Assessing Complex Left Ventricular Adaptations in Aortic Stenosis Using Personalized 3D + time Cardiac MRI Modeling

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Imaging

Background:

• Aortic stenosis (AS) significantly impacts left ventricular (LV) adaptations.
• Comorbidities like hypertension and ischemic heart disease further complicate LV response in AS patients.
• Accurate assessment of LV remodeling is crucial for effective treatment and surgical planning.

Purpose of the Study:

• To assess the feasibility of a motion-corrected personalized 3D+time LV modeling technique.
• To evaluate adaptive and maladaptive LV responses in AS patients using this novel technique.
• To aid in treatment decision-making for AS patients.

Main Methods:

• A motion-corrected personalized 3D+time LV modeling technique was developed and applied.
• 22 AS patients and 10 healthy subjects were analyzed.
• LV remodeling patterns, wall thickening, synchrony, and systolic function were assessed.

Main Results:

• Individualized LV remodeling patterns were observed in AS patients, associated with comorbidities and fibrosis.
• AS patients with hypertension showed better wall thickening and synchrony than those with AS alone.
• Ischemic heart disease in AS patients led to impaired wall thickening, synchrony, and systolic function.
• The 3D+time technique showed high correlation with echocardiography and clinical MRI measurements (r: 0.70-0.95; p < 0.01).
• Subtle and subclinical LV dysfunction was detected by the proposed technique.

Conclusions:

• The motion-corrected personalized 3D+time LV modeling is a feasible technique for evaluating AS.
• This method provides a personalized assessment of LV adaptive and maladaptive responses.
• The technique offers a superior approach for AS patient evaluation, surgical planning, and follow-up.