{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:15:27Z","timestamp":1792782927944,"version":"4.5.0"},"reference-count":83,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"European Union \u2013 Next Generation EU","award":["2022L7KK7L"],"award-info":[{"award-number":["2022L7KK7L"]}],"id":[{"id":"https:\/\/ror.org\/019w4f821","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Instituto de Salud Carlos III","award":["PI20\/01727"],"award-info":[{"award-number":["PI20\/01727"]}],"id":[{"id":"https:\/\/ror.org\/00ca2c886","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Instituto de Salud Carlos III","award":["CP24\/00121"],"award-info":[{"award-number":["CP24\/00121"]}],"id":[{"id":"https:\/\/ror.org\/00ca2c886","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Politecnico di Torino","id":[{"id":"https:\/\/ror.org\/00bgk9508","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Biomed Eng"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Helical flow in the ascending aorta (AAo) is recognized as beneficial to cardiovascular physiology. Previous in vivo studies of bicuspid aortic valve (BAV) disease have mainly relied on qualitative assessments or surrogate measures of helical flow, hampering its use as potential hemodynamic biomarker. Here, we leveraged a rigorous fluid mechanical framework for helical flow structures to (i) determine how aortic valve (AV) phenotype\u2014tricuspid (TAV) versus bicuspid\u2014influences AAo helical flow and (ii) identify its principal anatomical and hemodynamic determinants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>4D flow MRI data from sixty subjects (41 TAV, 19 BAV) were analyzed. Helicity-derived quantities were computed to quantify the intensity and topology of AAo helical flow. Conventional hemodynamic and anatomical parameters were also extracted and their association with helicity-based quantities was explored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with TAV subjects, BAV patients exhibited lower helicity intensity and reduced predisposition to form coherent helical flow patterns. In TAV, helical flow topology was primarily influenced by flow pulsatility and vessel anatomy, whereas in BAV, eccentric systolic jets promoted the arrangement of blood flow into helical structures without enhancing helicity intensity. Helical flow topology emerged as highly sensitive to AV phenotype, with its discriminative power augmented by conventional anatomical or hemodynamic parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AV phenotype critically shapes helical flow in AAo through phenotype-specific anatomical and hemodynamic determinants. The eccentric jet associated with BAV disrupts helicity intensity, potentially diminishing the protective role of helical flow. Integrating conventional hemodynamic and anatomical parameters with helical flow topology yields a robust, in vivo measurable morpho-hemodynamic signature of BAV, offering diagnostic and prognostic potential.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10439-026-04088-8","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T13:48:35Z","timestamp":1775569715000},"page":"3726-3742","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Aortic Valve Phenotype Shapes Helical Flow in the Ascending Aorta: Insights from 4D Flow MRI"],"prefix":"10.1007","volume":"54","author":[{"given":"Karol","family":"Cal\u00f2","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Guala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Mazzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Dux-Santoy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 F.","family":"Rodrigu\u00e9z Palomares","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Scarsoglio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Ridolfi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Steinman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Gallo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9854-1619","authenticated-orcid":false,"given":"Umberto","family":"Morbiducci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"4088_CR1","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/0021-9290(87)90048-0","volume":"20","author":"DN Ku","year":"1987","unstructured":"Ku, D. N., and D. P. Giddens. Laser Doppler anemometer measurements of pulsatile flow in a model carotid bifurcation. J. Biomech. 20:407\u2013421, 1987.","journal-title":"J. Biomech."},{"key":"4088_CR2","first-page":"297","volume":"5","author":"T Karino","year":"1986","unstructured":"Karino, T. Microscopic structure of disturbed flows in the arterial and venous systems, and its implication in the localization of vascular diseases. Int. Angiol. 5:297\u2013313, 1986.","journal-title":"Int. Angiol."},{"key":"4088_CR3","doi-asserted-by":"publisher","first-page":"1985","DOI":"10.1161\/01.CIR.82.6.1985","volume":"82","author":"LJ Frazin","year":"1990","unstructured":"Frazin, L. J., G. Lanza, M. Vonesh, F. Khasho, C. Spitzzeri, S. McGee, D. Mehlman, K. B. Chandran, J. Talano, and D. McPherson. Functional chiral asymmetry in descending thoracic aorta. Circulation. 82:1985\u20131994, 1990.","journal-title":"Circulation"},{"key":"4088_CR4","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1007\/s10439-018-02169-x","volume":"47","author":"G De Nisco","year":"2019","unstructured":"De Nisco, G., A. M. Kok, C. Chiastra, D. Gallo, A. Hoogendoorn, F. Migliavacca, J. J. Wentzel, and U. Morbiducci. The atheroprotective nature of helical flow in coronary arteries. Ann. Biomed. Eng. 47:425\u2013438, 2019. https:\/\/doi.org\/10.1007\/s10439-018-02169-x.","journal-title":"Ann. Biomed. Eng."},{"key":"4088_CR5","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1002\/jmri.1880040204","volume":"4","author":"HG Bogren","year":"1994","unstructured":"Bogren, H. G., and M. H. Buonocore. Blood flow measurements in the aorta and major arteries with MR velocity mapping. J. Magn. Reson. Imaging. 4:119\u2013130, 1994.","journal-title":"J. Magn. Reson. Imaging"},{"key":"4088_CR6","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1016\/j.ejvs.2016.07.018","volume":"52","author":"PA Stonebridge","year":"2016","unstructured":"Stonebridge, P. A., S. A. Suttie, R. Ross, and J. Dick. Spiral laminar flow: a survey of a three-dimensional arterial flow pattern in a group of volunteers. Eur. J. Vasc. Endovasc. Surg. 52:674\u2013680, 2016. https:\/\/doi.org\/10.1016\/j.ejvs.2016.07.018.","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"4088_CR7","doi-asserted-by":"publisher","first-page":"2398","DOI":"10.1016\/j.jbiomech.2012.07.007","volume":"45","author":"D Gallo","year":"2012","unstructured":"Gallo, D., D. A. Steinman, P. B. Bijari, and U. Morbiducci. Helical flow in carotid bifurcation as surrogate marker of exposure to disturbed shear. J. Biomech. 45:2398\u20132404, 2012. https:\/\/doi.org\/10.1016\/j.jbiomech.2012.07.007.","journal-title":"J. Biomech."},{"key":"4088_CR8","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1016\/j.jbiomech.2012.10.012","volume":"46","author":"U Morbiducci","year":"2013","unstructured":"Morbiducci, U., R. Ponzini, D. Gallo, C. Bignardi, and G. Rizzo. Inflow boundary conditions for image-based computational hemodynamics: Impact of idealized versus measured velocity profiles in the human aorta. J. Biomech. 46:102\u2013109, 2013. https:\/\/doi.org\/10.1016\/j.jbiomech.2012.10.012.","journal-title":"J. Biomech."},{"key":"4088_CR9","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1115\/1.1574332","volume":"125","author":"S Jin","year":"2003","unstructured":"Jin, S., J. Oshinski, and D. P. Giddens. Effects of wall motion and compliance on flow patterns in the ascending aorta. J. Biomech. Eng. 125:347\u2013354, 2003. https:\/\/doi.org\/10.1115\/1.1574332.","journal-title":"J. Biomech. Eng."},{"key":"4088_CR10","doi-asserted-by":"publisher","first-page":"H163","DOI":"10.1152\/ajpheart.00266.2009","volume":"297","author":"X Liu","year":"2009","unstructured":"Liu, X., F. Pu, Y. Fan, X. Deng, D. Li, and S. Li. A numerical study on the flow of blood and the transport of LDL in the human aorta: the physiological significance of the helical flow in the aortic arch. Am. J. Physiol. Heart Circ. Physiol. 297:H163\u2013H170, 2009. https:\/\/doi.org\/10.1152\/ajpheart.00266.2009.","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"4088_CR11","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/s10439-014-1097-2","volume":"43","author":"X Liu","year":"2015","unstructured":"Liu, X., A. Sun, Y. Fan, and X. Deng. Physiological significance of helical flow in the arterial system and its potential clinical applications. Ann. Biomed. Eng. 43:3\u201315, 2015. https:\/\/doi.org\/10.1007\/s10439-014-1097-2.","journal-title":"Ann. Biomed. Eng."},{"key":"4088_CR12","doi-asserted-by":"publisher","first-page":"2235","DOI":"10.1161\/01.CIR.88.5.2235","volume":"88","author":"PJ Kilner","year":"1993","unstructured":"Kilner, P. J., G. Z. Yang, R. H. Mohiaddin, D. N. Firmin, and D. B. Longmore. Helical and retrograde secondary flow patterns in the aortic arch studied by three-directional magnetic resonance velocity mapping. Circulation. 88:2235\u20132247, 1993.","journal-title":"Circulation"},{"key":"4088_CR13","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1007\/s10439-008-9609-6","volume":"37","author":"U Morbiducci","year":"2009","unstructured":"Morbiducci, U., R. Ponzini, G. Rizzo, M. Cadioli, A. Esposito, F. De Cobelli, A. Del Maschio, F. M. Montevecchi, and A. Redaelli. In vivo quantification of helical blood flow in human aorta by time-resolved three-dimensional cine phase contrast magnetic resonance imaging. Ann. Biomed. Eng. 37:516\u2013531, 2009. https:\/\/doi.org\/10.1007\/s10439-008-9609-6.","journal-title":"Ann. Biomed. Eng."},{"key":"4088_CR14","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1007\/s10237-010-0238-2","volume":"10","author":"U Morbiducci","year":"2011","unstructured":"Morbiducci, U., R. Ponzini, G. Rizzo, M. Cadioli, A. Esposito, F. M. Montevecchi, and A. Redaelli. Mechanistic insight into the physiological relevance of helical blood flow in the human aorta: an in vivo study. Biomech. Model. Mechanobiol. 10:339\u2013355, 2011. https:\/\/doi.org\/10.1007\/s10237-010-0238-2.","journal-title":"Biomech. Model. Mechanobiol."},{"key":"4088_CR15","doi-asserted-by":"publisher","first-page":"2818","DOI":"10.1161\/CIRCULATIONAHA.107.760124","volume":"117","author":"MD Hope","year":"2008","unstructured":"Hope, M. D., A. K. Meadows, T. A. Hope, K. G. Ordovas, G. P. Reddy, M. T. Alley, and C. B. Higgins. Evaluation of bicuspid aortic valve and aortic coarctation with 4D flow magnetic resonance imaging. Circulation. 117:2818\u20132819, 2008. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.107.760124.","journal-title":"Circulation"},{"key":"4088_CR16","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/j.medengphy.2020.09.005","volume":"91","author":"K Capellini","year":"2020","unstructured":"Capellini, K., E. Gasparotti, U. Cella, E. Costa, B. M. Fanni, C. Groth, S. Porziani, M. E. Biancolini, and S. Celi. A novel formulation for the study of the ascending aortic fluid dynamics with in vivo data. Med. Eng. Phys. 91:68\u201378, 2020. https:\/\/doi.org\/10.1016\/j.medengphy.2020.09.005.","journal-title":"Med. Eng. Phys."},{"key":"4088_CR17","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1016\/j.jbiomech.2015.02.027","volume":"48","author":"U Morbiducci","year":"2015","unstructured":"Morbiducci, U., D. Gallo, S. Cristofanelli, R. Ponzini, M. A. Deriu, G. Rizzo, and D. A. Steinman. A rational approach to defining principal axes of multidirectional wall shear stress in realistic vascular geometries, with application to the study of the influence of helical flow on wall shear stress directionality in aorta. J. Biomech. 48:899\u2013906, 2015. https:\/\/doi.org\/10.1016\/j.jbiomech.2015.02.027.","journal-title":"J. Biomech."},{"key":"4088_CR18","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1007\/s10439-009-9878-8","volume":"38","author":"X Liu","year":"2010","unstructured":"Liu, X., Y. Fan, and X. Deng. Effect of spiral flow on the transport of oxygen in the aorta: a numerical study. Ann. Biomed. Eng. 38:917\u2013926, 2010. https:\/\/doi.org\/10.1007\/s10439-009-9878-8.","journal-title":"Ann. Biomed. Eng."},{"key":"4088_CR19","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1146\/annurev.fl.24.010192.001433","volume":"24","author":"HK Moffatt","year":"1992","unstructured":"Moffatt, H. K., and A. Tsinober. Helicity in laminar and turbulent flow. Annu. Rev. Fluid Mech. 24:281\u2013312, 1992. https:\/\/doi.org\/10.1146\/annurev.fl.24.010192.001433.","journal-title":"Annu. Rev. Fluid Mech."},{"key":"4088_CR20","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2023.1124604","author":"P Dyverfeldt","year":"2023","unstructured":"Dyverfeldt, P., C. Trenti, M. Ziegler, N. Bjarneg\u00e5rd, and M. Lindenberger. Helical flow in tortuous aortas and its relationship to turbulence: a whole-aorta 4D flow MRI study. Front. Cardiovasc. Med. 2023. https:\/\/doi.org\/10.3389\/fcvm.2023.1124604.","journal-title":"Front. Cardiovasc. Med."},{"key":"4088_CR21","doi-asserted-by":"publisher","DOI":"10.1148\/ryct.240532","author":"D Dushfunian","year":"2025","unstructured":"Dushfunian, D., S. Cohn, H. Berhane, and M. Markl. 4D flow MRI of the thoracic aorta. Radiol. Cardiothorac. Imaging. 2025. https:\/\/doi.org\/10.1148\/ryct.240532.","journal-title":"Radiol. Cardiothorac. Imaging"},{"key":"4088_CR22","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1002\/(SICI)1522-2586(199911)10:5<861::AID-JMRI35>3.0.CO;2-E","volume":"10","author":"HG Bogren","year":"1999","unstructured":"Bogren, H. G., and M. H. Buonocore. 4D magnetic resonance velocity mapping of blood flow patterns in the aorta in young vs elderly normal subjects. J. Magn. Reson. Imaging. 10:861\u2013869, 1999.","journal-title":"J. Magn. Reson. Imaging"},{"key":"4088_CR23","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1148\/radiol.101298","volume":"257","author":"HG Bogren","year":"2010","unstructured":"Bogren, H. G., and M. H. Buonocore. Helical-shaped streamlines do not represent helical flow. Radiology. 257:895\u2013896, 2010. https:\/\/doi.org\/10.1148\/radiol.101298.","journal-title":"Radiology"},{"key":"4088_CR24","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.1002\/jmri.21082","volume":"26","author":"TA Hope","year":"2007","unstructured":"Hope, T. A., M. Markl, L. Wigstr\u00f6m, M. T. Alley, D. C. Miller, and R. J. Herfkens. Comparison of flow patterns in ascending aortic aneurysms and volunteers using four-dimensional magnetic resonance velocity mapping. J. Magn. Reson. Imaging. 26:1471\u20131479, 2007. https:\/\/doi.org\/10.1002\/jmri.21082.","journal-title":"J. Magn. Reson. Imaging"},{"key":"4088_CR25","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1186\/1532-429X-14-84","volume":"14","author":"J Burk","year":"2012","unstructured":"Burk, J., P. Blanke, Z. Stankovic, A. Barker, M. Russe, J. Geiger, A. Frydrychowicz, M. Langer, and M. Markl. Evaluation of 3D blood flow patterns and wall shear stress in the normal and dilated thoracic aorta using flow-sensitive 4D CMR. J. Cardiovasc. Magn. Reson. 14:84, 2012. https:\/\/doi.org\/10.1186\/1532-429X-14-84.","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"4088_CR26","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s12968-020-00608-0","volume":"22","author":"A Lenz","year":"2020","unstructured":"Lenz, A., J. Petersen, C. Riedel, J. M. Weinrich, H. Kooijman, B. P. Schoennagel, G. Adam, Y. von Kodolitsch, H. Reichenspurner, E. Girdauskas, and P. Bannas. 4D flow cardiovascular magnetic resonance for monitoring of aortic valve repair in bicuspid aortic valve disease. J. Cardiovasc. Magn. Reson. 22:29, 2020. https:\/\/doi.org\/10.1186\/s12968-020-00608-0.","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"4088_CR27","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1016\/j.jbiomech.2006.02.017","volume":"40","author":"U Morbiducci","year":"2007","unstructured":"Morbiducci, U., R. Ponzini, M. Grigioni, and A. Redaelli. Helical flow as fluid dynamic signature for atherogenesis risk in aortocoronary bypass. A numeric study. J. Biomech. 40:519\u2013534, 2007. https:\/\/doi.org\/10.1016\/j.jbiomech.2006.02.017.","journal-title":"J. Biomech."},{"key":"4088_CR28","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1002\/mrm.26387","volume":"78","author":"J Garcia","year":"2017","unstructured":"Garcia, J., A. J. Barker, J. D. Collins, J. C. Carr, and M. Markl. Volumetric quantification of absolute local normalized helicity in patients with bicuspid aortic valve and aortic dilatation. Magn. Reson. Med. 78:689\u2013701, 2017. https:\/\/doi.org\/10.1002\/mrm.26387.","journal-title":"Magn. Reson. Med."},{"key":"4088_CR29","doi-asserted-by":"publisher","first-page":"1542","DOI":"10.1002\/mrm.24802","volume":"71","author":"R Lorenz","year":"2014","unstructured":"Lorenz, R., J. Bock, A. J. Barker, F. von Knobelsdorff-Brenkenhoff, W. Wallis, J. G. Korvink, M. M. Bissell, J. Schulz-Menger, and M. Markl. 4D flow magnetic resonance imaging in bicuspid aortic valve disease demonstrates altered distribution of aortic blood flow helicity. Magn. Reson. Med. 71:1542\u20131553, 2014. https:\/\/doi.org\/10.1002\/mrm.24802.","journal-title":"Magn. Reson. Med."},{"key":"4088_CR30","doi-asserted-by":"publisher","first-page":"6285","DOI":"10.1038\/s41598-023-33219-7","volume":"13","author":"S Loose","year":"2023","unstructured":"Loose, S., D. Solou, C. Strecker, A. Hennemuth, M. H\u00fcllebrand, S. Grundmann, A. Asmussen, M. Treppner, H. Urbach, and A. Harloff. Characterization of aortic aging using 3D multi-parametric MRI-long-term follow-up in a population study. Sci. Rep. 13:6285, 2023. https:\/\/doi.org\/10.1038\/s41598-023-33219-7.","journal-title":"Sci. Rep."},{"key":"4088_CR31","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1097\/RLI.0000000000000768","volume":"56","author":"MJFG Ramaekers","year":"2021","unstructured":"Ramaekers, M. J. F. G., B. P. Adriaans, J. F. Juffermans, H. C. van Assen, S. C. A. M. Bekkers, A. J. H. A. Scholte, S. Kenjeres, H. J. Lamb, J. E. Wildberger, J. J. M. Westenberg, and S. Schalla. Characterization of ascending aortic flow in patients with degenerative aneurysms. Invest. Radiol. 56:494\u2013500, 2021. https:\/\/doi.org\/10.1097\/RLI.0000000000000768.","journal-title":"Invest. Radiol."},{"key":"4088_CR32","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.885338","author":"J Sotelo","year":"2022","unstructured":"Sotelo, J., P. Franco, A. Guala, L. Dux-Santoy, A. Ruiz-Mu\u00f1oz, A. Evangelista, H. Mella, J. Mura, D. E. Hurtado, J. F. Rodr\u00edguez-Palomares, and S. Uribe. Fully three-dimensional hemodynamic characterization of altered blood flow in bicuspid aortic valve patients with respect to aortic dilatation: a finite element approach. Front. Cardiovasc. Med. 2022. https:\/\/doi.org\/10.3389\/fcvm.2022.885338.","journal-title":"Front. Cardiovasc. Med."},{"key":"4088_CR33","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1093\/ehjci\/jes273","volume":"14","author":"C Meierhofer","year":"2013","unstructured":"Meierhofer, C., E. P. Schneider, C. Lyko, A. Hutter, S. Martinoff, M. Markl, A. Hager, J. Hess, H. Stern, and S. Fratz. Wall shear stress and flow patterns in the ascending aorta in patients with bicuspid aortic valves differ significantly from tricuspid aortic valves: a prospective study. Eur. Heart J. Cardiovasc. Imaging. 14:797\u2013804, 2013. https:\/\/doi.org\/10.1093\/ehjci\/jes273.","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"4088_CR34","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1161\/CIRCULATIONAHA.113.003026","volume":"129","author":"R Mahadevia","year":"2014","unstructured":"Mahadevia, R., A. J. Barker, S. Schnell, P. Entezari, P. Kansal, P. W. M. Fedak, S. C. Malaisrie, P. McCarthy, J. Collins, J. Carr, and M. Markl. Bicuspid aortic cusp fusion morphology alters aortic three-dimensional outflow patterns, wall shear stress, and expression of aortopathy. Circulation. 129:673\u2013682, 2014. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.113.003026.","journal-title":"Circulation"},{"key":"4088_CR35","doi-asserted-by":"publisher","first-page":"108369","DOI":"10.1016\/j.cmpb.2024.108369","volume":"255","author":"K Cal\u00f2","year":"2024","unstructured":"Cal\u00f2, K., A. Guala, V. Mazzi, M. L. Rizzini, L. Dux-Santoy, J. Rodriguez-Palomares, S. Scarsoglio, L. Ridolfi, D. Gallo, and U. Morbiducci. Pathophysiology of the ascending aorta: impact of dilation and valve phenotype on large-scale blood flow coherence detected by 4D flow MRI. Comput. Methods Programs Biomed. 255:108369, 2024. https:\/\/doi.org\/10.1016\/j.cmpb.2024.108369.","journal-title":"Comput. Methods Programs Biomed."},{"key":"4088_CR36","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1093\/ejcts\/ezy308","volume":"55","author":"Y Shan","year":"2019","unstructured":"Shan, Y., J. Li, Y. Wang, B. Wu, A. J. Barker, M. Markl, C. Wang, X. Wang, and X. Shu. Aortic stenosis exacerbates flow aberrations related to the bicuspid aortic valve fusion pattern and the aortopathy phenotype. Eur. J. Cardio-Thoracic Surg. 55:534\u2013542, 2019. https:\/\/doi.org\/10.1093\/ejcts\/ezy308.","journal-title":"Eur. J. Cardio-Thoracic Surg."},{"key":"4088_CR37","doi-asserted-by":"publisher","first-page":"2707","DOI":"10.1161\/CIRCULATIONAHA.119.039693","volume":"139","author":"A Guala","year":"2019","unstructured":"Guala, A., J. Rodriguez-Palomares, L. Galian-Gay, G. Teixido-Tura, K. M. Johnson, O. Wieben, A. S. Avil\u00e9s, and A. Evangelista. Partial aortic valve leaflet fusion is related to deleterious alteration of proximal aorta hemodynamics. Circulation. 139:2707\u20132709, 2019. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.119.039693.","journal-title":"Circulation"},{"key":"4088_CR38","doi-asserted-by":"publisher","first-page":"2816","DOI":"10.1002\/mrm.26927","volume":"79","author":"J Sotelo","year":"2018","unstructured":"Sotelo, J., L. Dux-Santoy, A. Guala, J. Rodr\u00edguez-Palomares, A. Evangelista, C. Sing-Long, J. Urbina, J. Mura, D. E. Hurtado, and S. Uribe. 3D axial and circumferential wall shear stress from 4D flow MRI data using a finite element method and a Laplacian approach. Magn. Reson. Med. 79:2816\u20132823, 2018. https:\/\/doi.org\/10.1002\/mrm.26927.","journal-title":"Magn. Reson. Med."},{"key":"4088_CR39","doi-asserted-by":"publisher","unstructured":"Guala, A., A. Evangelista, G. Teixido-Tura, L. La Mura, L. Dux-Santoy, A. Ruiz-Mu\u00f1oz, F. Valente, L. Galian-Gay, L. Guti\u00e9rrez, T. Gonz\u00e1lez-Alujas, I. Dentamaro, K. M. Johnson, O. Wieben, A. Sao Avil\u00e9s, I. Ferreira-Gonzalez, and J. F. Rodr\u00edguez-Palomares. Leaflet fusion length is associated with aortic dilation and flow alterations in non-dysfunctional bicuspid aortic valve. Eur. Radiol. 31:9262\u20139272, 2021. https:\/\/doi.org\/10.1007\/s00330-021-08016-3","DOI":"10.1007\/s00330-021-08016-3"},{"key":"4088_CR40","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1148\/radiol.09091437","volume":"255","author":"MD Hope","year":"2010","unstructured":"Hope, M. D., T. A. Hope, A. K. Meadows, K. G. Ordovas, T. H. Urbania, M. T. Alley, and C. B. Higgins. Bicuspid aortic valve: four-dimensional MR evaluation of ascending aortic systolic flow patterns. Radiology. 255:53\u201361, 2010. https:\/\/doi.org\/10.1148\/radiol.09091437.","journal-title":"Radiology"},{"key":"4088_CR41","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1016\/j.jcmg.2011.05.004","volume":"4","author":"MD Hope","year":"2011","unstructured":"Hope, M. D., T. A. Hope, S. E. S. Crook, K. G. Ordovas, T. H. Urbania, M. T. Alley, and C. B. Higgins. 4D flow CMR in assessment of valve-related ascending aortic disease. JACC Cardiovasc. Imaging. 4:781\u2013787, 2011. https:\/\/doi.org\/10.1016\/j.jcmg.2011.05.004.","journal-title":"JACC Cardiovasc. Imaging"},{"key":"4088_CR42","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.jcmg.2021.09.023","volume":"15","author":"A Guala","year":"2022","unstructured":"Guala, A., L. Dux-Santoy, G. Teixido-Tura, A. Ruiz-Mu\u00f1oz, L. Galian-Gay, M. L. Servato, F. Valente, L. Guti\u00e9rrez, T. Gonz\u00e1lez-Alujas, K. M. Johnson, O. Wieben, G. Casas-Masnou, A. S. Avil\u00e9s, R. Fernandez-Galera, I. Ferreira-Gonzalez, A. Evangelista, and J. F. Rodr\u00edguez-Palomares. Wall shear stress predicts aortic dilation in patients with bicuspid aortic valve. JACC Cardiovasc. Imaging. 15:46\u201356, 2022. https:\/\/doi.org\/10.1016\/j.jcmg.2021.09.023.","journal-title":"JACC Cardiovasc. Imaging"},{"key":"4088_CR43","doi-asserted-by":"publisher","first-page":"1680","DOI":"10.1093\/ehjci\/jeab290","volume":"23","author":"SCS Minderhoud","year":"2022","unstructured":"Minderhoud, S. C. S., J. W. Roos-Hesselink, R. G. Chelu, L. R. Bons, A. T. van den Hoven, S.-A. Korteland, A. E. van den Bosch, R. P. J. Budde, J. J. Wentzel, and A. Hirsch. Wall shear stress angle is associated with aortic growth in bicuspid aortic valve patients. Eur. Heart J. Cardiovasc. Imaging. 23:1680\u20131689, 2022. https:\/\/doi.org\/10.1093\/ehjci\/jeab290.","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"4088_CR44","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1161\/CIRCIMAGING.113.000528","volume":"6","author":"MM Bissell","year":"2013","unstructured":"Bissell, M. M., A. T. Hess, L. Biasiolli, S. J. Glaze, M. Loudon, A. Pitcher, A. Davis, B. Prendergast, M. Markl, A. J. Barker, S. Neubauer, and S. G. Myerson. Aortic dilation in bicuspid aortic valve disease. Circ. Cardiovasc. Imaging. 6:499\u2013507, 2013. https:\/\/doi.org\/10.1161\/CIRCIMAGING.113.000528.","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"4088_CR45","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/s12968-018-0451-1","volume":"20","author":"JF Rodr\u00edguez-Palomares","year":"2018","unstructured":"Rodr\u00edguez-Palomares, J. F., L. Dux-Santoy, A. Guala, R. Kale, G. Maldonado, G. Teixid\u00f3-Tur\u00e0, L. Galian, M. Huguet, F. Valente, L. Guti\u00e9rrez, T. Gonz\u00e1lez-Alujas, K. M. Johnson, O. Wieben, D. Garc\u00eda-Dorado, and A. Evangelista. Aortic flow patterns and wall shear stress maps by 4D-flow cardiovascular magnetic resonance in the assessment of aortic dilatation in bicuspid aortic valve disease. J. Cardiovasc. Magnet. Reson. 20:28, 2018. https:\/\/doi.org\/10.1186\/s12968-018-0451-1.","journal-title":"J. Cardiovasc. Magnet. Reson."},{"key":"4088_CR46","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s12968-018-0431-5","volume":"20","author":"MM Bissell","year":"2018","unstructured":"Bissell, M. M., M. Loudon, A. T. Hess, V. Stoll, E. Orchard, S. Neubauer, and S. G. Myerson. Differential flow improvements after valve replacements in bicuspid aortic valve disease: a cardiovascular magnetic resonance assessment. J. Cardiovasc. Magn. Reson. 20:10, 2018. https:\/\/doi.org\/10.1186\/s12968-018-0431-5.","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"4088_CR47","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.70064","author":"K Hattori","year":"2025","unstructured":"Hattori, K., N. Nakama, J. Takada, M. Nagao, Y. Goto, H. Niinami, and K. Iwasaki. In vitro characterization of hemodynamics in bicuspid aortic valves: the impact of valve and ascending aortic morphologies. Magn. Reson. Med. 2025. https:\/\/doi.org\/10.1002\/mrm.70064.","journal-title":"Magn. Reson. Med."},{"key":"4088_CR48","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.2514\/3.25224","volume":"28","author":"Y Levy","year":"1990","unstructured":"Levy, Y., D. Degani, and A. Seginer. Graphical visualization of vortical flows by means of helicity. AIAA J. 28:1347\u20131352, 1990. https:\/\/doi.org\/10.2514\/3.25224.","journal-title":"AIAA J."},{"key":"4088_CR49","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1017\/S0022112069000991","volume":"35","author":"HK Moffatt","year":"1969","unstructured":"Moffatt, H. K. The degree of knottedness of tangled vortex lines. J. Fluid Mech. 35:117\u2013129, 1969. https:\/\/doi.org\/10.1017\/S0022112069000991.","journal-title":"J. Fluid Mech."},{"key":"4088_CR50","doi-asserted-by":"publisher","first-page":"914","DOI":"10.1016\/j.amjcard.2014.06.024","volume":"114","author":"L Campens","year":"2014","unstructured":"Campens, L., L. Demulier, K. De Groote, K. Vandekerckhove, D. De Wolf, M. J. Roman, R. B. Devereux, A. De Paepe, and J. De Backer. Reference values for echocardiographic assessment of the diameter of the aortic root and ascending aorta spanning all age categories. Am. J. Cardiol. 114:914\u2013920, 2014. https:\/\/doi.org\/10.1016\/j.amjcard.2014.06.024.","journal-title":"Am. J. Cardiol."},{"key":"4088_CR51","doi-asserted-by":"publisher","first-page":"1329","DOI":"10.1002\/mrm.21763","volume":"60","author":"KM Johnson","year":"2008","unstructured":"Johnson, K. M., D. P. Lum, P. A. Turski, W. F. Block, C. A. Mistretta, and O. Wieben. Improved 3D phase contrast MRI with off-resonance corrected dual echo VIPR. Magn. Reson. Med. 60:1329\u20131336, 2008. https:\/\/doi.org\/10.1002\/mrm.21763.","journal-title":"Magn. Reson. Med."},{"key":"4088_CR52","doi-asserted-by":"publisher","first-page":"1407","DOI":"10.1093\/ehjci\/jez046","volume":"20","author":"L Dux-Santoy","year":"2019","unstructured":"Dux-Santoy, L., A. Guala, G. Teixid\u00f3-Tur\u00e0, A. Ruiz-Mu\u00f1oz, G. Maldonado, N. Villalva, L. Galian, F. Valente, L. Guti\u00e9rrez, T. Gonz\u00e1lez-Alujas, A. Sao-Avil\u00e9s, K. M. Johnson, O. Wieben, M. Huguet, D. Garc\u00eda-Dorado, A. Evangelista, and J. F. Rodr\u00edguez-Palomares. Increased rotational flow in the proximal aortic arch is associated with its dilation in bicuspid aortic valve disease. Eur. Heart J. Cardiovasc. Imaging. 20:1407\u20131417, 2019. https:\/\/doi.org\/10.1093\/ehjci\/jez046.","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"4088_CR53","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1109\/TBME.2022.3209736","volume":"70","author":"K Cal\u00f2","year":"2023","unstructured":"Cal\u00f2, K., D. Gallo, A. Guala, M. L. Rizzini, L. Dux-Santoy, J. Rodriguez-Palomares, S. Scarsoglio, L. Ridolfi, and U. Morbiducci. Network-based characterization of blood large-scale coherent motion in the healthy human aorta with 4D flow MRI. IEEE Trans. Biomed. Eng. 70:1095\u20131104, 2023. https:\/\/doi.org\/10.1109\/TBME.2022.3209736.","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"4088_CR54","doi-asserted-by":"publisher","first-page":"1226","DOI":"10.1002\/jmri.22800","volume":"34","author":"M Sigovan","year":"2011","unstructured":"Sigovan, M., M. D. Hope, P. Dyverfeldt, and D. Saloner. Comparison of four-dimensional flow parameters for quantification of flow eccentricity in the ascending aorta. J. Magn. Reson. Imaging. 34:1226\u20131230, 2011. https:\/\/doi.org\/10.1002\/jmri.22800.","journal-title":"J. Magn. Reson. Imaging"},{"key":"4088_CR55","doi-asserted-by":"publisher","first-page":"28","DOI":"10.3390\/jpm10020028","volume":"10","author":"F Cosentino","year":"2020","unstructured":"Cosentino, F., G. M. Raffa, G. Gentile, V. Agnese, D. Bellavia, M. Pilato, and S. Pasta. Statistical shape analysis of ascending thoracic aortic aneurysm: correlation between shape and biomechanical descriptors. J. Pers. Med. 10:28, 2020. https:\/\/doi.org\/10.3390\/jpm10020028.","journal-title":"J. Pers. Med."},{"key":"4088_CR56","doi-asserted-by":"publisher","first-page":"1122","DOI":"10.1007\/s00330-011-2353-6","volume":"22","author":"A Frydrychowicz","year":"2012","unstructured":"Frydrychowicz, A., A. Berger, A. M. Del Rio, M. F. Russe, J. Bock, A. Harloff, and M. Markl. Interdependencies of aortic arch secondary flow patterns, geometry, and age analysed by 4-dimensional phase contrast magnetic resonance imaging at 3 Tesla. Eur. Radiol. 22:1122\u20131130, 2012. https:\/\/doi.org\/10.1007\/s00330-011-2353-6.","journal-title":"Eur. Radiol."},{"key":"4088_CR57","doi-asserted-by":"publisher","first-page":"3538","DOI":"10.1093\/eurheartj\/ehae179","volume":"45","author":"L Mazzolai","year":"2024","unstructured":"Mazzolai, L., et al. 2024 ESC Guidelines for the management of peripheral arterial and aortic diseases. Eur. Heart J. 45:3538\u20133700, 2024. https:\/\/doi.org\/10.1093\/eurheartj\/ehae179.","journal-title":"Eur. Heart J."},{"key":"4088_CR58","doi-asserted-by":"publisher","first-page":"2441","DOI":"10.1007\/s10439-021-02798-9","volume":"49","author":"K Cal\u00f2","year":"2021","unstructured":"Cal\u00f2, K., D. Gallo, A. Guala, J. R. Palomares, S. Scarsoglio, L. Ridolfi, and U. Morbiducci. Combining 4D flow MRI and complex networks theory to characterize the hemodynamic heterogeneity in dilated and non-dilated human ascending aortas. Ann. Biomed. Eng. 49:2441\u20132453, 2021. https:\/\/doi.org\/10.1007\/s10439-021-02798-9.","journal-title":"Ann. Biomed. Eng."},{"key":"4088_CR59","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1007\/s10439-014-1119-0","volume":"43","author":"D Gallo","year":"2015","unstructured":"Gallo, D., D. A. Steinman, and U. Morbiducci. An insight into the mechanistic role of the common carotid artery on the hemodynamics at the carotid bifurcation. Ann. Biomed. Eng. 43:68\u201381, 2015. https:\/\/doi.org\/10.1007\/s10439-014-1119-0.","journal-title":"Ann. Biomed. Eng."},{"key":"4088_CR60","volume-title":"Kendall\u2019s Advanced Theory of Statistics, Vol. 2A, Chapter 28","author":"A Stuart","year":"2004","unstructured":"Stuart, A., K. Ord, and S. Arnold. Kendall\u2019s Advanced Theory of Statistics, Vol. 2A, Chapter 28, 6th ed. New York: Oxford University Press, 2004.","edition":"6"},{"key":"4088_CR61","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1001\/archinte.1916.00080130010002","volume":"XVII","author":"D Du Bois","year":"1916","unstructured":"Du Bois, D. A formula to estimate the approx-imate surface area if height and weight be known. Arch. Intern. Med. XVII:863\u2013871, 1916.","journal-title":"Arch. Intern. Med."},{"key":"4088_CR62","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1093\/ejcts\/ezt526","volume":"45","author":"E Semaan","year":"2014","unstructured":"Semaan, E., M. Markl, S. C. Malaisrie, A. Barker, B. Allen, P. McCarthy, J. C. Carr, and J. D. Collins. Haemodynamic outcome at four-dimensional flow magnetic resonance imaging following valve-sparing aortic root replacement with tricuspid and bicuspid valve morphology. Eur. J. Cardio-Thoracic Surg. 45:818\u2013825, 2014. https:\/\/doi.org\/10.1093\/ejcts\/ezt526.","journal-title":"Eur. J. Cardio-Thoracic Surg."},{"key":"4088_CR63","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1093\/ehjci\/jew149","volume":"17","author":"S Schnell","year":"2016","unstructured":"Schnell, S., D. A. Smith, A. J. Barker, P. Entezari, A. R. Honarmand, M. L. Carr, S. C. Malaisrie, P. M. McCarthy, J. Collins, J. C. Carr, and M. Markl. Altered aortic shape in bicuspid aortic valve relatives influences blood flow patterns. Eur. Heart J. Cardiovasc. Imaging. 17:1239\u20131247, 2016. https:\/\/doi.org\/10.1093\/ehjci\/jew149.","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"4088_CR64","doi-asserted-by":"publisher","first-page":"8597","DOI":"10.1007\/s00330-022-08866-5","volume":"32","author":"S Ebel","year":"2022","unstructured":"Ebel, S., A. K\u00fchn, A. Aggarwal, B. K\u00f6hler, B. Behrendt, R. Gohmann, B. Riekena, C. L\u00fccke, J. Ziegert, C. Vogtmann, B. Preim, S. Kropf, B. Jung, T. Denecke, M. Grothoff, and M. Gutberlet. Quantitative normal values of helical flow, flow jets and wall shear stress of healthy volunteers in the ascending aorta. Eur. Radiol. 32:8597\u20138607, 2022. https:\/\/doi.org\/10.1007\/s00330-022-08866-5.","journal-title":"Eur. Radiol."},{"key":"4088_CR65","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1002\/jmri.26210","volume":"49","author":"FM Callaghan","year":"2019","unstructured":"Callaghan, F. M., P. Bannon, E. Barin, D. Celemajer, R. Jeremy, G. Figtree, and S. M. Grieve. Age-related changes of shape and flow dynamics in healthy adult aortas: a 4D flow MRI study. J. Magn. Reson. Imaging. 49:90\u2013100, 2019. https:\/\/doi.org\/10.1002\/jmri.26210.","journal-title":"J. Magn. Reson. Imaging"},{"key":"4088_CR66","doi-asserted-by":"publisher","first-page":"101083","DOI":"10.1016\/j.jocmr.2024.101083","volume":"26","author":"MJ Ramaekers","year":"2024","unstructured":"Ramaekers, M. J., B. J. Te Kiefte, B. P. Adriaans, J. F. Juffermans, H. C. van Assen, B. Winkens, J. E. Wildberger, H. J. Lamb, S. Schalla, and J. J. M. Westenberg. Comprehensive sex-specific and age-dependent analysis of four-dimensional flow cardiovascular magnetic resonance assessed aortic blood flow-related parameters in normal subjects using single-vendor magnetic resonance systems and single-vendor software. J. Cardiovasc. Magn. Reson. 26:101083, 2024. https:\/\/doi.org\/10.1016\/j.jocmr.2024.101083.","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"4088_CR67","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1016\/j.jbiomech.2011.01.024","volume":"44","author":"X Liu","year":"2011","unstructured":"Liu, X., Y. Fan, X. Deng, and F. Zhan. Effect of non-Newtonian and pulsatile blood flow on mass transport in the human aorta. J. Biomech. 44:1123\u20131131, 2011. https:\/\/doi.org\/10.1016\/j.jbiomech.2011.01.024.","journal-title":"J. Biomech."},{"key":"4088_CR68","doi-asserted-by":"publisher","first-page":"1760","DOI":"10.1007\/s10439-012-0527-2","volume":"40","author":"N Saikrishnan","year":"2012","unstructured":"Saikrishnan, N., C.-H. Yap, N. C. Milligan, N. V. Vasilyev, and A. P. Yoganathan. In vitro characterization of bicuspid aortic valve hemodynamics using particle image velocimetry. Ann. Biomed. Eng. 40:1760\u20131775, 2012. https:\/\/doi.org\/10.1007\/s10439-012-0527-2.","journal-title":"Ann. Biomed. Eng."},{"key":"4088_CR69","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijengsci.2022.103702","volume":"177","author":"D Gallo","year":"2022","unstructured":"Gallo, D., U. Morbiducci, and M. D. de Tullio. On the unexplored relationship between kinetic energy and helicity in prosthetic heart valves hemodynamics. Int. J. Eng. Sci.177:103702, 2022. https:\/\/doi.org\/10.1016\/j.ijengsci.2022.103702.","journal-title":"Int. J. Eng. Sci."},{"key":"4088_CR70","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1016\/j.jacc.2012.01.072","volume":"60","author":"MD Hope","year":"2012","unstructured":"Hope, M. D., J. Wrenn, M. Sigovan, E. Foster, E. E. Tseng, and D. Saloner. Imaging biomarkers of aortic disease. J. Am. Coll. Cardiol. 60:356\u2013357, 2012. https:\/\/doi.org\/10.1016\/j.jacc.2012.01.072.","journal-title":"J. Am. Coll. Cardiol."},{"key":"4088_CR71","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1161\/CIRCIMAGING.112.973370","volume":"5","author":"AJ Barker","year":"2012","unstructured":"Barker, A. J., M. Markl, J. B\u00fcrk, R. Lorenz, J. Bock, S. Bauer, J. Schulz-Menger, and F. von Knobelsdorff-Brenkenhoff. Bicuspid aortic valve is associated with altered wall shear stress in the ascending aorta. Circ. Cardiovasc. Imaging. 5:457\u2013466, 2012. https:\/\/doi.org\/10.1161\/CIRCIMAGING.112.973370.","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"4088_CR72","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1148\/radiol.2019190411","volume":"293","author":"MSM Elbaz","year":"2019","unstructured":"Elbaz, M. S. M., M. B. Scott, A. J. Barker, P. McCarthy, C. Malaisrie, J. D. Collins, R. O. Bonow, J. Carr, and M. Markl. Four-dimensional virtual catheter: noninvasive assessment of intra-aortic hemodynamics in bicuspid aortic valve disease. Radiology. 293:541\u2013550, 2019. https:\/\/doi.org\/10.1148\/radiol.2019190411.","journal-title":"Radiology"},{"key":"4088_CR73","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2025.1576072","author":"M Yang","year":"2025","unstructured":"Yang, M., Z. Nie, H. Yue, W. Liang, and Z. Wu. Aortopathy associated with bicuspid aortic valve: advances in clinical and hemodynamics research. Front. Physiol. 2025. https:\/\/doi.org\/10.3389\/fphys.2025.1576072.","journal-title":"Front. Physiol."},{"key":"4088_CR74","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1016\/j.jacc.2015.06.1310","volume":"66","author":"DG Guzzardi","year":"2015","unstructured":"Guzzardi, D. G., A. J. Barker, P. van Ooij, S. C. Malaisrie, J. J. Puthumana, D. D. Belke, H. E. M. Mewhort, D. A. Svystonyuk, S. Kang, S. Verma, J. Collins, J. Carr, R. O. Bonow, M. Markl, J. D. Thomas, P. M. McCarthy, and P. W. M. Fedak. Valve-related hemodynamics mediate human bicuspid aortopathy: insights from wall shear stress mapping. J. Am. Coll. Cardiol. 66:892\u2013900, 2015. https:\/\/doi.org\/10.1016\/j.jacc.2015.06.1310.","journal-title":"J. Am. Coll. Cardiol."},{"key":"4088_CR75","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1016\/j.jacc.2022.10.042","volume":"82","author":"JF Rodr\u00edguez-Palomares","year":"2023","unstructured":"Rodr\u00edguez-Palomares, J. F., L. Dux-Santoy, A. Guala, L. Galian-Gay, and A. Evangelista. Mechanisms of aortic dilation in patients with bicuspid aortic valve. J. Am. Coll. Cardiol. 82:448\u2013464, 2023. https:\/\/doi.org\/10.1016\/j.jacc.2022.10.042.","journal-title":"J. Am. Coll. Cardiol."},{"key":"4088_CR76","doi-asserted-by":"publisher","first-page":"251","DOI":"10.3390\/fluids10100251","volume":"10","author":"F Galbiati","year":"2025","unstructured":"Galbiati, F., K. Capellini, E. Vignali, C. Angeletti, F. R. Parente, M. Cioffi, S. Avril, E. Costa, and S. Celi. Assessment of the combined effects of valve phenotype and aneurysm progression on ascending thoracic aortic hemodynamics. Fluids. 10:251, 2025. https:\/\/doi.org\/10.3390\/fluids10100251.","journal-title":"Fluids"},{"key":"4088_CR77","doi-asserted-by":"publisher","unstructured":"Guala, A., J. Rodriguez-Palomares, L. Dux-Santoy, G. Teixido-Tura, G. Maldonado, L. Galian, M. Huguet, F. Valente, L. Guti\u00e9rrez, T. Gonz\u00e1lez-Alujas, K. M. Johnson, O. Wieben, A. Sao Avil\u00e9s, D. Garcia-Dorado, and A. Evangelista. Influence of aortic dilation on the regional aortic stiffness of bicuspid aortic valve assessed by 4-dimensional flow cardiac magnetic resonance. JACC Cardiovasc. Imaging. 12:1020\u20131029, 2019. https:\/\/doi.org\/10.1016\/j.jcmg.2018.03.017","DOI":"10.1016\/j.jcmg.2018.03.017"},{"key":"4088_CR78","doi-asserted-by":"publisher","first-page":"988","DOI":"10.1002\/jmri.22519","volume":"33","author":"M Markl","year":"2011","unstructured":"Markl, M., W. Wallis, and A. Harloff. Reproducibility of flow and wall shear stress analysis using flow-sensitive four-dimensional MRI. J. Magn. Reson. Imaging. 33:988\u2013994, 2011. https:\/\/doi.org\/10.1002\/jmri.22519.","journal-title":"J. Magn. Reson. Imaging"},{"key":"4088_CR79","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1002\/jmri.25773","volume":"47","author":"J Garcia","year":"2018","unstructured":"Garcia, J., R. L. F. van der Palen, E. Bollache, K. Jarvis, M. J. Rose, A. J. Barker, J. D. Collins, J. C. Carr, J. Robinson, C. K. Rigsby, and M. Markl. Distribution of blood flow velocity in the normal aorta: effect of age and gender. J. Magn. Reson. Imaging. 47:487\u2013498, 2018. https:\/\/doi.org\/10.1002\/jmri.25773.","journal-title":"J. Magn. Reson. Imaging"},{"key":"4088_CR80","doi-asserted-by":"publisher","first-page":"3912","DOI":"10.3390\/app12083912","volume":"12","author":"JF Juffermans","year":"2022","unstructured":"Juffermans, J. F., H. C. van Assen, B. J. C. te Kiefte, M. J. F. G. Ramaekers, R. L. F. van der Palen, P. van den Boogaard, B. P. Adriaans, J. E. Wildberger, I. A. Dekkers, A. J. H. A. Scholte, S. Schalla, H. J. Lamb, and J. J. M. Westenberg. 4D flow MRI in ascending aortic aneurysms: reproducibility of hemodynamic parameters. Appl. Sci. 12:3912, 2022. https:\/\/doi.org\/10.3390\/app12083912.","journal-title":"Appl. Sci."},{"key":"4088_CR81","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1002\/jmri.27804","volume":"55","author":"A Demir","year":"2022","unstructured":"Demir, A., S. Wiesemann, J. Erley, S. Schmitter, R. F. Trauzeddel, B. Pieske, J. Hansmann, S. Kelle, and J. Schulz-Menger. Traveling volunteers: a multi-vendor, multi-center study on reproducibility and comparability of 4D flow derived aortic hemodynamics in cardiovascular magnetic resonance. J. Magn. Reson. Imaging. 55:211\u2013222, 2022. https:\/\/doi.org\/10.1002\/jmri.27804.","journal-title":"J. Magn. Reson. Imaging"},{"key":"4088_CR82","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1002\/jmri.24560","volume":"41","author":"WV Potters","year":"2015","unstructured":"Potters, W. V., P. Ooij, H. Marquering, E. Bavel, and A. J. Nederveen. Volumetric arterial wall shear stress calculation based on cine phase contrast MRI. J. Magn. Reson. Imaging. 41:505\u2013516, 2015. https:\/\/doi.org\/10.1002\/jmri.24560.","journal-title":"J. Magn. Reson. Imaging"},{"key":"4088_CR83","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1002\/jmri.26007","volume":"48","author":"J Zimmermann","year":"2018","unstructured":"Zimmermann, J., D. Demedts, H. Mirzaee, P. Ewert, H. Stern, C. Meierhofer, B. Menze, and A. Hennemuth. Wall shear stress estimation in the aorta: impact of wall motion, spatiotemporal resolution, and phase noise. J. Magn. Reson. Imaging. 48:718\u2013728, 2018. https:\/\/doi.org\/10.1002\/jmri.26007.","journal-title":"J. Magn. Reson. Imaging"}],"container-title":["Annals of Biomedical Engineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10439-026-04088-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10439-026-04088-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10439-026-04088-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T13:54:04Z","timestamp":1792763644000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10439-026-04088-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,7]]},"references-count":83,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["4088"],"URL":"https:\/\/doi.org\/10.1007\/s10439-026-04088-8","relation":{},"ISSN":["0090-6964","1573-9686"],"issn-type":[{"value":"0090-6964","type":"print"},{"value":"1573-9686","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,7]]},"assertion":[{"value":"25 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All participants recruitment and research procedures adhered to the principles of the Declaration of Helsinki. The study protocol was approved by the Ethics Committee of the Vall d\u2019Hebron Hospital (Approval n\u00b0 PR(AG)363\/2016) and written informed consent was obtained from all participants.","order":2,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}