Assessment of left ventricular flow in hypertrophic cardiomypathy by 4D-flow MRI

Congress:

ESCR 2019

Poster Number:

P-0031

Type:

Poster Abstract

Keywords:

Tissue characterisation, Pathology, Hyperplasia / Hypertrophy, Surgery, Physiological studies, Physics, MR-Functional imaging, MR-Angiography, MR, Vascular, MR physics, Cardiac

Authors:

O. Y. Dariy, E. Glazkova, S. Aleksandrova, V. Makarenko; moscow/RU

DOI:

DOI-Link:

https://dx.doi.org/

Fig. 1: phase contrast MRI

Fig. 2: patient with diffuse septal HCM

Fig. 3: 4D flow visualization in patient with obstructive HCM

Fig. 4: 4D flow visualization in patient with obstructive HCM

Purpose

Hypertrophic cardiomyopathy (HCM) is a genetic cardio- vascular disease, defined by an increase in the left ven- tricular wall thickness (end-diastolic left ventricular wall thickness ≥ 15 mm or the equivalent relative to the body surface area in children) that is not solely explained by abnormal loading conditions. A commonly diagnosed disease subtype is obstructive HCM that is associated with thickening of the interventricular septum and dynamic LV outflow tract (LVOT) obstruction, resulting in increased pressure gradients in the LVOT The purpose of our study...

Methods and Materials

We studied 11 patients with cardiac magnetic resonance imaging (CMR) for HCM assessment at Bakulev Scientific Center for Cardiovascular Surgery. Included patients were classified as having obstructive HCM if their echocardiographic- assessed peak resting LVOT pressure gradient was >30 mmHg. All measurements were performed on 1.5-T MR systems (Avanto, Siemens, Germany). The 3 (28%) patients were with HCM apical phenotype; 4 (36%) with diffuse-septal (Fig.2) and 4 (36%) with focal-basal phenotype. We also performed 4 cardiac (CMR) of healthy controls (43±12 years). All patients underwent...

Results

Of the 11 HCM patients, all patients had outflow obstruction (Table 1). Data Obstructive (n=8, 6males and 2 females) Non-obstructive HCM (n=3, 2 males and 1 female) control group (n=4) age,years 48±13 40±11 43±12 septal thickness,mm 20±0,65 17±0,69 10±0,1 SAM positive (n) 8 0 0 LVOT, mm 19.8±2.84 22±3.1 22.6±3.5 Data were obtained on the geometry and dynamics of vortex diastolic flows in the LV of all group patients. HCM demonstrated significantly increase in the distance to the center of the vortex and decrease in...

Conclusion

Phase-contrast MRI allows identifying and assessing the general trends in the LV vortical flow in HCM. Quantitative analysis of hemodynamic data can be used to characterize the LV blood flow remodeling of various HCM phenotypes.

Personal Information

References

1.Pasipoularides A.Heart's vortex: intracardiac blood flow phenomena. Shelton: People's Medical Publishing House; 2010; 960. 2.Sforza D., Putman Ch., Cebral J. Hemodynamics of Cerebral Aneurism. Annu Rev Fluid Mech. 2009; 1:41; 91-107 DOI:10.1146/annurev.fluid.40.111406.102126 3.Gorodkov A.Yu. Quantitative analysis of the structural organization of the pulsating blood flow in the left stomach of the heart and aorta. Author. diss.doc biol. sciences. M. 2004; 5. 4.Belenkov, Yu.N., Privalova, E.V., Kaplunova, V.Yu. Hypertrophic cardiomyopathy. M .: GEOTAR-Media. 2011; 392. 5.Dabiri J., Gharib M. The role of optimal vortex formation in...