Kat-ARC accelerated 4D flow CMR: clinical validation for transvalvular flow and peak velocity assessment

Assadi, Hosamadin ORCID: https://orcid.org/0000-0002-6143-8095, Uthayachandran, Bhalraam, Li, Rui, Wardley, James, Nyi, Tha H., Grafton-Clarke, Ciaran ORCID: https://orcid.org/0000-0002-8537-0806, Swift, Andrew J., Solana, Ana Beatriz, Aben, Jean-Paul, Thampi, Kurian, Hewson, David, Sawh, Chris, Greenwood, Richard, Hughes, Marina, Kasmai, Bahman, Zhong, Liang, Flather, Marcus, Vassiliou, Vassilios ORCID: https://orcid.org/0000-0002-4005-7752 and Garg, Pankaj ORCID: https://orcid.org/0000-0002-5483-169X (2022) Kat-ARC accelerated 4D flow CMR: clinical validation for transvalvular flow and peak velocity assessment. European Radiology, 6. ISSN 0938-7994

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Abstract

Background: To validate the k-adaptive-t autocalibrating reconstruction for Cartesian sampling (kat-ARC), an exclusive sparse reconstruction technique for four-dimensional (4D) flow cardiac magnetic resonance (CMR) using conservation of mass principle applied to transvalvular flow.   Methods: This observational retrospective study (2020/21-075) was approved by the local ethics committee at the University of East Anglia. Consent was waived. Thirty-five patients who had a clinical CMR scan were included. CMR protocol included cine and 4D flow using Kat-ARC acceleration factor 6. No respiratory navigation was applied. For validation, the agreement between mitral net flow (MNF) and the aortic net flow (ANF) was investigated. Additionally, we checked the agreement between peak aortic valve velocity derived by 4D flow and that derived by continuous-wave Doppler echocardiography in 20 patients.   Results: The median age of our patient population was 63 years (interquartile range [IQR] 54–73), and 18/35 (51%) were male. Seventeen (49%) patients had mitral regurgitation, and seven (20%) patients had aortic regurgitation. Mean acquisition time was 8 ± 4 min. MNF and ANF were comparable: 60 mL (51−78) versus 63 mL (57−77), p = 0.310). There was an association between MNF and ANF (rho = 0.58, p < 0.001). Peak aortic valve velocity by Doppler and 4D flow were comparable (1.40 m/s, [1.30−1.75] versus 1.46 m/s [1.25−2.11], p = 0.602) and also correlated with each other (rho = 0.77, p < 0.001).   Conclusions: Kat-ARC accelerated 4D flow CMR quantified transvalvular flow in accordance with the conservation of mass principle and is primed for clinical translation.

Item Type: Article
Additional Information: Funding Information: PG and AJS are funded by Wellcome Trust Clinical Research Career Development Fellowships (220703/Z/20/Z & 205188/Z/16/Z). LZ is funded by the National Medical Research Council of Singapore (Grant Nos. NMRC/OFIRG/0018/2016, MOH-000351). For the purpose of Open Access, these authors have applied a CC BY public copyright licence 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: aortic valve,blood flow velocity,echocardiography (doppler),,magnetic resonance imaging,mitral valve,echocardiography (doppler),aortic valve,radiology nuclear medicine and imaging ,/dk/atira/pure/subjectarea/asjc/2700/2741
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023)
Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit
Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health
Faculty of Science > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
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Depositing User: LivePure Connector
Date Deposited: 22 Sep 2022 09:30
Last Modified: 19 Oct 2023 03:24
URI: https://ueaeprints.uea.ac.uk/id/eprint/88582
DOI: 10.1186/s41747-022-00299-5

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