Evaluation of aortic stenosis: From Bernoulli and Doppler to Navier-Stokes

Harminder Gill; Joao Fernandes; Omar Chehab; Bernard Prendergast; Simon Redwood; Amedeo Chiribiri; David Nordsletten; Ronak Rajani; Pablo Lamata

doi:10.1016/j.tcm.2021.12.003

Evaluation of aortic stenosis: From Bernoulli and Doppler to Navier-Stokes

Trends Cardiovasc Med. 2023 Jan;33(1):32-43. doi: 10.1016/j.tcm.2021.12.003. Epub 2021 Dec 15.

Authors

Harminder Gill¹, Joao Fernandes², Omar Chehab³, Bernard Prendergast³, Simon Redwood³, Amedeo Chiribiri², David Nordsletten⁴, Ronak Rajani⁵, Pablo Lamata²

Affiliations

¹ School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK. Electronic address: harminder.gill@kcl.ac.uk.
² School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
³ Cardiology Department, Guy's and St. Thomas's Hospital NHS Foundation Trust, London, UK.
⁴ School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK; Department of Surgery and Biomedical Engineering, University of Michigan, 2800 Plymouth Rd, 48109, Ann Arbor, MI, USA.
⁵ School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK; Cardiology Department, Guy's and St. Thomas's Hospital NHS Foundation Trust, London, UK.

PMID: 34920129
DOI: 10.1016/j.tcm.2021.12.003

Abstract

Uni-dimensional Doppler echocardiography data provide the mainstay of quantative assessment of aortic stenosis, with the transvalvular pressure drop a key indicator of haemodynamic burden. Sophisticated methods of obtaining velocity data, combined with improved computational analysis, are facilitating increasingly robust and reproducible measurement. Imaging modalities which permit acquisition of three-dimensional blood velocity vector fields enable angle-independent valve interrogation and calculation of enhanced measures of the transvalvular pressure drop. This manuscript clarifies the fundamental principles of physics that underpin the evaluation of aortic stenosis and explores modern techniques that may provide more accurate means to grade aortic stenosis and inform appropriate management.

Keywords: 4D flow MRI; Aortic stenosis; Pressure drop; Velocity vector ultrasound.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Aortic Valve / diagnostic imaging
Aortic Valve Stenosis* / diagnostic imaging
Cardiac Catheterization
Echocardiography, Doppler
Hemodynamics
Humans
Models, Cardiovascular

Abstract

Publication types

MeSH terms

Grants and funding