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Impact of beta-blocker therapy on thoracic aorta 3D wall shear stress in patients with bicuspid aortic valve

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Time-resolved 3D phase contrast (4D flow) MRI allows for the quantification of 3D WSS regionally in the thoracic aorta... The aim of this study was to assess changes in thoracic aorta WSS associated with β-blocker therapy in BAV patients... BAV patients on β-blockers (BB+) (n = 10, M:F = 8:2, age: 53 ± 11 years) or not on β-blockers (BB-) (n = 10, M:F = 9:1, age: 51 ± 15 years) underwent 4D flow MRI as part of this IRB-approved study... WSSsysmaximum intensity projections (MIP) were mapped onto a sagittal view of each aorta for visual comparison... Quantitative results were compared using Student's t-test... Spearman (rS) or Pearson (r) correlation was performed as appropriate... Decreased eccentricity of WSSsys in the AAo was observed in BB+ patients... Our results suggest that the impact of β-blocker therapy on the degree of WSS in the thoracic aorta is limited, but treatment may alter AAo WSS distribution... The high inter-individual variability of 3D WSS highlights the potential diagnostic value of 4D flow MRI WSS quantification for individualized assessment β-blocker effectiveness in BAV aortopathy... A prospective study in a large number of patients pre- and post-treatment is required to better isolate the impact of β-blockers in this population.

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Peak Systolic Wall Shear Stress (WSSsys) maximum intensity projections in the study cohort. Values for WSSsys are in N/m2. Note that there is a large variation across both groups in terms of WSSsys values and where the maximum WSS is located. In general, patients appear to have WSSsys angled toward the lateral wall of the ascending aorta, however, there appears to be fewer patients with this eccentric WSS distribution in the β-blocker group (BB+).
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Figure 1: Peak Systolic Wall Shear Stress (WSSsys) maximum intensity projections in the study cohort. Values for WSSsys are in N/m2. Note that there is a large variation across both groups in terms of WSSsys values and where the maximum WSS is located. In general, patients appear to have WSSsys angled toward the lateral wall of the ascending aorta, however, there appears to be fewer patients with this eccentric WSS distribution in the β-blocker group (BB+).

Mentions: No statistical difference in max or mean WSSsys was observed between BB+ and BB- groups at any region along the aorta, although values were consistently lower in the BB+ group (Table 1). Max WSSsys in the AAo showed no correlation with aortic diameter (r = .289, p = 0.22) but did correlate with the degree of aortic stenosis (rS = 0.44, p = 0.05). WSSsys MIPs for all subjects are shown in Figure 1. The magnitude and regional distribution of WSSsyswas highly variable between individuals for both groups. Decreased eccentricity of WSSsys in the AAo was observed in BB+ patients.


Impact of beta-blocker therapy on thoracic aorta 3D wall shear stress in patients with bicuspid aortic valve
Peak Systolic Wall Shear Stress (WSSsys) maximum intensity projections in the study cohort. Values for WSSsys are in N/m2. Note that there is a large variation across both groups in terms of WSSsys values and where the maximum WSS is located. In general, patients appear to have WSSsys angled toward the lateral wall of the ascending aorta, however, there appears to be fewer patients with this eccentric WSS distribution in the β-blocker group (BB+).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4043193&req=5

Figure 1: Peak Systolic Wall Shear Stress (WSSsys) maximum intensity projections in the study cohort. Values for WSSsys are in N/m2. Note that there is a large variation across both groups in terms of WSSsys values and where the maximum WSS is located. In general, patients appear to have WSSsys angled toward the lateral wall of the ascending aorta, however, there appears to be fewer patients with this eccentric WSS distribution in the β-blocker group (BB+).
Mentions: No statistical difference in max or mean WSSsys was observed between BB+ and BB- groups at any region along the aorta, although values were consistently lower in the BB+ group (Table 1). Max WSSsys in the AAo showed no correlation with aortic diameter (r = .289, p = 0.22) but did correlate with the degree of aortic stenosis (rS = 0.44, p = 0.05). WSSsys MIPs for all subjects are shown in Figure 1. The magnitude and regional distribution of WSSsyswas highly variable between individuals for both groups. Decreased eccentricity of WSSsys in the AAo was observed in BB+ patients.

View Article: PubMed Central - HTML

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Time-resolved 3D phase contrast (4D flow) MRI allows for the quantification of 3D WSS regionally in the thoracic aorta... The aim of this study was to assess changes in thoracic aorta WSS associated with β-blocker therapy in BAV patients... BAV patients on β-blockers (BB+) (n = 10, M:F = 8:2, age: 53 ± 11 years) or not on β-blockers (BB-) (n = 10, M:F = 9:1, age: 51 ± 15 years) underwent 4D flow MRI as part of this IRB-approved study... WSSsysmaximum intensity projections (MIP) were mapped onto a sagittal view of each aorta for visual comparison... Quantitative results were compared using Student's t-test... Spearman (rS) or Pearson (r) correlation was performed as appropriate... Decreased eccentricity of WSSsys in the AAo was observed in BB+ patients... Our results suggest that the impact of β-blocker therapy on the degree of WSS in the thoracic aorta is limited, but treatment may alter AAo WSS distribution... The high inter-individual variability of 3D WSS highlights the potential diagnostic value of 4D flow MRI WSS quantification for individualized assessment β-blocker effectiveness in BAV aortopathy... A prospective study in a large number of patients pre- and post-treatment is required to better isolate the impact of β-blockers in this population.

No MeSH data available.