05 Mar Enhanced echocardiographic assessment of intracardiac flow in congenital heart disease
Four-dimensional flow MRI (4D flow MRI) is a powerful tool for assessing right ventricular (RV) flow dynamics in congenital heart disease, but its limited availability restricts widespread use. Doppler Velocity Reconstruction (DoVeR)from conventional echocardiography offers a promising alternative, but its accuracy compared to 4D flow MRI needs further validation. This study compared DoVeR and 4D flow MRI in 20 subjects (7 with normal RVs, 13 with congenital heart defects, including repaired Tetralogy of Fallot and atrial-level shunts). Key intracardiac flow parameters—including relative pressure differences, vortex strength, kinetic energy, and viscous energy loss—were quantified using both techniques. The results showed strong agreement between DoVeR and 4D flow MRI, with similar flow patterns, spatial distributions, and time evolutions of hemodynamic parameters. Correlation coefficients between the two methods ranged from 0.87 to 0.92, while the median deviation between measurements was 10–14%, demonstrating a high level of consistency. These findings suggest that DoVeR is a reliable alternative to 4D flow MRI for assessing RV intracardiac flow, offering a more accessible option for clinical evaluation. With its potential for broader application in congenital heart disease, DoVeR could enable more frequent and cost-effective monitoring of RV function and hemodynamic abnormalities in clinical settings.
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