Validation of aortic valve pressure gradient quantification using semi-automated 4D flow CMR pipeline

Grafton-Clarke, Ciaran ORCID:, Njoku, Paul, Aben, Jean-Paul, Ledoux, Leon, Zhong, Liang, Westenberg, Jos, Swift, Andrew, Archer, Gareth, Wild, James, Hose, Rod, Flather, Marcus, Vassiliou, Vassilios S. ORCID: and Garg, Pankaj ORCID: (2022) Validation of aortic valve pressure gradient quantification using semi-automated 4D flow CMR pipeline. BMC Research Notes, 15. ISSN 1756-0500

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Objective: Doppler echocardiographic aortic valve peak velocity and peak pressure gradient assessment across the aortic valve (AV) is the mainstay for diagnosing aortic stenosis. Four-dimensional flow cardiovascular magnetic resonance (4D flow CMR) is emerging as a valuable diagnostic tool for estimating the peak pressure drop across the aortic valve, but assessment remains cumbersome. We aimed to validate a novel semi-automated pipeline 4D flow CMR method of assessing peak aortic value pressure gradient (AVPG) using the commercially available software solution, CAAS MR Solutions, against invasive angiographic methods. Results: We enrolled 11 patients with severe AS on echocardiography from the EurValve programme. All patients had pre-intervention doppler echocardiography, invasive cardiac catheterisation with peak pressure drop assessment across the AV and 4D flow CMR. The peak AVPG was 51.9 ± 35.2 mmHg using the invasive pressure drop method and 52.2 ± 29.2 mmHg for the 4D flow CMR method (semi-automated pipeline), with good correlation between the two methods (r = 0.70, p = 0.017). Assessment of AVPG by 4D flow CMR using the novel semi-automated pipeline method shows excellent agreement to invasive assessment when compared to doppler-based methods and advocate for its use as complementary to echocardiography.

Item Type: Article
Additional Information: Funding Information: This work was partly funded by Wellcome Trust grants (220703/Z/20/Z and 215799/Z/19/Z). For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.
Uncontrolled Keywords: aortic stenosis,cardiac mri,validation,biochemistry, genetics and molecular biology(all) ,/dk/atira/pure/subjectarea/asjc/1300
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: 19 May 2023 09:39
DOI: 10.1186/s13104-022-06033-z

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