Aortic Disturbed Flow Is Associated with Aortic Angle in Patients with Tetralogy of Fallot or Double-Outlet Right Ventricle.

IF 3.2
Hideharu Oka, Kouichi Nakau, Rina Imanishi, Kazunori Fukao, Sadahiro Nakagawa, Tatsuya Suzuki, Satoru Takahashi
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Abstract

Purpose: Aortopathy, characterized by aortic dilatation caused by cystic medial necrosis, typically develops in adulthood but has been observed at a young age in patients with tetralogy of Fallot. We hypothesized that some patients with tetralogy of Fallot or double-outlet right ventricle experience early-onset aortic disturbed flow. This study aimed to identify and analyze the causes of disturbed flow using 4D flow MRI.

Methods: This study included 24 patients who underwent 4D flow MRI at our institution between January 2022 and September 2024. MRI and cardiac catheterization were performed during follow-up. 4D flow MRI was used to detect disturbed flow and investigate its underlying causes.

Results: The mean age of patients with tetralogy of Fallot or double-outlet right ventricle was 12 years (range, 1 to 37 years). Of the 24 participants, 11 (46%) exhibited disturbed flow. Patients with disturbed flow had significantly higher Valsalva Z-scores (4.7 ± 3.1 vs. 2.4 ± 1.4, P = 0.013) and a significantly narrower left ventricular outflow tract-ascending aorta angle (113.5 ± 11.6 vs. 127.1 ±  6.7°, P = 0.002). Wall shear stress and energy loss were not significantly different between the 2 groups.

Conclusion: Aortic disturbed flow may occur in patients with tetralogy of Fallot or double-outlet right ventricle, regardless of age, suggesting an association with the left ventricular outflow tract-ascending aorta angle. The occurrence of disturbed flow at a young age should be noted as it may contribute to the future progression of aortopathy.

法洛四联症或双出口右心室患者主动脉血流紊乱与主动脉角的关系
目的:主动脉病变,其特征是由囊性内侧坏死引起的主动脉扩张,通常发生在成年期,但在法洛四联症患者中也有观察到。我们假设一些法洛四联症或双出口右心室患者经历早发性主动脉血流紊乱。本研究旨在利用四维流动MRI识别和分析扰动流动的原因。方法:本研究包括24例于2022年1月至2024年9月在我院接受4D血流MRI检查的患者。随访期间行MRI及心导管检查。四维流动MRI检测血流紊乱,探讨其根本原因。结果:法洛四联症或双出口右心室患者的平均年龄为12岁(范围1 ~ 37岁)。在24名参与者中,11人(46%)表现出心流紊乱。血流紊乱患者的Valsalva z -score(4.7±3.1比2.4±1.4,P = 0.013)显著升高,左室流出道-升主动脉角显著变窄(113.5±11.6比127.1±6.7°,P = 0.002)。两组间壁面剪应力和能量损失无显著差异。结论:法洛四联症或双出口右心室患者均可能出现主动脉血流紊乱,与年龄无关,提示与左室流出道-升主动脉角度有关。在年轻时发生血流紊乱应予以注意,因为它可能有助于未来主动脉病变的进展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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