Multimodality imaging and computational fluid dynamics framework for quantifying wall shear stress on aortic valve leaflets in aortic stenosis

Motivation: Quantifying wall shear stress (WSS) on aortic valve leaflets is crucial for understanding platelet-vWF interactions and assessing the risk of aortic stenosis progression. Goal(s): Develop a multimodal framework to evaluate WSS on aortic valve leaflets in patients by integrating in-vivo, in-vitro, and in-silico imaging to capture valve morphology and flow velocity for precise WSS quantification. Approach: The study utilized CT and echocardiography data, performed 4D flow MRI and CFD simulations, validated CFD results against MRI data, and assessed WSS using the CFD simulation outcomes. Results: CFD results closely matched 4D flow MRI and provided regions of high WSS at the narrowest valve areas. Impact: This framework enables precise WSS mapping on aortic valve leaflets, supporting better AS progression risk assessment. Future investigations could validate the direct use of in-vivo 4D MRI combined with CFD, improving non-invasive diagnostics and treatment planning in AS patients.