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BRIEF RESEARCH REPORT article
Front. Cardiovasc. Med.
Sec. Cardiovascular Imaging
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1529350
This article is part of the Research Topic Revolutionizing Cardiovascular Diagnosis: Advances in Functional Imaging Technologies View all 8 articles
4D Flow Magnetic Resonance Assessment of Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy and Surgical Valve Replacement for Aortic Valve Stenosis
Provisionally accepted- Funabashi Municipal Medical Center, Chiba, Japan
Background: Hypertrophic cardiomyopathy (HCM) sometimes complicates left ventricular (LV) outflow tract obstruction. Alcohol septal ablation (ASA) is indicated for drug refractory hypertrophic obstructive cardiomyopathy (HOCM). And, with an aging population, aortic valve stenosis (AS) is increasing and surgical aortic valve replacement (SAVR) is indicated. Both AS and HOCM have stenosis at the exit of LV and there is a difference in valvular and/or muscular stenosis. However, it is not clear how the release of stenosis affects blood flow. We investigate the influence of ASA and SAVR on blood flow using four-dimensional flow phase-contrast magnetic resonance imaging (4D flow MRI).In this single-center retrospective observational study, we evaluated the blood flow of eight patients (5 HOCM patients and 3 AS patients) before and after the intervention using 4D flow MRI.The LV-Aortic pressure gradient (PG) was significantly improved from 79.4±3.9 to 23.0±2.0 mmHg (p<0.001) by SAVR in AS patients. However, turbulent kinetic energy value (TKE) loss was not improved. On the other hand, the intra LV PG in HOCM patients was improved from 79.0±54.2 to 8.7±4.0 mmHg (p<0.05) by ASA. TKE loss was improved from 7.0±2.0 to 5.0±0.1mW (p<0.05) and NYHA was significantly improved from 2.2±0.5 to 1.1±0.3. (p<0.001) by ASA. Conclusions: Release of valvular or muscular stenosis shows different effects on intra LV blood flow. ASA reduced TKE loss and 4D flow MRI is useful to evaluate the efficacy of therapeutic interventions.
Keywords: 4D flow MRI, Hypertrophic Cardiomyopathy, Aortic Valve Stenosis, alcohol septal ablation, aortic valve replacement
Received: 16 Nov 2024; Accepted: 14 Mar 2025.
Copyright: © 2025 Aoyama, Okino and Fukuzawa. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Rie Aoyama, Funabashi Municipal Medical Center, Chiba, Japan
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