Key result
4D flow MRI viscous energy loss yields 0.83 AUC, outperforming echocardiography for predicting AS-related events.
Why the study?
To investigate whether 4D flow MRI viscous energy loss could determine aortic stenosis severity in accordance with transvalvular energy loss and aid surgical decision-making in asymptomatic severe AS.
Does viscous energy loss measured by 4D flow MRI predict aortic stenosis-related events better than conventional echocardiography in asymptomatic patients with severe aortic stenosis?
Population
74 asymptomatic severe AS patients with preserved LVEF and 23 healthy volunteers
Comparison
4D flow MRI viscous energy loss vs Doppler echocardiography energy loss index
Design
Prospective single-center study
Follow-up
Median 42 months (IQR, 30–53 months)
Authors
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May aid risk stratification in asymptomatic severe AS; hypothesis-generating and requires prospective validation before adoption.
Observational (n=97)
No
Does viscous energy loss measured by 4D flow MRI predict aortic stenosis-related events better than conventional echocardiography in asymptomatic patients with severe aortic stenosis?
Effect estimate: AUC 0.83 (95% CI 0.74-0.93)
p-value: p=<0.001
Viscous energy loss measured by 4D flow MRI provides superior risk stratification for clinical events compared to conventional echocardiography in asymptomatic patients with severe aortic stenosis.
Shan et al. (2022) conducted an observational in Asymptomatic severe aortic stenosis (n=97). 4D flow MRI-derived viscous energy loss (E′L) vs. Conventional echocardiographic parameters was evaluated on AS-related events including aortic valve replacement (AUC 0.83, 95% CI 0.74-0.93, p=<0.001). Peak systolic viscous energy loss measured by 4D flow MRI showed better discrimination for AS-related events than conventional echocardiography (AUC 0.83; 95% CI 0.74-0.93; P<0.001).
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