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- Open Access
Non-invasive single slice estimate of aortic distensibility from phase-contrast MRI: application to hypoplastic left heart syndrome
© Biglino et al; licensee BioMed Central Ltd. 2012
- Published: 1 February 2012
- Aortic Arch
- Wave Speed
- Hypoplastic Left Heart Syndrome
- Nonrigid Registration
- Aortic Distensibility
Knowledge of aortic distensibility (D) is important in several congenital scenarios. For instance, palliation of hypoplastic left heart syndrome (HLHS) often involves surgical arch reconstruction with a patch. Patch calcification is likely to impinge on aortic arch D, with a detrimental effect on ventriculo-arterial coupling. D can thus be a useful measure to derive. In order to estimate it, pressure change data from invasive measurements is combined with area (A) change information. Alternatively, distensibility can be derived from wave speed. This study proposes a method for calculation of wave speed from a single phase-contrast MRI measurement and consequently single-point estimate of D, applying the method to a cohort of HLHS patients.
HLHS patients showed significantly higher wave speed (8.4±2.4 vs 4.5±0.9 m/s, p=0.00013) and, in turn, reduced aortic D due to the reconstructed arch (0.0023±0.0015 vs 0.0068±0.0029 1/mmHg, p=0.00075). Concomitantly, the HLHS cohort also had reduced cardiac output (3.3±0.6 vs 4.8±2.0 l/min, p=0.046) and ejection fraction (52.2±6.3 vs 60.1±4.7 %, p=0.005). This clearly suggests a link between the changes in aortic D following surgery and the coupling between the single ventricle and the artery, as the variation in D results in change in vascular impedance.
This work presents a method for local estimation of distensibility based on wave speed derived from one phase-contrast measurement, without the necessity of acquiring multiple slices for foot-to-foot estimate. Application of this method to a HLHS population has shown the detrimental effect of surgical arch reconstruction on distensibility.
Fondation Leducq, Royal Academy of Engineering, EPSRC, UK National Institute of Health Research (NIHR).
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.