Strain evaluation in patients with bicuspid aortic valve insufficiency: can the direction of the regurgitation jet influence diastolic function?

Congress:

ESCR 2019

Poster Number:

P-0065

Type:

Poster Abstract

Keywords:

Congenital, Imaging sequences, Computer Applications-Detection, diagnosis, Computer Applications-3D, MR-Functional imaging, MR-Angiography, MR, Cardiovascular system, Cardiac, Arteries / Aorta

Authors:

G. Cundari¹, N. Galea², G. Pambianchi¹, L. Marchitelli¹, I. Carbone², C. Catalano², M. Francone²; ¹Roma/IT, ²Rome/IT

DOI:

DOI-Link:

https://dx.doi.org/

Purpose

Bicuspid aortic valve (BAV) is one of the most frequent congenital cardiac malformation (prevalence 1-2%). Many vascular and cardiac complications can affect patients with BAV, such as valvular insufficiency. We analysed patients with insufficient BAV using Cardiac Magnetic Resonance (CMR), in order to examine the regurgitation jet direction and determine if the jet impact on the anterior mitral leaflet can worsen the ventricular diastolic function.

Methods and Materials

We retrospectively enrolleda group of 24 patients with BAV and aortic valve insufficiency, undergone to cine cardiac magnetic resonance study on a 3T scanner. The CMR protocol included long axis and short axis breath-hold cine-Steady State Free Precession sequences (Fig 1, 2, 3, 4).Jet regurgitation was visually assessed on three chamber cineMR images. Final study population was composed of 12 patients withjet regurgitation directed towards the mitral valve leaflet (group A) and other 12 patientswiththe jet presenting direction non-impactingon valve leaflet (group B). We analysed...

Results

We found a reduction in mean circumferential peak diastolic velocity (125.85 deg/s ± 40% in group B vs. 50.15 deg/s ± 12% in group A, p-value < 0.05), in mean longitudinal peak diastolic velocity (56.01 mm/s ± 30% in group B vs. 34.39 mm/s ± 4% in group A, p-value

Conclusion

Regurgitation jet direction can influence MV opening during diastole, causing a slowdown in peak diastolic velocity (circumferential, longitudinal and radial) and in strain rate (circumferential and longitudinal).

Personal Information

Correspondence to: Nicola Galea, MD PhD Assistant Professor in Radiology (RTD) Department of Experimental Medicine "Sapienza" University of Rome Viale del Policlinico 155 - 00161 Rome, Italy e-mail: [email protected]; [email protected]