Streamline-based three-dimensional peak-velocity tracing of transvalvular flow using four-dimensional flow cardiac magnetic resonance imaging for left ventricular diastolic assessment in aortic regurgitation: A case report

Njoku, Paul, Wardley, James and Garg, Pankaj ORCID: https://orcid.org/0000-0002-5483-169X (2022) Streamline-based three-dimensional peak-velocity tracing of transvalvular flow using four-dimensional flow cardiac magnetic resonance imaging for left ventricular diastolic assessment in aortic regurgitation: A case report. Journal of Medical Case Reports, 16. ISSN 1752-1947

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Abstract

Background: Doppler transthoracic echocardiography is routinely performed to measure peak mitral inflow velocities in the assessment of left ventricular diastolic function. The limitations of echocardiography are well documented, but its accuracy in the measurement of transmitral peak velocity in the presence of aortic valve regurgitation has not yet been compared with four-dimensional flow cardiac magnetic resonance imaging. Four-dimensional flow cardiac magnetic resonance imaging offers time-resolved cross-sectional velocity information that can be used to investigate mitral inflow peak velocity. We present a case report demonstrating the potential superior capabilities of four-dimensional flow cardiac magnetic resonance imaging in accurately detecting mitral inflow velocities over Doppler echocardiography in patients with aortic regurgitation. Case presentation: A 67-year-old Caucasian female presented to our outpatient cardiology clinic with exertional dyspnea. Doppler transthoracic echocardiography identified moderate to severe aortic regurgitation. Mapping of mitral inflow peak velocities proved challenging with Doppler echocardiography. Additionally, four-dimensional flow cardiac magnetic resonance imaging with automated three-dimensional flow streamlines was performed, which allowed for more accurate detection of mitral inflow peak velocities. Conclusions: Doppler echocardiography has a limited role in mitral inflow assessment where aortic regurgitation is present. In such cases, four-dimensional flow cardiac magnetic resonance imaging is an alternative imaging technique that may circumvent this issue and allow mitral inflow assessment.

Item Type: Article
Additional Information: Funding Information: This work was partly funded by Wellcome Trust grants (220703/Z/20/Z). For the purpose of open access, the author has applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission.
Uncontrolled Keywords: 4d flow cmr,aortic regurgitation,aortic valve insufficiency,diastolic function,echocardiography,hemodynamics,magnetic resonance imaging,mitral inflow,medicine(all) ,/dk/atira/pure/subjectarea/asjc/2700
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 07 Sep 2022 14:30
Last Modified: 20 Oct 2022 18:30
URI: https://ueaeprints.uea.ac.uk/id/eprint/87846
DOI: 10.1186/s13256-022-03422-7

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