Right Ventricular Flow Vorticity Relationships With Biventricular Shape in Adult Tetralogy of Fallot.

Autor:	Elsayed A; Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand., Mauger CA; Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand., Ferdian E; Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand., Gilbert K; Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand., Scadeng M; Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand., Occleshaw CJ; Department of Cardiology, Auckland District Health Board, Auckland, New Zealand., Lowe BS; Department of Cardiology, Auckland District Health Board, Auckland, New Zealand., McCulloch AD; Department of Bioengineering, University of California, San Diego, La Jolla, CA, United States., Omens JH; Department of Bioengineering, University of California, San Diego, La Jolla, CA, United States., Govil S; Department of Bioengineering, University of California, San Diego, La Jolla, CA, United States., Pushparajah K; Department of Biomedical Engineering, King's College London, London, United Kingdom., Young AA; Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand.; Department of Biomedical Engineering, King's College London, London, United Kingdom.
Jazyk:	angličtina
Zdroj:	Frontiers in cardiovascular medicine [Front Cardiovasc Med] 2022 Jan 21; Vol. 8, pp. 806107. Date of Electronic Publication: 2022 Jan 21 (Print Publication: 2021).
DOI:	10.3389/fcvm.2021.806107
Abstrakt:	Remodeling in adults with repaired tetralogy of Fallot (rToF) may occur due to chronic pulmonary regurgitation, but may also be related to altered flow patterns, including vortices. We aimed to correlate and quantify relationships between vorticity and ventricular shape derived from atlas-based analysis of biventricular shape. Adult rToF ( n = 12) patients underwent 4D flow and cine MRI imaging. Vorticity in the RV was computed after noise reduction using a neural network. A biventricular shape atlas built from 95 rToF patients was used to derive principal component modes, which were associated with vorticity and pulmonary regurgitant volume (PRV) using univariate and multivariate linear regression. Univariate analysis showed that indexed PRV correlated with 3 modes ( r = -0.55,-0.50, and 0.6, all p < 0.05) associated with RV dilatation and an increase in basal bulging, apical bulging and tricuspid annulus tilting with more severe regurgitation, as well as a smaller LV and paradoxical movement of the septum. RV outflow and inflow vorticity were also correlated with these modes. However, total vorticity over the whole RV was correlated with two different modes ( r = -0.62,-0.69, both p < 0.05). Higher vorticity was associated with both RV and LV shape changes including longer ventricular length, a larger bulge beside the tricuspid valve, and distinct tricuspid tilting. RV flow vorticity was associated with changes in biventricular geometry, distinct from associations with PRV. Flow vorticity may provide additional mechanistic information in rToF remodeling. Both LV and RV shapes are important in rToF RV flow patterns. Competing Interests: This study received working expenses and in-kind support from Siemens Healthineers, Erlangen, Germany. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication. AM and JHO are co-founders of and have an equity interest in Insilicomed, Inc., and serves on the scientific advisory board. Some of their research grants, including those acknowledged here, have been identified for conflict of interest management based on the overall scope of the project and its potential benefit to Insilicomed, Inc. The authors are required to disclose this relationship in publications acknowledging the grant support, however the research subject and findings reported here did not involve the company in any way and have no relationship whatsoever to the business activities or scientific interests of the company. The terms of this arrangement have been reviewed and approved by the University of California San Diego in accordance with its conflict of interest policies. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Elsayed, Mauger, Ferdian, Gilbert, Scadeng, Occleshaw, Lowe, McCulloch, Omens, Govil, Pushparajah and Young.)
Databáze:	MEDLINE
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