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

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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.

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Acknowledgements

The authors thank University Malaya Medical Centre for providing the data for this research.

Funding

This study was supported by Universiti Malaya Faculty Research Grant (GPF053B-2020) and private funding (PV005-2022) from University of Nottingham Malaysia (FOSE Pump Priming Grant 2020).

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Authors and Affiliations

  1. Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, 50603, Kuala Lumpur, Malaysia

    Shoon Hui Chuah, Khairunnisa Hasikin & Yih Miin Liew

  2. Department of Medicine, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia

    Nor Ashikin Md Sari

  3. Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia

    Li Kuo Tan & Jeyaraaj Jeyabalan

  4. University Malaya Research Imaging Centre, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia

    Li Kuo Tan & Yang Faridah Abdul Aziz

  5. Department of Software Engineering, Faculty of Computer Science and Information Technology, Universiti Malaya, 50603, Kuala Lumpur, Malaysia

    Yin Kia Chiam

  6. Department of Mechanical, Materials and Manufacturing Engineering, Faculty of Science and Engineering, University of Nottingham Malaysia, Jalan Broga, 43500, Semenyih, Malaysia

    Bee Ting Chan

Authors
  1. Shoon Hui Chuah
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  2. Nor Ashikin Md Sari
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  6. Yang Faridah Abdul Aziz
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  7. Jeyaraaj Jeyabalan
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  8. Khairunnisa Hasikin
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  9. Yih Miin Liew
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Corresponding author

Correspondence to Yih Miin Liew.

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Ethics Approval

This study was approved by the University Malaya Medical Centre Medical Research Ethics Committee (201866–6364).

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Informed consent was obtained from all individual participants included in the study.

Competing Interests

The authors declare no competing interests.

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Associate Editor Marat Fudim oversaw the review of this article .

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Chuah, S.H., Md Sari, N.A., Tan, L.K. et al. Assessing Complex Left Ventricular Adaptations in Aortic Stenosis Using Personalized 3D + time Cardiac MRI Modeling. J. of Cardiovasc. Trans. Res. 16, 1110–1122 (2023). https://doi.org/10.1007/s12265-023-10375-9

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  • DOI: https://doi.org/10.1007/s12265-023-10375-9

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