Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 17;7(2):E48-E54.
doi: 10.1055/a-1652-1261. eCollection 2021 Aug.

Transthoracic Vector Flow Imaging in Pediatric Patients with Valvular Stenosis - A Proof of Concept Study

Tin-Quoc Nguyen  1   2 , Thor Bechsgaard  3 , Michael Rahbek Schmidt  4 , Klaus Juul  5 , Ramin Moshavegh  6 , Lars Lönn  1   2 , Michael Bachmann Nielsen  1   2 , Jørgen Arendt Jensen  7 , Kristoffer Lindskov Hansen  1   2
Affiliations

Transthoracic Vector Flow Imaging in Pediatric Patients with Valvular Stenosis - A Proof of Concept Study

Tin-Quoc Nguyen et al. Ultrasound Int Open. .

Abstract

Purpose Continuous wave Doppler ultrasound is routinely used to detect cardiac valve stenoses. Vector flow imaging (VFI) is an angle-independent real-time ultrasound method that can quantify flow complexity. We aimed to evaluate if quantification of flow complexity could reliably assess valvular stenosis in pediatric patients. Materials and Methods Nine pediatric patients with echocardiographically confirmed valvular stenosis were included in the study. VFI and Doppler measurements were compared with transvalvular peak-to-peak pressure differences derived from invasive endovascular catheterization. Results Vector concentration correlated with the catheter measurements before intervention after exclusion of one outlier (r=-0.83, p=0.01), whereas the Doppler method did not (r=0.49, p=0.22). The change in vector concentration after intervention correlated strongly with the change in the measured catheter pressure difference (r=-0.86, p=0.003), while Doppler showed a tendency for a moderate correlation (r=0.63, p=0.07). Conclusion Transthoracic flow complexity quantification calculated from VFI data is feasible and may be useful for assessing valvular stenosis severity in pediatric patients.

Keywords: catheters; echocardiography; vector flow imaging, valvular stenosis, pressure gradient.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Ramin Moshavegh is employed at BK Medical Aps. Jørgen Arendt Jensen developed and patented the vector flow imaging technique.

Figures

Fig. 1
Fig. 1
Short-axis view of the pulmonary artery after intervention using vector flow imaging. The blood flow direction spans all 360 degrees. Here, blood flow is moving in a clockwise direction.
Fig. 2
Fig. 2
Long-axis view of the pulmonary artery after intervention using vector flow imaging. During systole, blood leaves the right ventricle (top-left), passes through the pulmonary valve (arrow), and enters the pulmonary artery (bottom right).
Fig. 3
Fig. 3
Vector flow imaging of a pulmonary valve stenosis before ( a ) and after ( b ) treatment. Vector concentration was calculated inside an ROI. In this patient, vector concentration increased from 0.40 to 0.51.
Fig. 4
Fig. 4
Transthoracic echocardiography of a pulmonary valve stenosis before ( a ) and after ( b ) intervention (same patient as in Fig. 3 ).
Fig. 5
Fig. 5
Vector concentration ( a ) and Doppler pressure differences ( b ) plotted against pressure differences measured with a pressure catheter. One patient had no valvular stenosis and is marked with triangles (▲).
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Liu Y, Chen S, Zühlke L. Global birth prevalence of congenital heart defects 1970–2017: Updated systematic review and meta-analysis of 260 studies. Int J Epidemiol. 2019;48:455–463. doi: 10.1093/ije/dyz009. - DOI - PMC - PubMed
    1. Singh Y. Echocardiographic Evaluation of Hemodynamics in Neonates and Children. Front Pediatr. 2017;5:201. doi: 10.3389/fped.2017.00201. - DOI - PMC - PubMed
    1. Yoganathan A P, Cape E G, Sung H W. Review of hydrodynamic principles for the cardiologist: applications to the study of blood flow and jets by imaging techniques. J Am Coll Cardiol. 1988;12:1344–1353. - PubMed
    1. Singh G K. Congenital Aortic Valve Stenosis. Children (Basel) 2019:6. doi: 10.3390/children6050069. - DOI - PMC - PubMed
    1. Ringle A, Castel A-L, Le Goffic C. Prospective assessment of the frequency of low gradient severe aortic stenosis with preserved left ventricular ejection fraction: Critical impact of aortic flow misalignment and pressure recovery phenomenon. Arch Cardiovasc Dis. 2018;111:518–527. doi: 10.1016/j.acvd.2017.11.004. - DOI - PubMed