Quantitative Assessment of Post-Valvular Mechanical Energy in BAV with Aortic Lesions and Preserved Ejection Fraction on LV Workload

Motivation: Bicuspid aortic valve (BAV) lesions, such as stenosis and regurgitation, increase the energetic load on the left ventricle (LV). Understanding how post-valvular mechanical energy relates to LV workload may aid in assessing cardiac risks. Goal(s): Determine if post-valvular kinetic energy (KE) and viscous energy loss (EL) can quantify LV load associated with BAV lesions. Approach: Four-dimensional cardiovascular magnetic resonance flow imaging data employed to calculate KE and EL in BAVs with different isolated lesion types. Results: Elevated KE was observed in both regurgitation and stenosis, with notable correlations to LV functional and structural metrics, underscoring KE's potential as a predictor of LV workload. Impact: This study demonstrates that post-valvular peak systolic integrated kinetic energy (KE) could serve as a non-invasive marker of LV workload, supporting early intervention strategies for improved risk stratification in diverse BAV patient profiles.