Age-associated changes in 4D flow CMR derived tricuspid valvular flow and right ventricular blood flow kinetic energy

Barker, Natasha, Zafar, Hamza, Fidock, Benjamin, Elhawaz, Alaa, Al-Mohammad, Abdallah, Rothman, Alexander, Kiely, David G., Van Der Geest, R. J., Westenberg, Jos, Swift, Andrew J., Wild, James M., Plein, Sven and Garg, Pankaj ORCID: (2020) Age-associated changes in 4D flow CMR derived tricuspid valvular flow and right ventricular blood flow kinetic energy. Scientific Reports, 10 (1). ISSN 2045-2322

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Assessment of right ventricular (RV) diastolic function is not routinely carried out. This is due to standard two-dimensional imaging techniques being unreliable. Four-dimensional flow (4D flow) derived right ventricular blood flow kinetic energy assessment could circumvent the issues of the current imaging modalities. It also remains unknown whether there is an association between right ventricular blood flow kinetic energy (KE) and healthy ageing. We hypothesise that healthy ageing requires maintaining normal RV intra-cavity blood flow as quantified using KE method. The main objective of this study was to investigate the effect of healthy ageing on tricuspid through-plane flow and right ventricular blood flow kinetic energy. In this study, fifty-three healthy participants received a 4D flow cardiovascular magnetic resonance (CMR) scan on 1.5 T Philips Ingenia. Cine segmentation and 4D flow analysis were performed using dedicated software. Standard statistical methods were carried out to investigate the associations. Both RV E-wave KEiEDV (r = −0.3, P = 0.04) and A-wave KEiEDV (r = 0.42, P < 0.01) showed an association with healthy ageing. Additionally, the right ventricular blood flow KEiEDV E/A ratio demonstrated the strongest association with healthy ageing (r = −0.53, P < 0.01) when compared to all RV functional and haemodynamic parameters. Furthermore, in a multivariate regression model, KEiEDV E/A ratio and 4D flow derived tricuspid valve stroke volume demonstrated independent association to healthy ageing (beta −0.02 and 0.68 respectively, P < 0.01). Ageing is independently associated with 4D flow derived tricuspid stroke volume and RV blood flow KE E/A ratio. These novel 4D flow CMR derived imaging markers have future potential for RV diastolic assessment.

Item Type: Article
Additional Information: Acknowledgements: We thank Gavin Bainbridge, Caroline Richmond, Margaret Saysell and Petra Bijsterveld for their assistance in recruiting and collecting data for this study. AR was supported by Clinical Research Career Development Fellowships from the Wellcome Trust (206632/Z/17/Z). AS was supported by the Wellcome Trust (205188/Z/16/Z). PG was supported by the Academy of Sciences Starter Grant (SGL018\1100). SP is supported by the British Heart Foundation [CH/16/2/32089].
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 17 Nov 2021 04:51
Last Modified: 23 Oct 2022 03:18
DOI: 10.1038/s41598-020-66958-y

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