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Ramaekers MJFG, van der Vlugt IB, Westenberg JJM, Perinajová R, Lamb HJ, Wildberger JE, Kenjereš S, Schalla S. Flow patterns in ascending aortic aneurysms: Determining the role of hypertension using phase contrast magnetic resonance and computational fluid dynamics. Comput Biol Med 2024; 172:108310. [PMID: 38508054 DOI: 10.1016/j.compbiomed.2024.108310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 02/22/2024] [Accepted: 03/12/2024] [Indexed: 03/22/2024]
Abstract
Thoracic aortic aneurysm (TAA) is a local dilation of the thoracic aorta. Although universally used, aneurysm diameter alone is a poor predictor of major complications such as rupture. There is a need for better biomarkers for risk assessment that also reflect the aberrant flow patterns found in TAAs. Furthermore, hypertension is often present in TAA patients and may play a role in progression of aneurysm. The exact relation between TAAs and hypertension is poorly understood. This study aims to create a numerical model of hypertension in the aorta by using computational fluid dynamics. First, a normotensive state was simulated in which flow and resistance were kept unaltered. Second, a hypertensive state was modeled in which blood inflow was increased by 30%. Third, a hypertensive state was modeled in which the proximal and peripheral resistances and capacitance parameters from the three-element Windkessel boundary condition were adjusted to mimic an increase in resistance of the rest of the cardiovascular system. One patient with degenerative TAA and one healthy control were successfully simulated at hypertensive states and were extensively analyzed. Furthermore, three additional TAA patients and controls were simulated to validate our method. Hemodynamic variables such as wall shear stress, oscillatory shear index, endothelial cell activation potential (ECAP), vorticity and helicity were studied to gain more insight on the effects of hypertension on flow patterns in TAAs. By comparing a TAA patient and a control at normotensive state at peak-systole, helicity and vorticity were found to be lower in the TAA patient throughout the entire domain. No major changes in flow and flow derived quantities were observed for the TAA patient and control when resistance was increased. When flow rate was increased, regions with high ECAP values were found to reduce in TAA patients in the aneurysm region which could reduce the risk of thrombogenesis. Thus, it may be important to assess cardiac output in patients with TAA.
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Affiliation(s)
- M J F G Ramaekers
- Departments of Cardiology and Radiology and Nuclear Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - I B van der Vlugt
- Department of Chemical Engineering, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - J J M Westenberg
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - R Perinajová
- Department of Chemical Engineering, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands; J.M. Burgerscentrum Research School for Fluid Mechanics, Delft, The Netherlands
| | - H J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - J E Wildberger
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - S Kenjereš
- Department of Chemical Engineering, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands; J.M. Burgerscentrum Research School for Fluid Mechanics, Delft, The Netherlands.
| | - S Schalla
- Departments of Cardiology and Radiology and Nuclear Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
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Ramaekers MJFG, Westenberg JJM, Venner MFGHM, Juffermans JF, van Assen HC, Te Kiefte BJC, Adriaans BP, Lamb HJ, Wildberger JE, Schalla S. Evaluating a Phase-Specific Approach to Aortic Flow: A 4D Flow MRI Study. J Magn Reson Imaging 2024; 59:1056-1067. [PMID: 37309838 DOI: 10.1002/jmri.28852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 05/25/2023] [Accepted: 05/27/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Aortic flow parameters can be quantified using 4D flow MRI. However, data are sparse on how different methods of analysis influence these parameters and how these parameters evolve during systole. PURPOSE To assess multiphase segmentations and multiphase quantification of flow-related parameters in aortic 4D flow MRI. STUDY TYPE Prospective. POPULATION 40 healthy volunteers (50% male, 28.9 ± 5.0 years) and 10 patients with thoracic aortic aneurysm (80% male, 54 ± 8 years). FIELD STRENGTH/SEQUENCE 4D flow MRI with a velocity encoded turbo field echo sequence at 3 T. ASSESSMENT Phase-specific segmentations were obtained for the aortic root and the ascending aorta. The whole aorta was segmented in peak systole. In all aortic segments, time to peak (TTP; for flow velocity, vorticity, helicity, kinetic energy, and viscous energy loss) and peak and time-averaged values (for velocity and vorticity) were calculated. STATISTICAL TESTS Static vs. phase-specific models were assessed using Bland-Altman plots. Other analyses were performed using phase-specific segmentations for aortic root and ascending aorta. TTP for all parameters was compared to TTP of flow rate using paired t-tests. Time-averaged and peak values were assessed using Pearson correlation coefficient. P < 0.05 was considered statistically significant. RESULTS In the combined group, velocity in static vs. phase-specific segmentations differed by 0.8 cm/sec for the aortic root, and 0.1 cm/sec (P = 0.214) for the ascending aorta. Vorticity differed by 167 sec-1 mL-1 (P = 0.468) for the aortic root, and by 59 sec-1 mL-1 (P = 0.481) for the ascending aorta. Vorticity, helicity, and energy loss in the ascending aorta, aortic arch, and descending aorta peaked significantly later than flow rate. Time-averaged velocity and vorticity values correlated significantly in all segments. DATA CONCLUSION Static 4D flow MRI segmentation yields comparable results as multiphase segmentation for flow-related parameters, eliminating the need for time-consuming multiple segmentations. However, multiphase quantification is necessary for assessing peak values of aortic flow-related parameters. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY STAGE: 3.
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Affiliation(s)
- Mitch J F G Ramaekers
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
- Department of Cardiology, Maastricht University Medical Center+, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jos J M Westenberg
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Max F G H M Venner
- Department of Cardiology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Joe F Juffermans
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Hans C van Assen
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Bouke P Adriaans
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
- Department of Cardiology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Joachim E Wildberger
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - Simon Schalla
- Department of Cardiology, Maastricht University Medical Center+, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
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Zeng W, Weng C, Yuan D, Wang T, Huang B, Zhao J, Xia C, Li Z, Wang J. Multimodality magnetic resonance evaluating the effect of enhanced physical exercise on the growth rate, flow haemodynamics, aneurysm wall and ventricular-aortic coupling of patients with small abdominal aortic aneurysms (AAA MOVE trial): a study protocol for an open-label randomised controlled trial. BMJ Open 2024; 14:e080073. [PMID: 38355193 PMCID: PMC10868247 DOI: 10.1136/bmjopen-2023-080073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/24/2024] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION The best lifestyle for small abdominal aortic aneurysms (sAAA) is essential for its conservative management. Physical exercise can improve the cardiopulmonary function of the patients, but it remains unclear which specific type of exercise is most beneficial for individuals with sAAA. The current study was designed to investigate the effect of physician-guided enhanced physical exercise programme on the aorto-cardiac haemodynamic environment, aneurysm sac wall, cardiac function and growth rate of sAAA by multimodality MRI. METHODS AND ANALYSIS AAA MOVE study is a prospective, parallel, equivalence, randomised controlled trial. Eligible individuals will be recruited if they are diagnosed with sAAA (focal dilation of abdominal aorta with maximum diameter <5 cm), without contraindication for MRI scanning, or severe heart failure, or uncontrolled arrhythmia. Participants will be randomly allocated to intervention group (physician-guided enhanced physical exercise programme: mainly aerobic training) and control group (standard clinical care) separately in a 1:1 ratio. The primary outcome is 12-month growth rate of sAAA. The first set of secondary outcomes involve multimodality MRI parameters covering flow haemodynamics, aortic wall inflammation and cardiac function. The other secondary outcome (safety end point) is a composite of exercise-related injury, aneurysm rupture and aneurysm intervention. Follow-up will be conducted at 6 and 12 months after intervention. ETHICS AND DISSEMINATION This study was approved by the Ethics Committee on Biomedical Research of West China Hospital (approval number: 2023-783) on 16 June 2023. Main findings from the trial will be disseminated through presentations at conferences, peer-reviewed publications and directly pushed to smartphone of participants. TRIAL REGISTRATION NUMBER ChiCTR2300073334.
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Affiliation(s)
- Wen Zeng
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chengxin Weng
- Division of vascular surgery, Department of general surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ding Yuan
- Division of vascular surgery, Department of general surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tiehao Wang
- Division of vascular surgery, Department of general surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bin Huang
- Division of vascular surgery, Department of general surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jichun Zhao
- Division of vascular surgery, Department of general surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chunchao Xia
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhenlin Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiarong Wang
- Division of vascular surgery, Department of general surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Ebel S, Köhler B, Aggarwal A, Preim B, Behrendt B, Jung B, Gohmann RF, Riekena B, Borger M, Lurz P, Denecke T, Grothoff M, Gutberlet M. Comparison of aortic blood flow rotational direction in healthy volunteers and patients with bicuspid aortic valves using volumetric velocity-sensitive cardiovascular magnetic resonance imaging. Quant Imaging Med Surg 2023; 13:7973-7986. [PMID: 38106267 PMCID: PMC10722022 DOI: 10.21037/qims-23-183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/13/2023] [Indexed: 12/19/2023]
Abstract
Background The rotational direction (RD) of helical blood flow can be classified as either a clockwise (RD+) or counter-clockwise (RD-) flow. We hypothesized that this simple classification might not be sufficient for analysis in vivo and a simultaneous existence of RD+/- may occur. We utilized volumetric velocity-sensitive cardiovascular magnetic resonance imaging (4D flow MRI) to analyze rotational blood flow in the thoracic aorta. Methods Forty volunteers (22 females; mean age, 41±16 years) and seventeen patients with bicuspid aortic valves (BAVs) (9 females; mean age, 42±14 years) were prospectively included. The RDs and the calculation of the rotating blood volumes (RBVs) in the thoracic aorta were performed using a pathline-projection strategy. Results We could confirm a mainly clockwise RD in the ascending, descending aorta and in the aortic arch. Furthermore, we found a simultaneous existence of RD+/RD-. The RD+/--volume in the ascending aorta was significantly higher in BAV patients, the mean RD+/RD- percentage was approximately 80%/20% vs. 60%/40% in volunteers (P<0.01). The maximum RBV always occurred during systole. There was significantly more clockwise than counter-clockwise rotational flow in the ascending aorta (P<0.01) and the aortic arch (P<0.01), but no significant differences in the descending aorta (P=0.48). Conclusions A simultaneous occurrence of RD+/RD- indicates that a simple categorization in either of both is insufficient to describe blood flow in vivo. Rotational flow in the ascending aorta and in the aortic arch differs significantly from flow in the descending aorta. BAV patients show significantly more clockwise rotating volume in the ascending aorta compared to healthy volunteers.
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Affiliation(s)
- Sebastian Ebel
- Department of Diagnostic and Interventional Radiology, University of Leipzig – Heart Centre, Leipzig, Germany
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | - Benjamin Köhler
- Department of Simulation and Graphics, University of Magdeburg, Magdeburg, Germany
| | | | - Bernhard Preim
- Department of Simulation and Graphics, University of Magdeburg, Magdeburg, Germany
| | - Benjamin Behrendt
- Department of Simulation and Graphics, University of Magdeburg, Magdeburg, Germany
| | - Bernd Jung
- Department of Diagnostic, Interventional and Paediatric Radiology, University of Bern, Bern, Switzerland
| | - Robin F. Gohmann
- Department of Diagnostic and Interventional Radiology, University of Leipzig – Heart Centre, Leipzig, Germany
| | - Boris Riekena
- Department of Diagnostic and Interventional Radiology, University of Leipzig – Heart Centre, Leipzig, Germany
| | - Michael Borger
- Department of Cardiac Surgery, University Leipzig – Heart Centre, Leipzig, Germany
| | - Philipp Lurz
- Department of Cardiology, University Leipzig – Heart Centre, Leipzig, Germany
| | - Timm Denecke
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | - Matthias Grothoff
- Department of Diagnostic and Interventional Radiology, University of Leipzig – Heart Centre, Leipzig, Germany
| | - Matthias Gutberlet
- Department of Diagnostic and Interventional Radiology, University of Leipzig – Heart Centre, Leipzig, Germany
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Rizzo M, Ait-Ali L, Federici D, Festa P, Piagneri V, Landra F, Cameli M, Montesi G. Surgical repair of partial anomalous pulmonary venous connection in adulthood: A 4-dimensional flow magnetic resonance imaging postoperative evaluation. JTCVS Tech 2023; 22:208-211. [PMID: 38152192 PMCID: PMC10750877 DOI: 10.1016/j.xjtc.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/23/2023] [Accepted: 09/16/2023] [Indexed: 12/29/2023] Open
Affiliation(s)
- Martina Rizzo
- Cardiac Surgery Unit, Department of Thoracic and Cardiovascular Disease, Santa Maria alle Scotte Hospital, University of Siena, Siena, Italy
| | - Lamia Ait-Ali
- Institute of Clinical Physiology, CNR, Monasterio Foundation, Massa, Italy
| | - Duccio Federici
- Paediatric Cardiac Surgery and GUCH Unit, Heart Hospital, Monasterio Foundation, Massa, Italy
| | - Pierluigi Festa
- Paediatric Cardiology and GUCH Unit, Heart Hospital, Monasterio Foundation, Massa, Italy
| | - Valeria Piagneri
- Diagnostic Imaging Unit, Heart Hospital, Monasterio Foundation, Massa, Italy
| | - Federico Landra
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Matteo Cameli
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Gianfranco Montesi
- Cardiac Surgery Unit, Department of Thoracic and Cardiovascular Disease, Santa Maria alle Scotte Hospital, Siena, Italy
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Zhao X, Garg P, Assadi H, Tan RS, Chai P, Yeo TJ, Matthews G, Mehmood Z, Leng S, Bryant JA, Teo LLS, Ong CC, Yip JW, Tan JL, van der Geest RJ, Zhong L. Aortic flow is associated with aging and exercise capacity. EUROPEAN HEART JOURNAL OPEN 2023; 3:oead079. [PMID: 37635784 PMCID: PMC10460199 DOI: 10.1093/ehjopen/oead079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 07/02/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023]
Abstract
Aims Increased blood flow eccentricity in the aorta has been associated with aortic (AO) pathology, however, its association with exercise capacity has not been investigated. This study aimed to assess the relationships between flow eccentricity parameters derived from 2-dimensional (2D) phase-contrast (PC) cardiovascular magnetic resonance (CMR) imaging and aging and cardiopulmonary exercise test (CPET) in a cohort of healthy subjects. Methods and Results One hundred and sixty-nine healthy subjects (age 44 ± 13 years, M/F: 96/73) free of cardiovascular disease were recruited in a prospective study (NCT03217240) and underwent CMR, including 2D PC at an orthogonal plane just above the sinotubular junction, and CPET (cycle ergometer) within one week. The following AO flow parameters were derived: AO forward and backward flow indexed to body surface area (FFi, BFi), average flow displacement during systole (FDsavg), late systole (FDlsavg), diastole (FDdavg), systolic retrograde flow (SRF), systolic flow reversal ratio (sFRR), and pulse wave velocity (PWV). Exercise capacity was assessed by peak oxygen uptake (PVO2) from CPET. The mean values of FDsavg, FDlsavg, FDdavg, SRF, sFRR, and PWV were 17 ± 6%, 19 ± 8%, 29 ± 7%, 4.4 ± 4.2 mL, 5.9 ± 5.1%, and 4.3 ± 1.6 m/s, respectively. They all increased with age (r = 0.623, 0.628, 0.353, 0.590, 0.649, 0.598, all P < 0.0001), and decreased with PVO2 (r = -0.302, -0.270, -0.253, -0.149, -0.219, -0.161, all P < 0.05). A stepwise multivariable linear regression analysis using left ventricular ejection fraction (LVEF), FFi, and FDsavg showed an area under the curve of 0.769 in differentiating healthy subjects with high-risk exercise capacity (PVO2 ≤ 14 mL/kg/min). Conclusion AO flow haemodynamics change with aging and predict exercise capacity. Registration NCT03217240.
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Affiliation(s)
- Xiaodan Zhao
- National Heart Research Institute Singapore, National Heart Centre
Singapore, 5 Hospital Drive, 169609 Singapore,
Singapore
| | - Pankaj Garg
- Cardiology Department, Norfolk and Norwich University Hospitals NHS
Foundation Trust,Colney Ln, Norwich, NR4 7UY Norfolk, UK
- Department of Cardiovascular and Metabolic Health, Norwich Medical School,
University of East Anglia, Rosalind Franklin Rd, Norwich, NR4
7UQ Norfolk, UK
| | - Hosamadin Assadi
- Cardiology Department, Norfolk and Norwich University Hospitals NHS
Foundation Trust,Colney Ln, Norwich, NR4 7UY Norfolk, UK
- Department of Cardiovascular and Metabolic Health, Norwich Medical School,
University of East Anglia, Rosalind Franklin Rd, Norwich, NR4
7UQ Norfolk, UK
| | - Ru-San Tan
- National Heart Research Institute Singapore, National Heart Centre
Singapore, 5 Hospital Drive, 169609 Singapore,
Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road,
169857 Singapore, Singapore
| | - Ping Chai
- Department of Diagnostic Imaging, National University Hospital
Singapore, 5 Lower Kent Ridge Road, 119074
Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of
Singapore, 10 Medical Drive, 117597 Singapore,
Singapore
| | - Tee Joo Yeo
- Department of Diagnostic Imaging, National University Hospital
Singapore, 5 Lower Kent Ridge Road, 119074
Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of
Singapore, 10 Medical Drive, 117597 Singapore,
Singapore
| | - Gareth Matthews
- Cardiology Department, Norfolk and Norwich University Hospitals NHS
Foundation Trust,Colney Ln, Norwich, NR4 7UY Norfolk, UK
- Department of Cardiovascular and Metabolic Health, Norwich Medical School,
University of East Anglia, Rosalind Franklin Rd, Norwich, NR4
7UQ Norfolk, UK
| | - Zia Mehmood
- Cardiology Department, Norfolk and Norwich University Hospitals NHS
Foundation Trust,Colney Ln, Norwich, NR4 7UY Norfolk, UK
- Department of Cardiovascular and Metabolic Health, Norwich Medical School,
University of East Anglia, Rosalind Franklin Rd, Norwich, NR4
7UQ Norfolk, UK
| | - Shuang Leng
- National Heart Research Institute Singapore, National Heart Centre
Singapore, 5 Hospital Drive, 169609 Singapore,
Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road,
169857 Singapore, Singapore
| | - Jennifer Ann Bryant
- National Heart Research Institute Singapore, National Heart Centre
Singapore, 5 Hospital Drive, 169609 Singapore,
Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road,
169857 Singapore, Singapore
| | - Lynette L S Teo
- Department of Diagnostic Imaging, National University Hospital
Singapore, 5 Lower Kent Ridge Road, 119074
Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of
Singapore, 10 Medical Drive, 117597 Singapore,
Singapore
| | - Ching Ching Ong
- Department of Diagnostic Imaging, National University Hospital
Singapore, 5 Lower Kent Ridge Road, 119074
Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of
Singapore, 10 Medical Drive, 117597 Singapore,
Singapore
| | - James W Yip
- Department of Diagnostic Imaging, National University Hospital
Singapore, 5 Lower Kent Ridge Road, 119074
Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of
Singapore, 10 Medical Drive, 117597 Singapore,
Singapore
| | - Ju Le Tan
- National Heart Research Institute Singapore, National Heart Centre
Singapore, 5 Hospital Drive, 169609 Singapore,
Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road,
169857 Singapore, Singapore
| | - Rob J van der Geest
- Department of Radiology, Leiden University Medical Center,
Albinusdreef 2, 2333 ZA Leiden, TheNetherlands
| | - Liang Zhong
- National Heart Research Institute Singapore, National Heart Centre
Singapore, 5 Hospital Drive, 169609 Singapore,
Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road,
169857 Singapore, Singapore
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Loose S, Solou D, Strecker C, Hennemuth A, Hüllebrand M, Grundmann S, Asmussen A, Treppner M, Urbach H, Harloff A. Characterization of aortic aging using 3D multi-parametric MRI-long-term follow-up in a population study. Sci Rep 2023; 13:6285. [PMID: 37072440 PMCID: PMC10111081 DOI: 10.1038/s41598-023-33219-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/10/2023] [Indexed: 05/03/2023] Open
Abstract
We comprehensively studied morphological and functional aortic aging in a population study using modern three-dimensional MR imaging to allow future comparison in patients with diseases of the aortic valve or aorta. We followed 80 of 126 subjects of a population study (20 to 80 years of age at baseline) using the identical methodology 6.0 ± 0.5 years later. All underwent 3 T MRI of the thoracic aorta including 3D T1 weighted MRI (spatial resolution 1 mm3) for measuring aortic diameter and plaque thickness and 4D flow MRI (spatial/temporal resolution = 2 mm3/20 ms) for calculating global and regional aortic pulse wave velocity (PWV) and helicity of aortic blood flow. Mean diameter of the ascending aorta (AAo) decreased and plaque thickness increased significantly in the aortic arch (AA) and descending aorta (DAo) in females. PWV of the thoracic aorta increased (6.4 ± 1.5 to 7.0 ± 1.7 m/s and 6.8 ± 1.5 to 7.3 ± 1.8 m/s in females and males, respectively) over time. Local normalized helicity volumes (LNHV) decreased significantly in the AAo and AA (0.33 to 0.31 and 0.34 to 0.32 in females and 0.34 to 0.32 and 0.32 to 0.28 in males). By contrast, helicity increased significantly in the DAo in both genders (0.28 to 0.29 and 0.29 to 0.30, respectively). 3D MRI was able to characterize changes in aortic diameter, plaque thickness, PWV and helicity during six years in our population. Aortic aging determined by 3D multi-parametric MRI is now available for future comparisons in patients with diseases of the aortic valve or aorta.
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Affiliation(s)
- Sophie Loose
- Department of Neurology and Neurophysiology, University Medical Center Freiburg, University of Freiburg, Breisacher Straße 64, 79106, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Demetris Solou
- Department of Neurology and Neurophysiology, University Medical Center Freiburg, University of Freiburg, Breisacher Straße 64, 79106, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Strecker
- Department of Neurology and Neurophysiology, University Medical Center Freiburg, University of Freiburg, Breisacher Straße 64, 79106, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anja Hennemuth
- Fraunhofer MEVIS, Bremen, Germany
- Institute of Computer-Assisted Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Markus Hüllebrand
- Fraunhofer MEVIS, Bremen, Germany
- Institute of Computer-Assisted Cardiovascular Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sebastian Grundmann
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Cardiology and Angiology I, Heart Center Freiburg University, University of Freiburg, Freiburg, Germany
| | - Alexander Asmussen
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Cardiology and Angiology I, Heart Center Freiburg University, University of Freiburg, Freiburg, Germany
| | - Martin Treppner
- Institute of Medical Biometry and Statistics, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Horst Urbach
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Neuroradiology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Andreas Harloff
- Department of Neurology and Neurophysiology, University Medical Center Freiburg, University of Freiburg, Breisacher Straße 64, 79106, Freiburg, Germany.
- Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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