Characterization of Abnormal Wall Shear Stress Using 4D Flow MRI in Human Bicuspid Aortopathy

Pim van Ooij*, Wouter V. Potters, Jeremy D Collins, Maria Carr, James Carr, S Chris Malaisrie, Paul W.M. Fedak, Patrick M McCarthy, Michael Markl, Alex J Barker

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

49 Scopus citations

Abstract

There exists considerable controversy surrounding the timing and extent of aortic resection for patients with BAV disease. Since abnormal wall shear stress (WSS) is potentially associated with tissue remodeling in BAV-related aortopathy, we propose a methodology that creates patient-specific ‘heat maps’ of abnormal WSS, based on 4D flow MRI. The heat maps were created by detecting outlier measurements from a volumetric 3D map of ensemble-averaged WSS in healthy controls. 4D flow MRI was performed in 13 BAV patients, referred for aortic resection and 10 age-matched controls. Systolic WSS was calculated from this data, and an ensemble-average and standard deviation (SD) WSS map of the controls was created. Regions of the individual WSS maps of the BAV patients that showed a higher WSS than the mean + 1.96SD of the ensemble-average control WSS map were highlighted. Elevated WSS was found on the greater ascending aorta (35% ± 15 of the surface area), which correlated significantly with peak systolic velocity (R2 = 0.5, p = 0.01) and showed good agreement with the resected aortic regions. This novel approach to characterize regional aortic WSS may allow clinicians to gain unique insights regarding the heterogeneous expression of aortopathy and may be leveraged to guide patient-specific resection strategies for aorta repair.

Original languageEnglish (US)
Pages (from-to)1385-1397
Number of pages13
JournalAnnals of Biomedical Engineering
Volume43
Issue number6
DOIs
StatePublished - Jun 11 2015

Keywords

  • Aortopathy
  • Bicuspid aortic valve
  • Oscillatory shear index
  • Patient-specific heat map
  • Wall shear stress

ASJC Scopus subject areas

  • Biomedical Engineering

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