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. 2023 Oct;16(5):1110-1122.
doi: 10.1007/s12265-023-10375-9. Epub 2023 Apr 6.

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

Shoon Hui Chuah  1 , Nor Ashikin Md Sari  2 , Li Kuo Tan  3   4 , Yin Kia Chiam  5 , Bee Ting Chan  6 , Yang Faridah Abdul Aziz  4 , Jeyaraaj Jeyabalan  3 , Khairunnisa Hasikin  1 , Yih Miin Liew  7
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Assessing Complex Left Ventricular Adaptations in Aortic Stenosis Using Personalized 3D + time Cardiac MRI Modeling

Shoon Hui Chuah et al. J Cardiovasc Transl Res. 2023 Oct.

Abstract

Left ventricular adaptations can be a complex process under the influence of aortic stenosis (AS) and comorbidities. This study proposed and assessed the feasibility of using a motion-corrected personalized 3D + time LV modeling technique to evaluate the adaptive and maladaptive LV response to aid treatment decision-making. A total of 22 AS patients were analyzed and compared against 10 healthy subjects. The 3D + time analysis showed a highly distinct and personalized pattern of remodeling in individual AS patients which is associated with comorbidities and fibrosis. Patients with AS alone showed better wall thickening and synchrony than those comorbid with hypertension. Ischemic heart disease in AS caused impaired wall thickening and synchrony and systolic function. Apart from showing significant correlations to echocardiography and clinical MRI measurements (r: 0.70-0.95; p < 0.01), the proposed technique helped in detecting subclinical and subtle LV dysfunction, providing a better approach to evaluate AS patients for specific treatment, surgical planning, and follow-up recovery.

Keywords: 3D + time models; Aortic stenosis; Comorbidities; LV remodeling; Left ventricle adaptation; MRI.

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