | - Jürgen Hennig
- Department of Diagnostic Radiology – Medical Physics, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Andreas Harloff
- Department of Neurology and Neuroscience, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 64, 79106 Freiburg, Germany
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19
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Ota H, Higuchi S, Sun W, Ueda T, Takase K, Tamura H. Four-Dimensional Flow Magnetic Resonance Imaging for Cardiovascular Imaging: from Basic Concept to Clinical Application. ACTA ACUST UNITED AC 2018. [DOI: 10.22468/cvia.2018.00045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Hideki Ota
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Satoshi Higuchi
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Wenyu Sun
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Takuya Ueda
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Kei Takase
- Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
| | - Hajime Tamura
- Division of Medical Physics, Tohoku University Graduate School of Medicine, Sendai, Japan
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20
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Manning WJ. Review of Journal of Cardiovascular Magnetic Resonance (JCMR) 2015-2016 and transition of the JCMR office to Boston. J Cardiovasc Magn Reson 2017; 19:108. [PMID: 29284487 PMCID: PMC5747150 DOI: 10.1186/s12968-017-0423-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 12/07/2017] [Indexed: 02/06/2023] Open
Abstract
The Journal of Cardiovascular Magnetic Resonance (JCMR) is the official publication of the Society for Cardiovascular Magnetic Resonance (SCMR). In 2016, the JCMR published 93 manuscripts, including 80 research papers, 6 reviews, 5 technical notes, 1 protocol, and 1 case report. The number of manuscripts published was similar to 2015 though with a 12% increase in manuscript submissions to an all-time high of 369. This reflects a decrease in the overall acceptance rate to <25% (excluding solicited reviews). The quality of submissions to JCMR continues to be high. The 2016 JCMR Impact Factor (which is published in June 2016 by Thomson Reuters) was steady at 5.601 (vs. 5.71 for 2015; as published in June 2016), which is the second highest impact factor ever recorded for JCMR. The 2016 impact factor means that the JCMR papers that were published in 2014 and 2015 were on-average cited 5.71 times in 2016.In accordance with Open-Access publishing of Biomed Central, the JCMR articles are published on-line in the order that they are accepted with no collating of the articles into sections or special thematic issues. For this reason, over the years, the Editors have felt that it is useful to annually summarize the publications into broad areas of interest or themes, so that readers can view areas of interest in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes with previously published JCMR papers to guide continuity of thought in the journal. In addition, I have elected to open this publication with information for the readership regarding the transition of the JCMR editorial office to the Beth Israel Deaconess Medical Center, Boston and the editorial process.Though there is an author publication charge (APC) associated with open-access to cover the publisher's expenses, this format provides a much wider distribution/availability of the author's work and greater manuscript citation. For SCMR members, there is a substantial discount in the APC. I hope that you will continue to send your high quality manuscripts to JCMR for consideration. Importantly, I also ask that you consider referencing recent JCMR publications in your submissions to the JCMR and elsewhere as these contribute to our impact factor. I also thank our dedicated Associate Editors, Guest Editors, and reviewers for their many efforts to ensure that the review process occurs in a timely and responsible manner and that the JCMR continues to be recognized as the leading publication in our field.
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Affiliation(s)
- Warren J Manning
- From the Journal of Cardiovascular Magnetic Resonance Editorial Office and the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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21
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Kamphuis VP, Westenberg JJM, van der Palen RLF, Blom NA, de Roos A, van der Geest R, Elbaz MSM, Roest AAW. Unravelling cardiovascular disease using four dimensional flow cardiovascular magnetic resonance. Int J Cardiovasc Imaging 2016; 33:1069-1081. [PMID: 27888419 PMCID: PMC5489572 DOI: 10.1007/s10554-016-1031-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 11/21/2016] [Indexed: 11/29/2022]
Abstract
Knowledge of normal and abnormal flow patterns in the human cardiovascular system increases our understanding of normal physiology and may help unravel the complex pathophysiological mechanisms leading to cardiovascular disease. Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) has emerged as a suitable technique that enables visualization of in vivo blood flow patterns and quantification of parameters that could potentially be of prognostic value in the disease process. In this review, current image processing tools that are used for comprehensive visualization and quantification of blood flow and energy distribution in the heart and great vessels will be discussed. Also, imaging biomarkers extracted from 4D flow CMR will be reviewed that have been shown to distinguish between normal and abnormal flow patterns. Furthermore, current applications of 4D flow CMR in the heart and great vessels will be discussed, showing its potential as an additional diagnostic modality which could aid in disease management and timing of surgical intervention.
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Affiliation(s)
- Vivian P Kamphuis
- Division of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.,Netherlands Heart Institute, Utrecht, The Netherlands
| | - Jos J M Westenberg
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Roel L F van der Palen
- Division of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Nico A Blom
- Division of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Albert de Roos
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Rob van der Geest
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mohammed S M Elbaz
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Arno A W Roest
- Division of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
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