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Abstract #0064

New Insights in the Disagreement of Transvalvular Mean Pressure Gradient Measured by Transthoracic Echo-Doppler and Cardiovascular Magnetic Resonance in Patients with Aortic Stenosis

Julio Garcia1, Romain Capoulade2, Lyes Kadem3, Eric Larose2, Philippe Pibarot2

1Radiology, Northwestern University, Chicago, IL, United States; 2Laval University, Quebec, Canada; 3Concordia University, Montreal, Quebec, Canada

Transvalvular mean pressure gradient (MPG) measured by CMR often underestimates echo-Doppler MPG. This underestimation might be due to physical factors as flow turbulence generated downstream the severe AS, local signal loss, background noise and phase wrap. However fluid dynamic parameters may play also a significant role in the MPG measurement by CMR. The aims of this study were to identify the fluid dynamic factors associated with MPG underestimation by CMR and to investigate the association of those factors in the AS severity assessment by CMR.

Keywords

absolute according accurate acquisition addition adjusted affect agreement alternative aorta aortic ascending assess assessment association background bias bicuspid bland blood cape cardiac cardiovascular chair circulation classified clockwise compute computed consisted context contrast control corroborate cost criteria cross decisions define density derived detection dimensionless discordance discordant discrepancies diseases dissipation downstream dynamic effective eight emerged energetic energy error examination findings flow fluid frequently function furthermore generated generates gradient gradients greater guidelines healthy heart highlighted identification identify importance important included inconsistencies incorrect independently indicates insights investigate laminar layer limits local location loss lyes magnitude mainly matrix measured mechanic might mild morphology multivariate needed noise northwestern objectives orifice patient patients peak pixel plot potential pressure previous radiology recovery regression related represents resolved scanner seas severe severity shear significantly sixty spacing stroke studies subjects supported systolic table theoretical therapeutic turbulence typically uncertain underestimation underwent univariate upstream useful usefulness valid valve valvular velocity volume vorticity wrap years