The International Journal of Cardiovascular Imaging

, Volume 33, Issue 12, pp 1969–1978 | Cite as

Association between flow skewness and aortic dilatation in patients with aortic stenosis

  • Hojin Ha
  • Hyun Jung Koo
  • June Goo Lee
  • Guk Bae Kim
  • Jihoon Kweon
  • Sang Joon Lee
  • Joon Won Kang
  • Tae Hwan Lim
  • Dae Hee Kim
  • Jong Min Song
  • Duk Hyun Kang
  • Jae Kwan Song
  • Young Hak Kim
  • Namkug Kim
  • Dong Hyun YangEmail author
Original Paper


We investigated association between hemodynamic characteristics and aortic dilatation in patients with severe aortic stenosis (AS). Eighty patients with severe AS (mean age, 67.2 ± 12.5 years) who underwent multi-detector computed tomography and phase-contrast magnetic resonance imaging at the ascending aorta were retrospectively analyzed. Patients with an ascending aorta diameter >4 cm had a significantly higher forward flow rate at systole (28.5 ± 6.0 vs. 36.2 ± 8.6 L min, P < 0.001), and retrograde flow rate at systole (11.3 ± 4.2 vs. 18.8 ± 5.8 L min, P < 0.001), fractional reverse ratio (a ratio of retrograde flow rate to forward flow rate; 34.1 ± 11.9% vs. 43.5 ± 18.0%, P = 0.014), flow skewness Rskewness (a ratio of sum of forward and retrograde systole flow to net systole flow rate; 2.4 ± 0.7 vs. 3.2 ± 1.0, P < 0.001). The presence of bicuspid aortic valve (BAV; odds ratio [OR] 72.01, 95% confidence interval [CI] 10.57–490.46, P < 0.001), Left ventricular mass index (LVMI; OR 1.02 /g/m2; CI 1.00–1.04, P = 0.043) and Rskewness (OR 5.6 per 1, 95% CI 1.8–17.1, P = 0.001) were associated with aortic dilatation. BAV, LVMI, and increased Rskewness in the ascending aorta are associated with aortic dilatation in patients with AS.


Phase-contrast magnetic resonance imaging 2D PC-MRI Wall shear stress Aortic stenosis Hemodynamics Aortic dilatation 



This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2016R1A1A1A05921207, 2015R1A2A2A04003034) and a grant (2017-7208) from the Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea. The study protocol was approved by the hospital institutional review board.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10554_2017_1196_MOESM1_ESM.pdf (367 kb)
Supplementary material 1 (PDF 366 KB)


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Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  • Hojin Ha
    • 1
  • Hyun Jung Koo
    • 2
  • June Goo Lee
    • 3
  • Guk Bae Kim
    • 3
  • Jihoon Kweon
    • 4
  • Sang Joon Lee
    • 1
    • 5
  • Joon Won Kang
    • 2
  • Tae Hwan Lim
    • 2
  • Dae Hee Kim
    • 4
  • Jong Min Song
    • 4
  • Duk Hyun Kang
    • 4
  • Jae Kwan Song
    • 4
  • Young Hak Kim
    • 4
  • Namkug Kim
    • 2
    • 6
  • Dong Hyun Yang
    • 2
    Email author
  1. 1.POSTECH Biotech CenterPohang University of Science and TechnologyPohangSouth Korea
  2. 2.Department of Radiology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
  3. 3.Asan Institute of Life ScienceSeoulSouth Korea
  4. 4.Department of Cardiology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
  5. 5.Department of Mechanical EngineeringPohang University of Science and TechnologyPohangSouth Korea
  6. 6.Department of Convergence Medicine, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea

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