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首页> 外文期刊>JACC. Cardiovascular imaging. >Magnetic resonance measurement of turbulent kinetic energy for the estimation of irreversible pressure loss in aortic stenosis
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Magnetic resonance measurement of turbulent kinetic energy for the estimation of irreversible pressure loss in aortic stenosis

机译：磁共振测量湍动能以估计主动脉瓣狭窄的不可逆压力损失

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Objectives: The authors sought to measure the turbulent kinetic energy (TKE) in the ascending aorta of patients with aortic stenosis and to assess its relationship to irreversible pressure loss. Background: Irreversible pressure loss caused by energy dissipation in post-stenotic flow is an important determinant of the hemodynamic significance of aortic stenosis. The simplified Bernoulli equation used to estimate pressure gradients often misclassifies the ventricular overload caused by aortic stenosis. The current gold standard for estimation of irreversible pressure loss is catheterization, but this method is rarely used due to its invasiveness. Post-stenotic pressure loss is largely caused by dissipation of turbulent kinetic energy into heat. Recent developments in magnetic resonance flow imaging permit noninvasive estimation of TKE. Methods: The study was approved by the local ethics review board and all subjects gave written informed consent. Three-dimensional cine magnetic resonance flow imaging was used to measure TKE in 18 subjects (4 normal volunteers, 14 patients with aortic stenosis with and without dilation). For each subject, the peak total TKE in the ascending aorta was compared with a pressure loss index. The pressure loss index was based on a previously validated theory relating pressure loss to measures obtainable by echocardiography. Results: The total TKE did not appear to be related to global flow patterns visualized based on magnetic resonance-measured velocity fields. The TKE was significantly higher in patients with aortic stenosis than in normal volunteers (p 0.001). The peak total TKE in the ascending aorta was strongly correlated to index pressure loss (R2 = 0.91). Conclusions: Peak total TKE in the ascending aorta correlated strongly with irreversible pressure loss estimated by a well-established method. Direct measurement of TKE by magnetic resonance flow imaging may, with further validation, be used to estimate irreversible pressure loss in aortic stenosis. ? 2013 American College of Cardiology Foundation.
机译：目的：作者试图测量主动脉瓣狭窄患者升主动脉中的湍动能（TKE），并评估其与不可逆压力损失的关系。背景：狭窄后血流中能量耗散引起的不可逆压力损失是主动脉狭窄的血液动力学意义的重要决定因素。用于估算压力梯度的简化Bernoulli方程经常误分类由主动脉瓣狭窄引起的心室超负荷。目前用于评估不可逆压力损失的金标准是导管插入术，但是由于其侵入性，这种方法很少使用。狭窄后的压力损失主要是由湍动能耗散到热中引起的。磁共振流成像的最新发展允许对TKE进行无创估计。方法：该研究获得当地伦理审查委员会的批准，所有受试者均签署了知情同意书。三维电影磁共振流成像技术用于测量18位受试者（4位正常志愿者，14位有或没有扩张的主动脉瓣狭窄患者）的TKE。对于每个受试者，将升主动脉中的总峰值TKE与压力损失指数进行比较。压力损失指数基于先前验证的理论，该理论将压力损失与可通过超声心动图获得的测量值相关。结果：总的TKE似乎与基于磁共振测量的速度场可视化的整体流动模式无关。主动脉瓣狭窄患者的TKE显着高于正常志愿者（p <0.001）。升主动脉中的总总TKE与指数压力损失密切相关（R2 = 0.91）。结论：升主动脉中的总TKE峰值与通过公认的方法估计的不可逆压力损失密切相关。经过进一步的验证，可以通过磁共振流成像直接测量TKE，以评估主动脉瓣狭窄中不可逆的压力损失。 ？ 2013美国心脏病学会基金会。

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