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4D-flow MRI derived wall shear stress for the risk stratification of bicuspid aortic valve aortopathy: A systematic review

PURPOSE: Current intervention guidelines for bicuspid aortic valve (BAV) associated ascending aorta (AAo) dilatation are suboptimal predictors of clinical outcome. There is growing interest in identifying better biomarkers such as wall shear stress (WSS) to help risk stratify BAV aortopathy. The aim...

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Autores principales: Qin, Jiaxing Jason, Obeidy, Peyman, Gok, Mustafa, Gholipour, Alireza, Grieve, Stuart M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9869052/
https://www.ncbi.nlm.nih.gov/pubmed/36698944
http://dx.doi.org/10.3389/fcvm.2022.1075833
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author Qin, Jiaxing Jason
Obeidy, Peyman
Gok, Mustafa
Gholipour, Alireza
Grieve, Stuart M.
author_facet Qin, Jiaxing Jason
Obeidy, Peyman
Gok, Mustafa
Gholipour, Alireza
Grieve, Stuart M.
author_sort Qin, Jiaxing Jason
collection PubMed
description PURPOSE: Current intervention guidelines for bicuspid aortic valve (BAV) associated ascending aorta (AAo) dilatation are suboptimal predictors of clinical outcome. There is growing interest in identifying better biomarkers such as wall shear stress (WSS) to help risk stratify BAV aortopathy. The aim of the systematic review is to synthesize existing evidence of the relationship between WSS and aortopathy in the BAV population. METHODS: A comprehensive literature search of available major databases was performed in May 2022 to include studies that used four-dimensional flow cardiac magnetic resonance (4D-flow) MRI to quantify WSS in the AAo in adult BAV populations. Summary results and statistical analysis were provided for key numerical results. A narrative summary was provided to assess similarities between studies. RESULTS: A total of 26 studies that satisfied selection criteria and quality assessment were included in the review. The presence of BAV resulted in significantly elevated WSS magnitude and circumferential WSS, but not axial WSS. The presence of aortic stenosis had additional impact on WSS and flow alterations. BAV phenotypes were associated with different WSS distributions and flow profiles. Altered protein expression in the AAo wall associated with WSS supported the contribution of altered hemodynamics to aortopathy in addition to genetic factors. CONCLUSION: WSS has the potential to be a valid biomarker for BAV aortopathy. Future work would benefit from larger study cohorts with longitudinal evaluations to further characterize WSS association with aortopathy, mortality, and morbidities. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022337077, identifier CRD42022337077.
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spelling pubmed-98690522023-01-24 4D-flow MRI derived wall shear stress for the risk stratification of bicuspid aortic valve aortopathy: A systematic review Qin, Jiaxing Jason Obeidy, Peyman Gok, Mustafa Gholipour, Alireza Grieve, Stuart M. Front Cardiovasc Med Cardiovascular Medicine PURPOSE: Current intervention guidelines for bicuspid aortic valve (BAV) associated ascending aorta (AAo) dilatation are suboptimal predictors of clinical outcome. There is growing interest in identifying better biomarkers such as wall shear stress (WSS) to help risk stratify BAV aortopathy. The aim of the systematic review is to synthesize existing evidence of the relationship between WSS and aortopathy in the BAV population. METHODS: A comprehensive literature search of available major databases was performed in May 2022 to include studies that used four-dimensional flow cardiac magnetic resonance (4D-flow) MRI to quantify WSS in the AAo in adult BAV populations. Summary results and statistical analysis were provided for key numerical results. A narrative summary was provided to assess similarities between studies. RESULTS: A total of 26 studies that satisfied selection criteria and quality assessment were included in the review. The presence of BAV resulted in significantly elevated WSS magnitude and circumferential WSS, but not axial WSS. The presence of aortic stenosis had additional impact on WSS and flow alterations. BAV phenotypes were associated with different WSS distributions and flow profiles. Altered protein expression in the AAo wall associated with WSS supported the contribution of altered hemodynamics to aortopathy in addition to genetic factors. CONCLUSION: WSS has the potential to be a valid biomarker for BAV aortopathy. Future work would benefit from larger study cohorts with longitudinal evaluations to further characterize WSS association with aortopathy, mortality, and morbidities. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022337077, identifier CRD42022337077. Frontiers Media S.A. 2023-01-09 /pmc/articles/PMC9869052/ /pubmed/36698944 http://dx.doi.org/10.3389/fcvm.2022.1075833 Text en Copyright © 2023 Qin, Obeidy, Gok, Gholipour and Grieve. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Qin, Jiaxing Jason
Obeidy, Peyman
Gok, Mustafa
Gholipour, Alireza
Grieve, Stuart M.
4D-flow MRI derived wall shear stress for the risk stratification of bicuspid aortic valve aortopathy: A systematic review
title 4D-flow MRI derived wall shear stress for the risk stratification of bicuspid aortic valve aortopathy: A systematic review
title_full 4D-flow MRI derived wall shear stress for the risk stratification of bicuspid aortic valve aortopathy: A systematic review
title_fullStr 4D-flow MRI derived wall shear stress for the risk stratification of bicuspid aortic valve aortopathy: A systematic review
title_full_unstemmed 4D-flow MRI derived wall shear stress for the risk stratification of bicuspid aortic valve aortopathy: A systematic review
title_short 4D-flow MRI derived wall shear stress for the risk stratification of bicuspid aortic valve aortopathy: A systematic review
title_sort 4d-flow mri derived wall shear stress for the risk stratification of bicuspid aortic valve aortopathy: a systematic review
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9869052/
https://www.ncbi.nlm.nih.gov/pubmed/36698944
http://dx.doi.org/10.3389/fcvm.2022.1075833
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