Right ventricular energetics and power in pulmonary regurgitation vs. stenosis using four dimensional phase contrast magnetic resonance

Joao Filipe Fernandes, James M Hammel, Jia Zhou, Yunbin Xiao, Manuela Chen, Rita Alves, John Lof, Stuart M. Grieve, Andreas Schuster, Titus Kuehne, Shelby Kutty

Research output: Contribution to journalArticle

Abstract

Objective: We investigated a full energetic profile of pressure and volume loaded right ventricle (RV) in porcine models by evaluating kinetic energy (KE), stroke power, power output and power loss across pulmonary valves with stenosis (PS) or with regurgitation (PR). Methods: Fifteen pigs (6 PS and 6 PR, 3 unoperated controls) were studied. Phase-contrast 4D-flow MRI was performed in models of PS and PR at baseline and at 10–12 weeks, in conjunction with cardiac catheterization. Phase contrast velocities over 1 cardiac cycle were registered with a dynamic mask of the RV segmented from cine images. Mean KE and KE curve profiles were measured, normalized for RV volumes and compared between groups. Right heart catheterization pressures were used to calculate RV stroke power and power output, from which pulmonary valve power loss and RV power output ratio were calculated, and compared between groups. Results: PS and PR groups had similar KE pre procedure but significant changes in KE post procedure. The PR group had higher RV power output ratio and KE (72.1% ± 11.4%; 20.6 ± 6.1) than PS group (25.6% ± 4.7%; 13.8 ± 5.0) post procedure. Volume loaded RV from PR had higher KE and power output ratio compared to pressure load from PS. Conclusions: In porcine models of PS and PR, the RV presents altered systolic and diastolic energetic profiles. Pulmonary valve efficiency appeared to decrease in the medium term with somatic growth, with increased power loss in all groups studied, and greatly within the PS group.

Original languageEnglish (US)
Pages (from-to)165-170
Number of pages6
JournalInternational Journal of Cardiology
Volume263
DOIs
StatePublished - Jul 15 2018

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Pulmonary Valve Insufficiency
Heart Ventricles
Pathologic Constriction
Magnetic Resonance Spectroscopy
Pulmonary Valve
Swine
Cardiac Catheterization
Pressure
Stroke
Pulmonary Valve Stenosis
Masks

Keywords

  • Cardiovascular magnetic resonance
  • Congenital heart disease
  • Four-dimensional flow
  • Right ventricular remodeling

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Right ventricular energetics and power in pulmonary regurgitation vs. stenosis using four dimensional phase contrast magnetic resonance. / Fernandes, Joao Filipe; Hammel, James M; Zhou, Jia; Xiao, Yunbin; Chen, Manuela; Alves, Rita; Lof, John; Grieve, Stuart M.; Schuster, Andreas; Kuehne, Titus; Kutty, Shelby.

In: International Journal of Cardiology, Vol. 263, 15.07.2018, p. 165-170.

Research output: Contribution to journalArticle

Fernandes, Joao Filipe ; Hammel, James M ; Zhou, Jia ; Xiao, Yunbin ; Chen, Manuela ; Alves, Rita ; Lof, John ; Grieve, Stuart M. ; Schuster, Andreas ; Kuehne, Titus ; Kutty, Shelby. / Right ventricular energetics and power in pulmonary regurgitation vs. stenosis using four dimensional phase contrast magnetic resonance. In: International Journal of Cardiology. 2018 ; Vol. 263. pp. 165-170.
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AU - Fernandes, Joao Filipe

AU - Hammel, James M

AU - Zhou, Jia

AU - Xiao, Yunbin

AU - Chen, Manuela

AU - Alves, Rita

AU - Lof, John

AU - Grieve, Stuart M.

AU - Schuster, Andreas

AU - Kuehne, Titus

AU - Kutty, Shelby

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N2 - Objective: We investigated a full energetic profile of pressure and volume loaded right ventricle (RV) in porcine models by evaluating kinetic energy (KE), stroke power, power output and power loss across pulmonary valves with stenosis (PS) or with regurgitation (PR). Methods: Fifteen pigs (6 PS and 6 PR, 3 unoperated controls) were studied. Phase-contrast 4D-flow MRI was performed in models of PS and PR at baseline and at 10–12 weeks, in conjunction with cardiac catheterization. Phase contrast velocities over 1 cardiac cycle were registered with a dynamic mask of the RV segmented from cine images. Mean KE and KE curve profiles were measured, normalized for RV volumes and compared between groups. Right heart catheterization pressures were used to calculate RV stroke power and power output, from which pulmonary valve power loss and RV power output ratio were calculated, and compared between groups. Results: PS and PR groups had similar KE pre procedure but significant changes in KE post procedure. The PR group had higher RV power output ratio and KE (72.1% ± 11.4%; 20.6 ± 6.1) than PS group (25.6% ± 4.7%; 13.8 ± 5.0) post procedure. Volume loaded RV from PR had higher KE and power output ratio compared to pressure load from PS. Conclusions: In porcine models of PS and PR, the RV presents altered systolic and diastolic energetic profiles. Pulmonary valve efficiency appeared to decrease in the medium term with somatic growth, with increased power loss in all groups studied, and greatly within the PS group.

AB - Objective: We investigated a full energetic profile of pressure and volume loaded right ventricle (RV) in porcine models by evaluating kinetic energy (KE), stroke power, power output and power loss across pulmonary valves with stenosis (PS) or with regurgitation (PR). Methods: Fifteen pigs (6 PS and 6 PR, 3 unoperated controls) were studied. Phase-contrast 4D-flow MRI was performed in models of PS and PR at baseline and at 10–12 weeks, in conjunction with cardiac catheterization. Phase contrast velocities over 1 cardiac cycle were registered with a dynamic mask of the RV segmented from cine images. Mean KE and KE curve profiles were measured, normalized for RV volumes and compared between groups. Right heart catheterization pressures were used to calculate RV stroke power and power output, from which pulmonary valve power loss and RV power output ratio were calculated, and compared between groups. Results: PS and PR groups had similar KE pre procedure but significant changes in KE post procedure. The PR group had higher RV power output ratio and KE (72.1% ± 11.4%; 20.6 ± 6.1) than PS group (25.6% ± 4.7%; 13.8 ± 5.0) post procedure. Volume loaded RV from PR had higher KE and power output ratio compared to pressure load from PS. Conclusions: In porcine models of PS and PR, the RV presents altered systolic and diastolic energetic profiles. Pulmonary valve efficiency appeared to decrease in the medium term with somatic growth, with increased power loss in all groups studied, and greatly within the PS group.

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