Validation of time-resolved, automated peak trans-mitral velocity tracking: Two center four-dimensional flow cardiovascular magnetic resonance study

Njoku, Paul, Grafton-Clarke, Ciaran ORCID:, Assadi, Hosamadin ORCID:, Gosling, Rebecca C., Archer, Gareth T., Swift, Andrew J., Morris, Paul, Albaraikan, Abdulaziz, Williams, Gareth, Westenberg, Jos J. M., Aben, Jean-Paul, Ledoux, Leon, Alabed, Samer, Flather, Marcus, Cameron, Donnie ORCID:, Broncano Cabrero, Jordi, Del Val, Javier Royuela, Nair, Sunil, Ryding, Alisdair, Sawh, Chris, Swoboda, Peter P., Levelt, Eylem, Chowdhary, Amrit, Vassiliou, Vassilios ORCID:, Zhong, Liang and Garg, Pankaj ORCID: (2022) Validation of time-resolved, automated peak trans-mitral velocity tracking: Two center four-dimensional flow cardiovascular magnetic resonance study. International Journal of Cardiology, 364. pp. 148-156. ISSN 1874-1754

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Objective: We aim to validate four-dimensional flow cardiovascular magnetic resonance (4D flow CMR) peak velocity tracking methods for measuring the peak velocity of mitral inflow against Doppler echocardiography.  Method: Fifty patients were recruited who had 4D flow CMR and Doppler Echocardiography. After transvalvular flow segmentation using established valve tracking methods, peak velocity was automatically derived using three-dimensional streamlines of transvalvular flow. In addition, a static planar method was used at the tip of mitral valve to mimic Doppler technique.  Results: Peak E-wave mitral inflow velocity was comparable between TTE and the novel 4D flow automated dynamic method (1.02±0.41 m/s vs 1.02±0.36 m/s; P=0.77) however there was a statistically significant difference when compared with the static planar method (0.93±0.37 m/s; P=0.04). Mean A-wave peak velocity was also comparable across TTE and the automated dynamic streamline (0.87±0.39 m/s vs 0.87±0.36 m/s; P=0.99). A significant difference was seen with the static planar method (0.78±0.36 m/s; P=0.04). E/A ratio was comparable between TTE and both the automated dynamic and static planar method (1.22±0.52 vs 1.20±0.34; p=0.76 and 1.36±0.81; p=0.25 respectively). Both novel 4D flow methods showed good correlation with TTE for E-wave (dynamic method; r=0.70; P<0.001 and static planar method; r=0.67; P<0.001) and A-wave velocity measurements (dynamic method; r=0.83; P<0.001 and static method; r=0.71; P<0.001). The automated dynamic method demonstrated excellent intra/inter-observer reproducibility for all parameters.  Conclusion: Automated dynamic peak velocity tracing method using 4D flow CMR is comparable to Doppler echocardiography for mitral inflow assessment and has excellent reproducibility for clinical use.

Item Type: Article
Additional Information: Funding Information: PG, AJS and EL are funded by Wellcome Trust Clinical Research Career Development Fellowships (220703/Z/20/Z, 205188/Z/16/Z & 221690/Z/20/Z). AC is funded by BHF Clinical Research Training Fellowship (FS/CRTF/20/24003). For the purpose of Open Access, these authors have applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Uncontrolled Keywords: 4d flow cmr,mitral valve,peak velocity quantification,validation,cardiology and cardiovascular medicine ,/dk/atira/pure/subjectarea/asjc/2700/2705
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 20 Jun 2022 11:30
Last Modified: 23 Oct 2022 03:50
DOI: 10.1016/j.ijcard.2022.06.032

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