Open or closed: Changes in ductus arteriosus flow patterns at birth using 4D flow MRI in newborn piglets. Issue 17 (26th August 2021)

• Record Type: Journal Article
• Authors: Schrauben, Eric M.; Darby, Jack R. T.; Berry, Mary J.; Saini, Brahmdeep S.; Quinn, Megan; Holman, Stacey L.; Bradshaw, Emma L.; Lock, Mitchell C.; Perumal, Sunthara R.; Cho, Steven K. S.; Aujla, Tanroop; Seed, Mike; Macgowan, Christopher K.; Morrison, Janna L.
• Is Part Of: Physiological reports. Volume 9:Issue 17(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-08-26
• Subjects: 4D flow MRI -- ductus arteriosus -- newborn; Physiology -- Periodicals; 571
• DOI: 10.14814/phy2.14999
• Languages: English
• ISSNs: 2051-817X

Abstract

Abstract: The ductus arteriosus (DA) functionally closes during the transition from fetal to postnatal life because of lung aeration and corresponding cardiovascular changes. The thorough and explicit measurement and visualization of the right and left heart output during this transition has not been previously accomplished. We combined 4D flow MRI (dynamic volumetric blood flow measurements) and T2 relaxometry (oxygen delivery quantification) in surgically instrumented newborn piglets to assess the DA. This was performed in Large White‐Landrace‐Duroc piglets ( n = 34) spanning four age groups: term‐9 days, term‐3, term+1, and term+5. Subject's DA status was classified using 4D flow: closed DA, forward DA flow, reversed DA flow, and bidirectional DA flow. Over all states, vessel diameters and flows normalized to body weight increased with age (for example in the ascending aorta flow—term‐9: 126.6 ± 45.4; term+5: 260.2 ± 80.0 ml/min per kg; p = 0.0005; ascending aorta diameter—term‐9: 5.2 ± 0.8; term+5: 7.7 ± 0.4 mm; p = 0.0004). In subjects with reversed DA blood flow there was lower common carotid artery blood flow (forward: 37.5 ± 9.0; reversed: 20.0 ± 7.4 ml/min per kg; p = 0.032). Linear regression revealed that as net DA flow decreases, common carotid artery flow decreases (R 2 = 0.32, p = 0.004), and left (R 2 = 0.33, p = 0.003) and right (R 2 = 0.34, p = 0.003) pulmonary artery flow increases. Bidirectional DA blood flow changed oxygen saturation as determined by MRI between the ascending and descending aorta (ascending aorta: 90.1% ± 8.4%; descending aorta: 75.6% ± 14.2%; p < 0.05). Expanded use of these techniques in preterm animal models will aid in providing new understandings of normal versus abnormal DA transition, as well as to test the effectiveness of related clinical interventions. Abstract : At birth, the lungs and surrounding vasculature work to functionally close the ductus arteriosus (DA). This process is delayed in preterm newborns. MRI techniques, namely 4D flow and T2 relaxometry, can be used to comprehensively assess cardiac blood flow and oxygen delivery in newborns. These approaches are demonstrated across preterm and term‐born piglets, and whole heart blood flow visualization is paired alongside flow and oxygenation quantification.