ArticleAnnals of biomedical engineering2026
The Effect of Aortic Regurgitation on Left Ventricular Flow Dynamics Assessed by 4D-Flow MRI.
Article in Annals of biomedical engineering, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAortic regurgitation (AR) alters normal blood flow patterns in the left ventricle (LV), affecting diastolic filling dynamics, and is commonly quantified by the regurgitant fraction (RF). However, conventional diagnostic methods have notable limitations, prompting growing interest in four-dimensional flow magnetic resonance imaging (4D-flow MRI) as a tool for quantitatively assessing AR severity. In parallel, viscous energy dissipation (VED), which captures the energy loss caused by viscous forces within blood flow, provides additional important insight into the hemodynamic burden imposed on the LV by valvular dysfunction.
objectiveThis study aims to investigate the potential correlation between RF and VED in patients with AR, hypothesizing that higher RF values are associated with increased VED, thereby reflecting greater hemodynamic compromise.
methodsThis pilot study included 10 patients with diagnosed AR and 9 healthy controls, all of whom underwent standardized cardiac MRI, including 4D-flow MRI. Volumetric blood flow and VED were assessed using validated post-processing techniques. Statistical analyses were conducted to evaluate group differences and explore the correlation between RF and VED.
resultsIn healthy controls, LV flow exhibited a typical pattern during diastole and systole, forming a vortex during filling. Severe AR patients displayed disrupted LV flow, with regurgitant jets altering the flow dynamics. Quantitatively, integrated kinetic energy (iKE), vorticity (iVRT), and VED (iVED) were significantly elevated in AR patients compared to controls: iKE (0.003 ± 0.002 J vs. 0.001 ± 0.0004 J, p = 0.019), iVRT (0.304 ± 0.0738 s
conclusionThis study quantifies the impact of AR on LV flow dynamics and demonstrates elevated VED in patients with AR. The observed correlation underscores the potential of VED as a complementary metric to RF in evaluating the hemodynamic impact of valvular regurgitation. Further studies with larger cohorts are needed to validate these findings and explore their clinical implications.
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