Ascending aorta flow derangement is a marker of outflow obstruction in hypertrophic cardiomyopathy
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KeywordsHypertrophic Cardiomyopathy Left Ventricular Outflow Tract Helical Flow Systolic Blood Flow Flow Derangement
Alterations in systolic blood flow are a characteristic finding in patients with obstructive hypertrophic cardiomyopathy (HCM). Echocardiography is the gold standard for hemodynamic assessment in HCM, but this technique is generally limited to measurement of the left ventricular outflow tract (LVOT) pressure gradient and may not provide a complete description of the hemodynamic impact of the disease. In this study, we sought to employ time-resolved, three-dimensional phase contrast (4D flow) MRI to visualize and quantify 3D blood flow patterns in the LVOT and ascending aorta (AAo) in patients with obstructive and non-obstructive HCM.
Our results demonstrate that AAo flow derangement assessed using 4D flow MRI is more severe in obstructive HCM than non-obstructive HCM, and is strongly correlated with LVOT pressure gradient. This finding suggests that flow derangement is a unique marker of disease severity in this population. Further studies are required to evaluate how helical flow correlates with patient symptoms and outcomes in HCM.
NIH NCI 5R25CA132822-04, NIH NHLBI R01HL115828; AHA13SDG14360004.
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