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4D-Flow MRI Characterization of Pulmonary Flow in Repaired Tetralogy of Fallot
Open accessAbstract
Patients with Tetralogy of Fallot (TOF) have multiple surgical sequelae altering the pulmonary flow hemodynamics. Repaired TOF (rTOF) adults frequently develop pulmonary regurgitation impacting the blood flow pressure, right ventricle load, and pulmonary hemodynamics. We aimed to evaluate the pulmonary flow hemodynamics using 4D-flow magnetic resonance imaging (MRI) for characterizing altered blood flow, viscous energy loss (EL), wall shear stress (WSS), pressure drop (PD), and ventricular flow analysis (VFA) in rTOF patients. We hypothesized that 4D-flow based parameters can identify pulmonary blood flow alterations. A total of 17 rTOF patients (age: 29 ± 10 years, 35% women) and 20 controls (age: 36 ± 12 years, 25% women) were scanned using a dedicated cardiac MRI protocol. Peak velocity and regurgitant fraction were significantly higher for rTOF patients (p < 0.001). WSS was consistently elevated along the PA in the rTOF (p ≤ 0.05). The rTOF average circumferential WSS was higher than axial WSS at the main pulmonary artery (p ≤ 0.001). PD and EL were consistently higher in the rTOF as compared with controls (p < 0.05). For VFA, delayed ejection increased and retained inflow decreased in rTOF patients (p < 0.001). To conclude, this study demonstrated that 4D-flow MRI pulmonary flow in the rTOF can exhibit altered peak velocity, valvular regurgitation, WSS, EL, PD, and VFA.
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Phase-contrast flow CMR sequence measures blood flow velocities and can assess the severity of any obstructions or abnormalities in blood flow.
“This sequence measures blood flow velocities and can assess the severity of any obstructions or abnormalities in blood flow.”
From Multimodality imaging assessment of tetralogy of Fallot: From diagnosis to long-term follow-up (2023) · cites this paper as [38]
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Metadata
- Authors
- Hudani, A., Ihsan Ali, S., Patton, D., Myers, K. A., Fine, N. M., White, J. A., Greenway, S., & Garcia, J.
- Affiliations
- University of Calgary (CA)
- Department of Biomedical Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada
- Stephenson Cardiac Imaging Centre, University of Calgary, Calgary, AB T2N 1N4, Canada
- Venue
- Applied Sciences
- Publisher
- MDPI AG
- Published
- 2023-02-22
- Volume
- 13
- Issue
- 5
- Pages
- 2810
- ISSN
- 2076-3417 (ISSN-L)
- OpenAlex
- W4321598928
- Cited by
- 9
- References
- 29
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1 · 2023: 4
- FWCI
- 1.79
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Applied Sciences (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- University of Calgary (URGC SEM #1054341, DGECR-2020-00204, RGPIN-2020-04549)
- Natural Science and Engineering Research Council of Canada/Conseil de recherche en science naturelles et en génie du Canada (URGC SEM #1054341, DGECR-2020-00204, RGPIN-2020-04549)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Keywords
- repaired tetralogy of Fallot, pulmonary regurgitation, wall shear stress, viscous energy loss, pressure drop, main pulmonary artery, 4D flow MRI, regurgitant fraction, right ventricular outflow
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