Cargando…

Superiority of a Representative MRI Flow Waveform over Doppler Ultrasound for Aortic Wave Reflection Assessment in Children and Adolescents With/Without a History of Heart Disease

Wave separation analysis (WSA) reveals the impact of forward- and backward-running waves on the arterial pressure pulse, but the calculations require a flow waveform. This study investigated (1) the variability of the ascending aortic flow waveform in children and adolescents with/without a childhoo...

Descripción completa

Detalles Bibliográficos
Autores principales: Mynard, Jonathan P., Kowalski, Remi, Harrington, Hilary A., Kondiboyina, Avinash, Smolich, Joseph J., Cheung, Michael M. H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10632254/
https://www.ncbi.nlm.nih.gov/pubmed/37561232
http://dx.doi.org/10.1007/s10439-023-03339-2
_version_ 1785146123995840512
author Mynard, Jonathan P.
Kowalski, Remi
Harrington, Hilary A.
Kondiboyina, Avinash
Smolich, Joseph J.
Cheung, Michael M. H.
author_facet Mynard, Jonathan P.
Kowalski, Remi
Harrington, Hilary A.
Kondiboyina, Avinash
Smolich, Joseph J.
Cheung, Michael M. H.
author_sort Mynard, Jonathan P.
collection PubMed
description Wave separation analysis (WSA) reveals the impact of forward- and backward-running waves on the arterial pressure pulse, but the calculations require a flow waveform. This study investigated (1) the variability of the ascending aortic flow waveform in children and adolescents with/without a childhood heart disease history (CHD); (2) the accuracy of WSA obtained with a representative flow waveform (RepFlow), compared with the triangulation method and published ultrasound-derived adult representative flow; (3) the impact of limitations in Doppler ultrasound on WSA; and (4) generalizability of results to adults with a history of CHD. Phase contrast MRI was performed in youth without (n = 45, Group 1, 10–19 years) and with CHD (n = 79, Group 2, 7–18 years), and adults with CHD history (n = 29, Group 3, 19–59 years). Segmented aortic cross-sectional area was used as a surrogate for the central pressure waveform in WSA. A subject-specific virtual Doppler ultrasound was performed on MRI data by extracting velocities from a sample volume. Time/amplitude-normalized ascending aortic flow waveforms were highly consistent amongst all groups. WSA with RepFlow therefore yielded errors < 10% in all groups for reflected wave magnitude and return time. Absolute errors were typically 1.5–3 times greater with other methods, including subject-specific (best-case/virtual) Doppler ultrasound, for which velocity profile skewing introduced waveform errors. Our data suggest that RepFlow is the optimal approach for pressure-only WSA in children and adolescents with/without CHD, as well as adults with CHD history, and may even be more accurate than subject-specific Doppler ultrasound in the ascending aorta. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10439-023-03339-2.
format Online
Article
Text
id pubmed-10632254
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Springer International Publishing
record_format MEDLINE/PubMed
spelling pubmed-106322542023-11-14 Superiority of a Representative MRI Flow Waveform over Doppler Ultrasound for Aortic Wave Reflection Assessment in Children and Adolescents With/Without a History of Heart Disease Mynard, Jonathan P. Kowalski, Remi Harrington, Hilary A. Kondiboyina, Avinash Smolich, Joseph J. Cheung, Michael M. H. Ann Biomed Eng Original Article Wave separation analysis (WSA) reveals the impact of forward- and backward-running waves on the arterial pressure pulse, but the calculations require a flow waveform. This study investigated (1) the variability of the ascending aortic flow waveform in children and adolescents with/without a childhood heart disease history (CHD); (2) the accuracy of WSA obtained with a representative flow waveform (RepFlow), compared with the triangulation method and published ultrasound-derived adult representative flow; (3) the impact of limitations in Doppler ultrasound on WSA; and (4) generalizability of results to adults with a history of CHD. Phase contrast MRI was performed in youth without (n = 45, Group 1, 10–19 years) and with CHD (n = 79, Group 2, 7–18 years), and adults with CHD history (n = 29, Group 3, 19–59 years). Segmented aortic cross-sectional area was used as a surrogate for the central pressure waveform in WSA. A subject-specific virtual Doppler ultrasound was performed on MRI data by extracting velocities from a sample volume. Time/amplitude-normalized ascending aortic flow waveforms were highly consistent amongst all groups. WSA with RepFlow therefore yielded errors < 10% in all groups for reflected wave magnitude and return time. Absolute errors were typically 1.5–3 times greater with other methods, including subject-specific (best-case/virtual) Doppler ultrasound, for which velocity profile skewing introduced waveform errors. Our data suggest that RepFlow is the optimal approach for pressure-only WSA in children and adolescents with/without CHD, as well as adults with CHD history, and may even be more accurate than subject-specific Doppler ultrasound in the ascending aorta. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10439-023-03339-2. Springer International Publishing 2023-08-10 2023 /pmc/articles/PMC10632254/ /pubmed/37561232 http://dx.doi.org/10.1007/s10439-023-03339-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Mynard, Jonathan P.
Kowalski, Remi
Harrington, Hilary A.
Kondiboyina, Avinash
Smolich, Joseph J.
Cheung, Michael M. H.
Superiority of a Representative MRI Flow Waveform over Doppler Ultrasound for Aortic Wave Reflection Assessment in Children and Adolescents With/Without a History of Heart Disease
title Superiority of a Representative MRI Flow Waveform over Doppler Ultrasound for Aortic Wave Reflection Assessment in Children and Adolescents With/Without a History of Heart Disease
title_full Superiority of a Representative MRI Flow Waveform over Doppler Ultrasound for Aortic Wave Reflection Assessment in Children and Adolescents With/Without a History of Heart Disease
title_fullStr Superiority of a Representative MRI Flow Waveform over Doppler Ultrasound for Aortic Wave Reflection Assessment in Children and Adolescents With/Without a History of Heart Disease
title_full_unstemmed Superiority of a Representative MRI Flow Waveform over Doppler Ultrasound for Aortic Wave Reflection Assessment in Children and Adolescents With/Without a History of Heart Disease
title_short Superiority of a Representative MRI Flow Waveform over Doppler Ultrasound for Aortic Wave Reflection Assessment in Children and Adolescents With/Without a History of Heart Disease
title_sort superiority of a representative mri flow waveform over doppler ultrasound for aortic wave reflection assessment in children and adolescents with/without a history of heart disease
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10632254/
https://www.ncbi.nlm.nih.gov/pubmed/37561232
http://dx.doi.org/10.1007/s10439-023-03339-2
work_keys_str_mv AT mynardjonathanp superiorityofarepresentativemriflowwaveformoverdopplerultrasoundforaorticwavereflectionassessmentinchildrenandadolescentswithwithoutahistoryofheartdisease
AT kowalskiremi superiorityofarepresentativemriflowwaveformoverdopplerultrasoundforaorticwavereflectionassessmentinchildrenandadolescentswithwithoutahistoryofheartdisease
AT harringtonhilarya superiorityofarepresentativemriflowwaveformoverdopplerultrasoundforaorticwavereflectionassessmentinchildrenandadolescentswithwithoutahistoryofheartdisease
AT kondiboyinaavinash superiorityofarepresentativemriflowwaveformoverdopplerultrasoundforaorticwavereflectionassessmentinchildrenandadolescentswithwithoutahistoryofheartdisease
AT smolichjosephj superiorityofarepresentativemriflowwaveformoverdopplerultrasoundforaorticwavereflectionassessmentinchildrenandadolescentswithwithoutahistoryofheartdisease
AT cheungmichaelmh superiorityofarepresentativemriflowwaveformoverdopplerultrasoundforaorticwavereflectionassessmentinchildrenandadolescentswithwithoutahistoryofheartdisease