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Zeng W, Wang J, Weng C, Peng W, Wang T, Yuan D, Huang B, Zhao J, Xia C, Li Z, Guo Y. Assessment of aortic hemodynamics in patients with thoracoabdominal aortic aneurysm using four-dimensional magnetic resonance imaging: a cross-sectional study. Quant Imaging Med Surg 2024; 14:2800-2815. [PMID: 38617138 PMCID: PMC11007523 DOI: 10.21037/qims-23-1321] [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: 09/17/2023] [Accepted: 02/19/2024] [Indexed: 04/16/2024]
Abstract
Background Thoracoabdominal aortic aneurysms (TAAAs) are rare but complicated aortic pathologies that can result in high morbidity and mortality. The whole-aorta hemodynamic characteristics of TAAA survivors remains unknown. This study sought to obtain a comprehensive view of flow hemodynamics of the whole aorta in patients with TAAA using four-dimensional flow (4D flow) magnetic resonance imaging (MRI). Methods This study included patients who had experienced TAAA or abdominal aortic aneurysm (AAA) and age- and sex-matched volunteers who had attended China Hospital from December 2021 to December 2022 in West. Patients with unstable ruptured aneurysm or other cardiovascular diseases were excluded. 4D-flow MRI that covered the whole aorta was acquired. Both planar parameters [(regurgitation fraction (RF), peak systolic velocity (Vmax), overall wall shear stress (WSS)] and segmental parameters [pulse wave velocity (PWV) and viscous energy loss (VEL)] were generated during postprocessing. The Student's t-test or Mann-Whitney test was used to compare flow dynamics among the three groups. Results A total of 11 patients with TAAA (mean age 53.2±11.9 years; 10 males), 19 patients with AAA (mean age 58.0±11.7 years; 16 males), and 21 controls (mean age 55.4±15.0 years; 19 males) were analyzed. The patients with TAAA demonstrated a significantly higher RF and lower Vmax in the aortic arch compared to healthy controls. The whole length of the aorta in patients with TAAA was characterized by lower WSS, predominantly in the planes of pulmonary artery bifurcation and the middle infrarenal planes (all P values <0.001). As for segmental hemodynamics, compared to controls, patients with TAAA had a significantly higher PWV in the thoracic aorta (TAAA: median 11.41 m/s, IQR 9.56-14.32 m/s; control: median 7.21 m/s, IQR 5.57-7.79 m/s; P<0.001) as did those with AAA (AAA: median 8.75 m/s, IQR 7.35-10.75 m/s; control: median 7.21 m/s, IQR 5.57-7.79 m/s; P=0.024). Moreover, a greater VEL was observed in the whole aorta and abdominal aorta in patients with TAAA. Conclusions Patients with TAAA exhibited a stiffer aortic wall with a lower WSS and a greater VEL for the whole aorta, which was accompanied by a higher RF and lower peak velocity in the dilated portion of the aorta.
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Affiliation(s)
- Wen Zeng
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Jiarong Wang
- Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Chengxin Weng
- Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Wanlin Peng
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Tiehao Wang
- Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Ding Yuan
- Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Bin Huang
- Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jichun Zhao
- Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Chunchao Xia
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhenlin Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yingkun Guo
- Department of Radiology, Development and Related Diseases of Women and Children Key Laboratory of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, China
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Lindenberger M, Ziegler M, Bjarnegård N, Ebbers T, Dyverfeldt P. Regional and Global Aortic Pulse Wave Velocity in Patients with Abdominal Aortic Aneurysm. Eur J Vasc Endovasc Surg 2024; 67:506-513. [PMID: 37777048 DOI: 10.1016/j.ejvs.2023.09.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/22/2023] [Accepted: 09/22/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVE Abdominal aortic aneurysm (AAA) is commonly defined as localised aortic dilatation with a diameter > 30 mm. The pathophysiology of AAA includes chronic inflammation and enzymatic degradation of elastin, possibly increasing aortic wall stiffness and pulse wave velocity (PWV). Whether aortic stiffness is more prominent in the abdominal aorta at the aneurysm site is not elucidated. The aim of this study was to evaluate global and regional aortic PWV in patients with AAA. METHODS Experimental study of local PWV in the thoracic descending and abdominal aorta in patients with AAA and matched controls. The study cohort comprised 25 patients with an AAA > 30 mm (range 36 - 70 mm, all male, age range 65 - 76 years) and 27 age and sex matched controls free of AAA. PWV was measured with applanation tonometry (carotid-femoral PWV, cfPWV) as well as a 4D flow MRI technique, assessing regional aortic PWV. Blood pressure and anthropometrics were measured. RESULTS Global aortic PWV was greater in men with an AAA than controls, both by MRI (AAA 8.9 ± 2.4 m/s vs. controls 7.1 ± 1.5 m/s; p = .007) and cfPWV (AAA 11.0 ± 2.1 m/s vs. controls 9.3 ± 2.3 m/s; p = .007). Regionally, PWV was greater in the abdominal aorta in the AAA group (AAA 7.0 ± 1.8 m/s vs. controls 5.8 ± 1.0 m/s; p = .022), but similar in the thoracic descending aorta (AAA 8.7 ± 3.2 m/s vs. controls 8.2 ± 2.4 m/s; p = .59). Furthermore, PWV was positively associated with indices of central adiposity both in men with AAA and controls. CONCLUSION PWV is higher in men with AAA compared with matched controls in the abdominal but not the thoracic descending aorta. Furthermore, aortic stiffness was linked with central fat deposition. It remains to be seen whether there is a causal link between AAA and increased regional aortic stiffness.
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Affiliation(s)
- Marcus Lindenberger
- Department of Cardiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - Magnus Ziegler
- Cardiovascular Sciences, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Centre for Medical Image Science and Visualisation (CMIV), Linköping University, Linköping, Sweden
| | - Niclas Bjarnegård
- Cardiovascular Sciences, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Tino Ebbers
- Cardiovascular Sciences, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Centre for Medical Image Science and Visualisation (CMIV), Linköping University, Linköping, Sweden
| | - Petter Dyverfeldt
- Cardiovascular Sciences, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Centre for Medical Image Science and Visualisation (CMIV), Linköping University, Linköping, Sweden
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Bouaou K, Dietenbeck T, Soulat G, Bargiotas I, Houriez-Gombaud-Saintonge S, De Cesare A, Gencer U, Giron A, Jiménez E, Messas E, Lucor D, Bollache E, Mousseaux E, Kachenoura N. Four-dimensional flow cardiovascular magnetic resonance aortic cross-sectional pressure changes and their associations with flow patterns in health and ascending thoracic aortic aneurysm. J Cardiovasc Magn Reson 2024; 26:101030. [PMID: 38403074 PMCID: PMC10950879 DOI: 10.1016/j.jocmr.2024.101030] [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: 12/01/2023] [Accepted: 02/20/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Ascending thoracic aortic aneurysm (ATAA) is a silent and threatening dilation of the ascending aorta (AscAo). Maximal aortic diameter which is currently used for ATAA patients management and surgery planning has been shown to inadequately characterize risk of dissection in a large proportion of patients. Our aim was to propose a comprehensive quantitative evaluation of aortic morphology and pressure-flow-wall associations from four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) data in healthy aging and in patients with ATAA. METHODS We studied 17 ATAA patients (64.7 ± 14.3 years, 5 females) along with 17 age- and sex-matched healthy controls (59.7 ± 13.3 years, 5 females) and 13 younger healthy subjects (33.5 ± 11.1 years, 4 females). All subjects underwent a CMR exam, including 4D flow and three-dimensional anatomical images of the aorta. This latter dataset was used for aortic morphology measurements, including AscAo maximal diameter (iDMAX) and volume, indexed to body surface area. 4D flow MRI data were used to estimate 1) cross-sectional local AscAo spatial (∆PS) and temporal (∆PT) pressure changes as well as the distance (∆DPS) and time duration (∆TPT) between local pressure peaks, 2) AscAo maximal wall shear stress (WSSMAX) at peak systole, and 3) AscAo flow vorticity amplitude (VMAX), duration (VFWHM), and eccentricity (VECC). RESULTS Consistency of flow and pressure indices was demonstrated through their significant associations with AscAo iDMAX (WSSMAX:r = -0.49, p < 0.001; VECC:r = -0.29, p = 0.045; VFWHM:r = 0.48, p < 0.001; ∆DPS:r = 0.37, p = 0.010; ∆TPT:r = -0.52, p < 0.001) and indexed volume (WSSMAX:r = -0.63, VECC:r = -0.51, VFWHM:r = 0.53, ∆DPS:r = 0.54, ∆TPT:r = -0.63, p < 0.001 for all). Intra-AscAo cross-sectional pressure difference, ∆PS, was significantly and positively associated with both VMAX (r = 0.55, p = 0.002) and WSSMAX (r = 0.59, p < 0.001) in the 30 healthy subjects (48.3 ± 18.0 years). Associations remained significant after adjustment for iDMAX, age, and systolic blood pressure. Superimposition of ATAA patients to normal aging trends between ∆PS and WSSMAX as well as VMAX allowed identifying patients with substantially high pressure differences concomitant with AscAo dilation. CONCLUSION Local variations in pressures within ascending aortic cross-sections derived from 4D flow MRI were associated with flow changes, as quantified by vorticity, and with stress exerted by blood on the aortic wall, as quantified by wall shear stress. Such flow-wall and pressure interactions might help for the identification of at-risk patients.
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Affiliation(s)
- Kevin Bouaou
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, Paris, France.
| | - Thomas Dietenbeck
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, Paris, France.
| | - Gilles Soulat
- Hôpital Européen Georges Pompidou, INSERM 970, Paris, France.
| | - Ioannis Bargiotas
- CMLA, ENS Cachan, CNRS, Université Paris-Saclay, 94235 Cachan, France.
| | | | - Alain De Cesare
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, Paris, France.
| | - Umit Gencer
- Hôpital Européen Georges Pompidou, INSERM 970, Paris, France.
| | - Alain Giron
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, Paris, France.
| | - Elena Jiménez
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, Paris, France.
| | - Emmanuel Messas
- Hôpital Européen Georges Pompidou, INSERM 970, Paris, France.
| | - Didier Lucor
- Université Paris-Saclay, CNRS, Laboratoire Interdisciplinaire des Sciences du Numérique, Orsay, France.
| | - Emilie Bollache
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, Paris, France.
| | - Elie Mousseaux
- Hôpital Européen Georges Pompidou, INSERM 970, Paris, France.
| | - Nadjia Kachenoura
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, Paris, France.
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Regnault V, Lacolley P, Laurent S. Arterial Stiffness: From Basic Primers to Integrative Physiology. Annu Rev Physiol 2024; 86:99-121. [PMID: 38345905 DOI: 10.1146/annurev-physiol-042022-031925] [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] [Indexed: 02/15/2024]
Abstract
The elastic properties of conductance arteries are one of the most important hemodynamic functions in the body, and data continue to emerge regarding the importance of their dysfunction in vascular aging and a range of cardiovascular diseases. Here, we provide new insight into the integrative physiology of arterial stiffening and its clinical consequence. We also comprehensively review progress made on pathways/molecules that appear today as important basic determinants of arterial stiffness, particularly those mediating the vascular smooth muscle cell (VSMC) contractility, plasticity and stiffness. We focus on membrane and nuclear mechanotransduction, clearance function of the vascular wall, phenotypic switching of VSMCs, immunoinflammatory stimuli and epigenetic mechanisms. Finally, we discuss the most important advances of the latest clinical studies that revisit the classical therapeutic concepts of arterial stiffness and lead to a patient-by-patient strategy according to cardiovascular risk exposure and underlying disease.
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Ma P, Zhu L, Wen R, Lv F, Li Y, Li X, Zhang Z. Revolutionizing vascular imaging: trends and future directions of 4D flow MRI based on a 20-year bibliometric analysis. Quant Imaging Med Surg 2024; 14:1873-1890. [PMID: 38415143 PMCID: PMC10895087 DOI: 10.21037/qims-23-1227] [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: 06/14/2023] [Accepted: 12/08/2023] [Indexed: 02/29/2024]
Abstract
Background Four-dimensional flow magnetic resonance imaging (4D flow MRI) is a promising new technology with potential clinical value in hemodynamic quantification. Although an increasing number of articles on 4D flow MRI have been published over the past decades, few studies have statistically analyzed these published articles. In this study, we aimed to perform a systematic and comprehensive bibliometric analysis of 4D flow MRI to explore the current hotspots and potential future directions. Methods The Web of Science Core Collection searched for literature on 4D flow MRI between 2003 and 2022. CiteSpace was utilized to analyze the literature data, including co-citation, cooperative network, cluster, and burst keyword analysis. Results A total of 1,069 articles were extracted for this study. The main research hotspots included the following: quantification and visualization of blood flow in different clinical settings, with keywords such as "cerebral aneurysm", "heart", "great vessel", "tetralogy of Fallot", "portal hypertension", and "stiffness"; optimization of image acquisition schemes, such as "resolution" and "reconstruction"; measurement and analysis of flow components and patterns, as indicated by keywords "pattern", "KE", "WSS", and "fluid dynamics". In addition, international consensus for metrics derived from 4D flow MRI and multimodality imaging may also be the future research direction. Conclusions The global domain of 4D flow MRI has grown over the last 2 decades. In the future, 4D flow MRI will evolve towards becoming a relatively short scan duration with adequate spatiotemporal resolution, expansion into the diagnosis and treatment of vascular disease in other related organs, and a shift in focus from vascular structure to function. In addition, artificial intelligence (AI) will assist in the clinical promotion and application of 4D flow MRI.
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Affiliation(s)
- Peisong Ma
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lishu Zhu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ru Wen
- Department of Radiology, Guizhou Provincial People Hospital, Guiyang, China
| | - Fajin Lv
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yongmei Li
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xinyou Li
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhiwei Zhang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Guo J, Bouaou K, Houriez-Gombaud-Saintonge S, Gueda M, Gencer U, Nguyen V, Charpentier E, Soulat G, Redheuil A, Mousseaux E, Kachenoura N, Dietenbeck T. Deep Learning-Based Analysis of Aortic Morphology From Three-Dimensional MRI. J Magn Reson Imaging 2024. [PMID: 38216546 DOI: 10.1002/jmri.29236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Quantification of aortic morphology plays an important role in the evaluation and follow-up assessment of patients with aortic diseases, but often requires labor-intensive and operator-dependent measurements. Automatic solutions would help enhance their quality and reproducibility. PURPOSE To design a deep learning (DL)-based automated approach for aortic landmarks and lumen detection derived from three-dimensional (3D) MRI. STUDY TYPE Retrospective. POPULATION Three hundred ninety-one individuals (female: 47%, age = 51.9 ± 18.4) from three sites, including healthy subjects and patients (hypertension, aortic dilation, Turner syndrome), randomly divided into training/validation/test datasets (N = 236/77/78). Twenty-five subjects were randomly selected and analyzed by three operators with different levels of expertise. FIELD STRENGTH/SEQUENCE 1.5-T and 3-T, 3D spoiled gradient-recalled or steady-state free precession sequences. ASSESSMENT Reinforcement learning and a two-stage network trained using reference landmarks and segmentation from an existing semi-automatic software were used for aortic landmark detection and segmentation from sinotubular junction to coeliac trunk. Aortic segments were defined using the detected landmarks while the aortic centerline was extracted from the segmentation and morphological indices (length, aortic diameter, and volume) were computed for both the reference and the proposed segmentations. STATISTICAL TESTS Segmentation: Dice similarity coefficient (DSC), Hausdorff distance (HD), average symmetrical surface distance (ASSD); landmark detection: Euclidian distance (ED); model robustness: Spearman correlation, Bland-Altman analysis, Kruskal-Wallis test for comparisons between reference and DL-derived aortic indices; inter-observer study: Williams index (WI). A WI 95% confidence interval (CI) lower bound >1 indicates that the method is within the inter-observer variability. A P-value <0.05 was considered statistically significant. RESULTS DSC was 0.90 ± 0.05, HD was 12.11 ± 7.79 mm, and ASSD was 1.07 ± 0.63 mm. ED was 5.0 ± 6.1 mm. A good agreement was found between all DL-derived and reference aortic indices (r >0.95, mean bias <7%). Our segmentation and landmark detection performances were within the inter-observer variability except the sinotubular junction landmark (CI = 0.96;1.04). DATA CONCLUSION A DL-based aortic segmentation and anatomical landmark detection approach was developed and applied to 3D MRI data for achieve aortic morphology evaluation. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Jia Guo
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale (LIB), Paris, France
- Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Kevin Bouaou
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale (LIB), Paris, France
- Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Sophia Houriez-Gombaud-Saintonge
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale (LIB), Paris, France
- Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
- ESME Sudria Research Lab, Paris, France
| | - Moussa Gueda
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale (LIB), Paris, France
- Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Umit Gencer
- Université de Paris Cité, PARCC, INSERM, Paris, France
- Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Vincent Nguyen
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale (LIB), Paris, France
- Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Etienne Charpentier
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale (LIB), Paris, France
- ESME Sudria Research Lab, Paris, France
- Imagerie Cardio-Thoracique (ICT), Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Gilles Soulat
- Université de Paris Cité, PARCC, INSERM, Paris, France
- Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Alban Redheuil
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale (LIB), Paris, France
- Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
- Imagerie Cardio-Thoracique (ICT), Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Elie Mousseaux
- Université de Paris Cité, PARCC, INSERM, Paris, France
- Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Nadjia Kachenoura
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale (LIB), Paris, France
- Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Thomas Dietenbeck
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale (LIB), Paris, France
- Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
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Park S, Kwon M, Nam H, Huh H. Interpolation time-optimized aortic pulse wave velocity estimation by 4D flow MRI. Sci Rep 2023; 13:16484. [PMID: 37777620 PMCID: PMC10542805 DOI: 10.1038/s41598-023-43799-z] [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: 01/31/2023] [Accepted: 09/28/2023] [Indexed: 10/02/2023] Open
Abstract
Four-dimensional flow magnetic resonance imaging-based pulse wave velocity (4D flow PWV) estimation is a promising tool for measuring regional aortic stiffness for non-invasive cardiovascular disease screening. However, the effect of variations in the shape of flow waveforms on 4D flow PWV measurements remains unclear. In this study, 4D flow PWV values were compared using cross-correlation algorithm with different interpolation times (iTs) based on flow rate and beat frequency. A critical iT (iTCrit) was proposed from in vitro study using flexible and stiff phantom models to simultaneously achieve a low difference and a low computation time. In vivo 4D flow PWV values from six healthy volunteers were also compared between iTCrit and the conventionally used interpolation time of 1 ms (iT1 ms). The results indicated that iTCrit reduced the mean difference of in vitro 4D flow PWV values by 19%, compared to iT1 ms. In addition, iTCrit measured in vivo 4D flow PWV, showing differences similar to those obtained with iT1 ms. A difference estimation model was proposed to retrospectively estimate potential differences of 4D flow PWV using known values of PWV and the used iT. This study would be helpful for understanding the differences of PWV generated by physiological changes and time step of obtained flow waveforms.
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Affiliation(s)
- Sungho Park
- Daegu-Gyeongbuk Medical Innovation Foundation, Medical Device Development Center, Daegu, 41061, South Korea
- Institute of Medical Devices, Kangwon National University, Chuncheon, South Korea
- Department of Radiology, Section of Pediatric Radiology, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Minseong Kwon
- Daegu-Gyeongbuk Medical Innovation Foundation, Medical Device Development Center, Daegu, 41061, South Korea
| | - Hyojin Nam
- Daegu-Gyeongbuk Medical Innovation Foundation, Medical Device Development Center, Daegu, 41061, South Korea
| | - Hyungkyu Huh
- Daegu-Gyeongbuk Medical Innovation Foundation, Medical Device Development Center, Daegu, 41061, South Korea.
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Dietenbeck T, Bouaou K, Houriez-Gombaud-Saintonge S, Guo J, Gencer U, Charpentier E, Giron A, De Cesare A, Nguyen V, Gallo A, Boussouar S, Pasi N, Soulat G, Redheuil A, Mousseaux E, Kachenoura N. Value of aortic volumes assessed by automated segmentation of 3D MRI data in patients with thoracic aortic dilatation: A case-control study. Diagn Interv Imaging 2023; 104:419-426. [PMID: 37105782 DOI: 10.1016/j.diii.2023.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 04/04/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE The purpose of this study was to investigate the benefit of aortic volumes compared to diameters or cross-sectional areas on three-dimensional (3D) magnetic resonance imaging (MRI) in discriminating between patients with dilated aorta and matched controls. MATERIALS AND METHODS Sixty-two patients (47 men and 15 women; median age, 66 years; age range: 33-86 years) with tricuspid aortic valve and ascending thoracic aorta aneurysm (TAV-ATAA) and 43 patients (35 men and 8 women; median age, 51 years; age range: 17-76 years) with bicuspid aortic valve and dilated ascending aorta (BAV) were studied. One group of 54 controls matched for age and sex to patients with TAV-ATAA (39 men and 15 women; median age, 68 years; age range: 33-81 years) and one group of 42 controls matched for age and sex to patients with BAV (34 men and 8 women; median age, 50 years; age range: 17-77 years) were identified. All participants underwent 3D MRI, used for 3D-segmentation for measuring aortic length, maximal diameter, maximal cross-sectional area (CSA) and volume for the ascending aorta. RESULTS An increase in ascending aorta volume (TAV-ATAA: +107%; BAV: +171% vs. controls; P < 0.001) was found, which was three times greater than the increase in diameter (TAV-ATAA: +29%; BAV: +40% vs. controls; P < 0.001). In differentiating patients with TAV-ATAA from their controls, the indexed ascending aorta volume showed better performances (AUC, 0.935 [95% confidence interval (CI): 0.882-0.989]; accuracy, 88.7% [95% CI: 82.9-94.5]) than indexed ascending aorta length (P < 0.001), indexed ascending aorta maximal diameter (P = 0.003) and indexed ascending aorta maximal CSA (P = 0.03). In differentiating patients with BAV from matched controls, indexed ascending aorta volume showed significantly better performances performance (AUC, 0.908 [95% CI: 0.829-0.987]; accuracy, 88.0% [95% CI: 80.9-95.0]) than indexed ascending aorta length (P = 0.02) and not different from indexed ascending aorta maximal diameter (P = 0.07) or from indexed ascending aorta maximal CSA (P = 0.27) CONCLUSION: Aortic volume measured by 3D-MRI integrates both elongation and luminal dilatation, resulting in greater classification performance than maximal diameter and length in differentiating patients with dilated ascending aorta or aneurysm from controls.
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Affiliation(s)
- Thomas Dietenbeck
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, 75006 Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), 75013 Paris, France.
| | - Kevin Bouaou
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, 75006 Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), 75013 Paris, France
| | - Sophia Houriez-Gombaud-Saintonge
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, 75006 Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), 75013 Paris, France; ESME Sudria Research Lab, 75006 Paris, France
| | - Jia Guo
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, 75006 Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), 75013 Paris, France
| | - Umit Gencer
- Université Paris Cité, PARCC, INSERM, 75015 Paris, France; Department of Radiology, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, 75015 Paris, France
| | - Etienne Charpentier
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, 75006 Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), 75013 Paris, France; Department of Cardiothoracic Imaging, Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, 75013 Paris, France
| | - Alain Giron
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, 75006 Paris, France
| | - Alain De Cesare
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, 75006 Paris, France
| | - Vincent Nguyen
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, 75006 Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), 75013 Paris, France
| | - Antonio Gallo
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, 75006 Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), 75013 Paris, France
| | - Samia Boussouar
- Department of Cardiothoracic Imaging, Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, 75013 Paris, France
| | - Nicoletta Pasi
- Department of Cardiothoracic Imaging, Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, 75013 Paris, France
| | - Gilles Soulat
- Université Paris Cité, PARCC, INSERM, 75015 Paris, France; Department of Radiology, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, 75015 Paris, France
| | - Alban Redheuil
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, 75006 Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), 75013 Paris, France; Department of Cardiothoracic Imaging, Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, 75013 Paris, France
| | - Elie Mousseaux
- Université Paris Cité, PARCC, INSERM, 75015 Paris, France; Department of Radiology, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, 75015 Paris, France
| | - Nadjia Kachenoura
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, 75006 Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), 75013 Paris, France
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9
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Ramaekers MJFG, Westenberg JJM, Adriaans BP, Nijssen EC, Wildberger JE, Lamb HJ, Schalla S. A clinician's guide to understanding aortic 4D flow MRI. Insights Imaging 2023; 14:114. [PMID: 37395817 DOI: 10.1186/s13244-023-01458-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 06/03/2023] [Indexed: 07/04/2023] Open
Abstract
Four-dimensional flow magnetic resonance imaging is an emerging technique which may play a role in diagnosis and risk-stratification of aortic disease. Some knowledge of flow dynamics and related parameters is necessary to understand and apply this technique in clinical workflows. The purpose of the current review is to provide a guide for clinicians to the basics of flow imaging, frequently used flow-related parameters, and their relevance in the context of aortic disease.Clinical relevance statement Understanding normal and abnormal aortic flow could improve clinical care in patients with aortic disease.
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Affiliation(s)
- Mitch J F G Ramaekers
- Department of Cardiology and Radiology and Nuclear Medicine, Maastricht University Medical Center +, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands.
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
| | - Jos J M Westenberg
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Bouke P Adriaans
- Department of Cardiology and Radiology and Nuclear Medicine, Maastricht University Medical Center +, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - Estelle C Nijssen
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center +, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Joachim E Wildberger
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center +, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Simon Schalla
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
- Department of Cardiology, Maastricht University Medical Center +, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
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10
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Nguyen LA, Houriez-Gombaud-Saintonge S, Puymirat E, Gencer U, Dietenbeck T, Bouaou K, De Cesare A, Bollache E, Mousseaux E, Kachenoura N, Soulat G. Aortic Stiffness Measured from Either 2D/4D Flow and Cine MRI or Applanation Tonometry in Coronary Artery Disease: A Case-Control Study. J Clin Med 2023; 12:jcm12113643. [PMID: 37297837 DOI: 10.3390/jcm12113643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/15/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Aortic stiffness can be evaluated by aortic distensibility or pulse wave velocity (PWV) using applanation tonometry, 2D phase contrast (PC) MRI and the emerging 4D flow MRI. However, such MRI tools may reach their technical limitations in populations with cardiovascular disease. Accordingly, this work focuses on the diagnostic value of aortic stiffness evaluated either by applanation tonometry or MRI in high-risk coronary artery disease (CAD) patients. METHODS 35 patients with a multivessel CAD and a myocardial infarction treated 1 year before were prospectively recruited and compared with 18 controls with equivalent age and sex distribution. Ascending aorta distensibility and aortic arch 2D PWV were estimated along with 4D PWV. Furthermore, applanation tonometry carotid-to-femoral PWV (cf PWV) was recorded immediately after MRI. RESULTS While no significant changes were found for aortic distensibility; cf PWV, 2D PWV and 4D PWV were significantly higher in CAD patients than controls (12.7 ± 2.9 vs. 9.6 ± 1.1; 11.0 ± 3.4 vs. 8.0 ± 2.05 and 17.3 ± 4.0 vs. 8.7 ± 2.5 m·s-1 respectively, p < 0.001). The receiver operating characteristic (ROC) analysis performed to assess the ability of stiffness indices to separate CAD subjects from controls revealed the highest area under the curve (AUC) for 4D PWV (0.97) with an optimal threshold of 12.9 m·s-1 (sensitivity of 88.6% and specificity of 94.4%). CONCLUSIONS PWV estimated from 4D flow MRI showed the best diagnostic performances in identifying severe stable CAD patients from age and sex-matched controls, as compared to 2D flow MRI PWV, cf PWV and aortic distensibility.
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Affiliation(s)
- Lan-Anh Nguyen
- Université Paris Cité, PARCC, INSERM, F-75015 Paris, France
| | | | - Etienne Puymirat
- Université Paris Cité, PARCC, INSERM, F-75015 Paris, France
- Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, F-75015 Paris, France
| | - Umit Gencer
- Université Paris Cité, PARCC, INSERM, F-75015 Paris, France
| | - Thomas Dietenbeck
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, INSERM, CNRS, F-75006 Paris, France
| | - Kevin Bouaou
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, INSERM, CNRS, F-75006 Paris, France
| | - Alain De Cesare
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, INSERM, CNRS, F-75006 Paris, France
| | - Emilie Bollache
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, INSERM, CNRS, F-75006 Paris, France
| | - Elie Mousseaux
- Université Paris Cité, PARCC, INSERM, F-75015 Paris, France
- Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, F-75015 Paris, France
| | - Nadjia Kachenoura
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, INSERM, CNRS, F-75006 Paris, France
| | - Gilles Soulat
- Université Paris Cité, PARCC, INSERM, F-75015 Paris, France
- Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, F-75015 Paris, France
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11
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Bianchini E, Lønnebakken MT, Wohlfahrt P, Piskin S, Terentes‐Printzios D, Alastruey J, Guala A. Magnetic Resonance Imaging and Computed Tomography for the Noninvasive Assessment of Arterial Aging: A Review by the VascAgeNet COST Action. J Am Heart Assoc 2023; 12:e027414. [PMID: 37183857 PMCID: PMC10227315 DOI: 10.1161/jaha.122.027414] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Magnetic resonance imaging and computed tomography allow the characterization of arterial state and function with high confidence and thus play a key role in the understanding of arterial aging and its translation into the clinic. Decades of research into the development of innovative imaging sequences and image analysis techniques have led to the identification of a large number of potential biomarkers, some bringing improvement in basic science, others in clinical practice. Nonetheless, the complexity of some of these biomarkers and the image analysis techniques required for their computation hamper their widespread use. In this narrative review, current biomarkers related to aging of the aorta, their founding principles, the sequence, and postprocessing required, and their predictive values for cardiovascular events are summarized. For each biomarker a summary of reference values and reproducibility studies and limitations is provided. The present review, developed in the COST Action VascAgeNet, aims to guide clinicians and technical researchers in the critical understanding of the possibilities offered by these advanced imaging modalities for studying the state and function of the aorta, and their possible clinically relevant relationships with aging.
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Affiliation(s)
| | - Mai Tone Lønnebakken
- Department of Clinical ScienceUniversity of BergenBergenNorway
- Department of Heart DiseaseHaukeland University HospitalBergenNorway
| | - Peter Wohlfahrt
- Department of Preventive CardiologyInstitute for Clinical and Experimental MedicinePragueCzech Republic
- Centre for Cardiovascular PreventionCharles University Medical School I and Thomayer HospitalPragueCzech Republic
- Department of Medicine IICharles University in Prague, First Faculty of MedicinePragueCzech Republic
| | - Senol Piskin
- Department of Mechanical Engineering, Faculty of Engineering and Natural SciencesIstinye UniversityIstanbulTurkey
- Modeling, Simulation and Extended Reality LaboratoryIstinye UniversityIstanbulTurkey
| | - Dimitrios Terentes‐Printzios
- First Department of Cardiology, Hippokration Hospital, Athens Medical SchoolNational and Kapodistrian University of AthensGreece
| | - Jordi Alastruey
- School of Biomedical Engineering and Imaging SciencesKing’s College LondonLondonUK
| | - Andrea Guala
- Vall d’Hebron Institut de Recerca (VHIR)BarcelonaSpain
- CIBER‐CV, Instituto de Salud Carlos IIIMadridSpain
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12
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Richards CE, Parker AE, Alfuhied A, McCann GP, Singh A. The role of 4-dimensional flow in the assessment of bicuspid aortic valve and its valvulo-aortopathies. Br J Radiol 2022; 95:20220123. [PMID: 35852109 PMCID: PMC9793489 DOI: 10.1259/bjr.20220123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Bicuspid aortic valve is the most common congenital cardiac malformation and the leading cause of aortopathy and aortic stenosis in younger patients. Aortic wall remodelling secondary to altered haemodynamic flow patterns, changes in peak velocity, and wall shear stress may be implicated in the development of aortopathy in the presence of bicuspid aortic valve and dysfunction. Assessment of these parameters as potential predictors of disease severity and progression is thus desirable. The anatomic and functional information acquired from 4D flow MRI can allow simultaneous visualisation and quantification of the pathological geometric and haemodynamic changes of the aorta. We review the current clinical utility of haemodynamic quantities including velocity, wall sheer stress and energy losses, as well as visual descriptors such as vorticity and helicity, and flow direction in assessing the aortic valve and associated aortopathies.
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Affiliation(s)
- Caryl Elizabeth Richards
- Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health Research Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Alex E Parker
- Leicester Medical School, University of Leicester, Leicester, UK
| | - Aseel Alfuhied
- Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health Research Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Gerry P McCann
- Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health Research Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Anvesha Singh
- Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health Research Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
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13
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Rabineau J, Issertine M, Hoffmann F, Gerlach D, Caiani EG, Haut B, van de Borne P, Tank J, Migeotte PF. Cardiovascular deconditioning and impact of artificial gravity during 60-day head-down bed rest—Insights from 4D flow cardiac MRI. Front Physiol 2022; 13:944587. [PMID: 36277205 PMCID: PMC9586290 DOI: 10.3389/fphys.2022.944587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 09/13/2022] [Indexed: 12/03/2022] Open
Abstract
Microgravity has deleterious effects on the cardiovascular system. We evaluated some parameters of blood flow and vascular stiffness during 60 days of simulated microgravity in head-down tilt (HDT) bed rest. We also tested the hypothesis that daily exposure to 30 min of artificial gravity (1 g) would mitigate these adaptations. 24 healthy subjects (8 women) were evenly distributed in three groups: continuous artificial gravity, intermittent artificial gravity, or control. 4D flow cardiac MRI was acquired in horizontal position before (−9 days), during (5, 21, and 56 days), and after (+4 days) the HDT period. The false discovery rate was set at 0.05. The results are presented as median (first quartile; third quartile). No group or group × time differences were observed so the groups were combined. At the end of the HDT phase, we reported a decrease in the stroke volume allocated to the lower body (−30% [−35%; −22%]) and the upper body (−20% [−30%; +11%]), but in different proportions, reflected by an increased share of blood flow towards the upper body. The aortic pulse wave velocity increased (+16% [+9%; +25%]), and so did other markers of arterial stiffness (CAVI; CAVI0). In males, the time-averaged wall shear stress decreased (−13% [−17%; −5%]) and the relative residence time increased (+14% [+5%; +21%]), while these changes were not observed among females. Most of these parameters tended to or returned to baseline after 4 days of recovery. The effects of the artificial gravity countermeasure were not visible. We recommend increasing the load factor, the time of exposure, or combining it with physical exercise. The changes in blood flow confirmed the different adaptations occurring in the upper and lower body, with a larger share of blood volume dedicated to the upper body during (simulated) microgravity. The aorta appeared stiffer during the HDT phase, however all the changes remained subclinical and probably the sole consequence of reversible functional changes caused by reduced blood flow. Interestingly, some wall shear stress markers were more stable in females than in males. No permanent cardiovascular adaptations following 60 days of HDT bed rest were observed.
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Affiliation(s)
- Jeremy Rabineau
- LPHYS, Département de Cardiologie, Université Libre de Bruxelles, Brussels, Belgium
- TIPs, École Polytechnique de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
- *Correspondence: Jeremy Rabineau,
| | - Margot Issertine
- LPHYS, Département de Cardiologie, Université Libre de Bruxelles, Brussels, Belgium
| | - Fabian Hoffmann
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Darius Gerlach
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Enrico G. Caiani
- Electronic, Information and Biomedical Engineering Department, Politecnico di Milano, Milan, Italy
| | - Benoit Haut
- TIPs, École Polytechnique de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Jens Tank
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
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14
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Jarvis K, Scott MB, Soulat G, Elbaz MSM, Barker AJ, Carr JC, Markl M, Ragin A. Aortic Pulse Wave Velocity Evaluated by 4D Flow MRI Across the Adult Lifespan. J Magn Reson Imaging 2022; 56:464-473. [PMID: 35001455 PMCID: PMC9387532 DOI: 10.1002/jmri.28045] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Evaluation of aortic stiffness by pulse wave velocity (PWV) across the adult lifespan is needed to better understand normal aging in women and men. PURPOSE To characterize PWV in the thoracic aorta using 4D flow MRI in an age- and sex-stratified cohort of healthy adults. STUDY TYPE Retrospective. POPULATION Ninety nine healthy participants (age: 46 ± 15 [19-79] years, 50% female), divided into young adults (<45 years) (N = 48), midlife (45-65 years) (N = 37), and later life (>65 years) (N = 14) groups. FIELD STRENGTH/SEQUENCE 1.5 T or 3 T, 2D cine bSSFP, 4D flow MRI. ASSESSMENT Cardiac functional parameters of end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and myocardial mass were assessed by 2D cine bSSFP. PWV and aortic blood flow velocity were assessed by 4D flow MRI. Reproducibility of PWV was evaluated in a subset of nine participants. STATISTICAL TESTS Analysis of variance, Pearson's correlation coefficient (r), linear regression, intraclass correlation coefficient (ICC). A P value < 0.05 was considered statistically significant. RESULTS PWV increased significantly with age (young adults: 5.4 ± 0.9 m/sec, midlife: 7.2 ± 1.1 m/sec, and later life: 9.4 ± 1.8 m/sec) (r = 0.79, slope = 0.09 m/sec/year). PWV did not differ in women and men in entire sample (P = 0.40) or within age groups (young adults: P = 0.83, midlife: P = 0.17, and later life: P = 0.96). PWV was significantly correlated with EDV (r = -0.29), ESV (r = -0.23), SV (r = -0.28), myocardial mass (r = 0.21), and mean aortic blood flow velocity (r = -0.62). In the test-retest subgroup (N = 9), PWV was 6.7 ± 1.5 [4.4-9.3] m/sec and ICC = 0.75. DATA CONCLUSION 4D flow MRI quantified higher aortic PWV with age, by approximately 1 m/sec per decade, and significant differences between young adults, midlife and later life. Reproducibility analysis showed good test-retest agreement. Increased PWV was associated with decline in cardiac function and reduced aortic blood flow velocity. This study demonstrates the utility of 4D flow MRI-derived aortic PWV for studying aging. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Kelly Jarvis
- Radiology, Northwestern University, Chicago, IL, USA
| | - Michael B. Scott
- Radiology, Northwestern University, Chicago, IL, USA
- Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Gilles Soulat
- Radiology, Northwestern University, Chicago, IL, USA
| | | | - Alex J Barker
- Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - James C. Carr
- Radiology, Northwestern University, Chicago, IL, USA
| | - Michael Markl
- Radiology, Northwestern University, Chicago, IL, USA
- Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Ann Ragin
- Radiology, Northwestern University, Chicago, IL, USA
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15
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Pugliese NR, Balletti A, Armenia S, De Biase N, Faita F, Mengozzi A, Paneni F, Ruschitzka F, Virdis A, Ghiadoni L, Taddei S, Williams B, Antonini-Canterin F, Masi S. Ventricular-Arterial Coupling Derived From Proximal Aortic Stiffness and Aerobic Capacity Across the Heart Failure Spectrum. JACC Cardiovasc Imaging 2022; 15:1545-1559. [DOI: 10.1016/j.jcmg.2022.03.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/28/2022] [Accepted: 03/25/2022] [Indexed: 12/27/2022]
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16
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Xu L, Zhou S, Wang L, Yao Y, Hao L, Qi L, Yao Y, Han H, Mukkamala R, Greenwald SE. Improving the accuracy and robustness of carotid-femoral pulse wave velocity measurement using a simplified tube-load model. Sci Rep 2022; 12:5147. [PMID: 35338246 PMCID: PMC8956634 DOI: 10.1038/s41598-022-09256-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/21/2022] [Indexed: 11/09/2022] Open
Abstract
Arterial stiffness, as measured by pulse wave velocity, for the early non-invasive screening of cardiovascular disease is becoming ever more widely used and is an independent prognostic indicator for a variety of pathologies including arteriosclerosis. Carotid-femoral pulse wave velocity (cfPWV) is regarded as the gold standard for aortic stiffness. Existing algorithms for cfPWV estimation have been shown to have good repeatability and accuracy, however, further assessment is needed, especially when signal quality is compromised. We propose a method for calculating cfPWV based on a simplified tube-load model, which allows for the propagation and reflection of the pulse wave. In-vivo cfPWV measurements from 57 subjects and numerical cfPWV data based on a one-dimensional model were used to assess the method and its performance was compared to three other existing approaches (waveform matching, intersecting tangent, and cross-correlation). The cfPWV calculated using the simplified tube-load model had better repeatability than the other methods (Intra-group Correlation Coefficient, ICC = 0.985). The model was also more accurate than other methods (deviation, 0.13 ms−1) and was more robust when dealing with noisy signals. We conclude that the determination of cfPWV based on the proposed model can accurately and robustly evaluate arterial stiffness.
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Affiliation(s)
- Lisheng Xu
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China. .,Engineering Research Center of Medical Imaging and Intelligent Analysis, Ministry of Education, Shenyang, China. .,Neusoft Research of Intelligent Healthcare Technology, Co. Ltd., Shenyang, China.
| | - Shuran Zhou
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Lu Wang
- School of Computer Science and Engineering, Northeastern University, Shenyang, China
| | - Yang Yao
- School of Information Science and Technology, ShanghaiTech University, Shanghai, China
| | - Liling Hao
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Lin Qi
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Yudong Yao
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Hongguang Han
- General Hospital of Northern Theater Command, Shenyang, China.
| | - Ramakrishna Mukkamala
- Department of Bioengineering, Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, USA
| | - Stephen E Greenwald
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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17
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Moore EE, Liu D, Li J, Schimmel SJ, Cambronero FE, Terry JG, Nair S, Pechman KR, Moore ME, Bell SP, Beckman JA, Gifford KA, Hohman TJ, Blennow K, Zetterberg H, Carr JJ, Jefferson AL. Association of Aortic Stiffness With Biomarkers of Neuroinflammation, Synaptic Dysfunction, and Neurodegeneration. Neurology 2021; 97:e329-e340. [PMID: 34031194 PMCID: PMC8362359 DOI: 10.1212/wnl.0000000000012257] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 04/21/2021] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES To test the hypothesis that increased aortic stiffening is associated with greater CSF evidence of core Alzheimer disease pathology (β-amyloid [Aβ], phosphorylated tau [p-tau]), neurodegeneration (total tau [t-tau]), synaptic dysfunction (neurogranin), neuroaxonal injury (neurofilament light [NFL]), and neuroinflammation (YKL-40, soluble triggering receptor expressed on myeloid cells 2 [sTREM2]), we analyzed pulse wave velocity (PWV) data and CSF data among older adults. METHODS Participants free of stroke and dementia from the Vanderbilt Memory and Aging Project, an observational community-based study, underwent cardiac magnetic resonance to assess aortic PWV (meters per second) and lumbar puncture to obtain CSF. Linear regressions related aortic PWV to CSF Aβ, p-tau, t-tau, neurogranin, NFL, YKL-40, and sTREM2 concentrations after adjustment for age, race/ethnicity, education, apolipoprotein (APOE) ε4 status, Framingham Stroke Risk Profile, and cognitive diagnosis. Models were repeated testing PWV interactions with age, diagnosis, APOE ε4, and hypertension on each biomarker. RESULTS One hundred forty-six participants were examined (age 72 ± 6 years). Aortic PWV interacted with age on p-tau (β = 0.31, p = 0.04), t-tau, (β = 2.67, p = 0.05), neurogranin (β = 0.94, p = 0.04), and sTREM2 (β = 20.4, p = 0.05). Among participants >73 years of age, higher aortic PWV related to higher p-tau (β = 2.4, p = 0.03), t-tau (β = 19.3, p = 0.05), neurogranin (β = 8.4, p = 0.01), and YKL-40 concentrations (β = 7,880, p = 0.005). Aortic PWV had modest interactions with diagnosis on neurogranin (β = -10.76, p = 0.03) and hypertension status on YKL-40 (β = 18,020, p < 0.001). CONCLUSIONS Among our oldest participants, ≥74 years of age, greater aortic stiffening is associated with in vivo biomarker evidence of neuroinflammation, tau phosphorylation, synaptic dysfunction, and neurodegeneration, but not amyloidosis. Central arterial stiffening may lead to cumulative cerebral microcirculatory damage and reduced blood flow delivery to tissue, resulting in neuroinflammation and neurodegeneration in more advanced age.
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Affiliation(s)
- Elizabeth E Moore
- From the Vanderbilt Memory & Alzheimer's Center (E.E.M., D.L., J.L., S.J.S., F.E.C., K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Department of Biostatistics (D.L.), Radiology & Radiological Sciences (J.G.T., S.N., J.J.C.), Department of Neurology (K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Division of Cardiovascular Medicine (S.P.B., J.A.B., A.L.J.), Department of Medicine, and Vanderbilt Genetics Institute (T.J.H.), Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Neurochemistry (K.B., H.Z.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Molndal, Sweden; Department of Neurodegenerative Disease (H.Z.), University College London Institute of Neurology, Queen Square; and United Kingdom Dementia Research Institute at University College London (H.Z.), UK
| | - Dandan Liu
- From the Vanderbilt Memory & Alzheimer's Center (E.E.M., D.L., J.L., S.J.S., F.E.C., K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Department of Biostatistics (D.L.), Radiology & Radiological Sciences (J.G.T., S.N., J.J.C.), Department of Neurology (K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Division of Cardiovascular Medicine (S.P.B., J.A.B., A.L.J.), Department of Medicine, and Vanderbilt Genetics Institute (T.J.H.), Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Neurochemistry (K.B., H.Z.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Molndal, Sweden; Department of Neurodegenerative Disease (H.Z.), University College London Institute of Neurology, Queen Square; and United Kingdom Dementia Research Institute at University College London (H.Z.), UK
| | - Judy Li
- From the Vanderbilt Memory & Alzheimer's Center (E.E.M., D.L., J.L., S.J.S., F.E.C., K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Department of Biostatistics (D.L.), Radiology & Radiological Sciences (J.G.T., S.N., J.J.C.), Department of Neurology (K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Division of Cardiovascular Medicine (S.P.B., J.A.B., A.L.J.), Department of Medicine, and Vanderbilt Genetics Institute (T.J.H.), Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Neurochemistry (K.B., H.Z.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Molndal, Sweden; Department of Neurodegenerative Disease (H.Z.), University College London Institute of Neurology, Queen Square; and United Kingdom Dementia Research Institute at University College London (H.Z.), UK
| | - Samantha J Schimmel
- From the Vanderbilt Memory & Alzheimer's Center (E.E.M., D.L., J.L., S.J.S., F.E.C., K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Department of Biostatistics (D.L.), Radiology & Radiological Sciences (J.G.T., S.N., J.J.C.), Department of Neurology (K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Division of Cardiovascular Medicine (S.P.B., J.A.B., A.L.J.), Department of Medicine, and Vanderbilt Genetics Institute (T.J.H.), Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Neurochemistry (K.B., H.Z.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Molndal, Sweden; Department of Neurodegenerative Disease (H.Z.), University College London Institute of Neurology, Queen Square; and United Kingdom Dementia Research Institute at University College London (H.Z.), UK
| | - Francis E Cambronero
- From the Vanderbilt Memory & Alzheimer's Center (E.E.M., D.L., J.L., S.J.S., F.E.C., K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Department of Biostatistics (D.L.), Radiology & Radiological Sciences (J.G.T., S.N., J.J.C.), Department of Neurology (K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Division of Cardiovascular Medicine (S.P.B., J.A.B., A.L.J.), Department of Medicine, and Vanderbilt Genetics Institute (T.J.H.), Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Neurochemistry (K.B., H.Z.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Molndal, Sweden; Department of Neurodegenerative Disease (H.Z.), University College London Institute of Neurology, Queen Square; and United Kingdom Dementia Research Institute at University College London (H.Z.), UK
| | - James G Terry
- From the Vanderbilt Memory & Alzheimer's Center (E.E.M., D.L., J.L., S.J.S., F.E.C., K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Department of Biostatistics (D.L.), Radiology & Radiological Sciences (J.G.T., S.N., J.J.C.), Department of Neurology (K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Division of Cardiovascular Medicine (S.P.B., J.A.B., A.L.J.), Department of Medicine, and Vanderbilt Genetics Institute (T.J.H.), Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Neurochemistry (K.B., H.Z.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Molndal, Sweden; Department of Neurodegenerative Disease (H.Z.), University College London Institute of Neurology, Queen Square; and United Kingdom Dementia Research Institute at University College London (H.Z.), UK
| | - Sangeeta Nair
- From the Vanderbilt Memory & Alzheimer's Center (E.E.M., D.L., J.L., S.J.S., F.E.C., K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Department of Biostatistics (D.L.), Radiology & Radiological Sciences (J.G.T., S.N., J.J.C.), Department of Neurology (K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Division of Cardiovascular Medicine (S.P.B., J.A.B., A.L.J.), Department of Medicine, and Vanderbilt Genetics Institute (T.J.H.), Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Neurochemistry (K.B., H.Z.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Molndal, Sweden; Department of Neurodegenerative Disease (H.Z.), University College London Institute of Neurology, Queen Square; and United Kingdom Dementia Research Institute at University College London (H.Z.), UK
| | - Kimberly R Pechman
- From the Vanderbilt Memory & Alzheimer's Center (E.E.M., D.L., J.L., S.J.S., F.E.C., K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Department of Biostatistics (D.L.), Radiology & Radiological Sciences (J.G.T., S.N., J.J.C.), Department of Neurology (K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Division of Cardiovascular Medicine (S.P.B., J.A.B., A.L.J.), Department of Medicine, and Vanderbilt Genetics Institute (T.J.H.), Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Neurochemistry (K.B., H.Z.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Molndal, Sweden; Department of Neurodegenerative Disease (H.Z.), University College London Institute of Neurology, Queen Square; and United Kingdom Dementia Research Institute at University College London (H.Z.), UK
| | - Marissa E Moore
- From the Vanderbilt Memory & Alzheimer's Center (E.E.M., D.L., J.L., S.J.S., F.E.C., K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Department of Biostatistics (D.L.), Radiology & Radiological Sciences (J.G.T., S.N., J.J.C.), Department of Neurology (K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Division of Cardiovascular Medicine (S.P.B., J.A.B., A.L.J.), Department of Medicine, and Vanderbilt Genetics Institute (T.J.H.), Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Neurochemistry (K.B., H.Z.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Molndal, Sweden; Department of Neurodegenerative Disease (H.Z.), University College London Institute of Neurology, Queen Square; and United Kingdom Dementia Research Institute at University College London (H.Z.), UK
| | - Susan P Bell
- From the Vanderbilt Memory & Alzheimer's Center (E.E.M., D.L., J.L., S.J.S., F.E.C., K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Department of Biostatistics (D.L.), Radiology & Radiological Sciences (J.G.T., S.N., J.J.C.), Department of Neurology (K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Division of Cardiovascular Medicine (S.P.B., J.A.B., A.L.J.), Department of Medicine, and Vanderbilt Genetics Institute (T.J.H.), Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Neurochemistry (K.B., H.Z.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Molndal, Sweden; Department of Neurodegenerative Disease (H.Z.), University College London Institute of Neurology, Queen Square; and United Kingdom Dementia Research Institute at University College London (H.Z.), UK
| | - Joshua A Beckman
- From the Vanderbilt Memory & Alzheimer's Center (E.E.M., D.L., J.L., S.J.S., F.E.C., K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Department of Biostatistics (D.L.), Radiology & Radiological Sciences (J.G.T., S.N., J.J.C.), Department of Neurology (K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Division of Cardiovascular Medicine (S.P.B., J.A.B., A.L.J.), Department of Medicine, and Vanderbilt Genetics Institute (T.J.H.), Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Neurochemistry (K.B., H.Z.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Molndal, Sweden; Department of Neurodegenerative Disease (H.Z.), University College London Institute of Neurology, Queen Square; and United Kingdom Dementia Research Institute at University College London (H.Z.), UK
| | - Katherine A Gifford
- From the Vanderbilt Memory & Alzheimer's Center (E.E.M., D.L., J.L., S.J.S., F.E.C., K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Department of Biostatistics (D.L.), Radiology & Radiological Sciences (J.G.T., S.N., J.J.C.), Department of Neurology (K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Division of Cardiovascular Medicine (S.P.B., J.A.B., A.L.J.), Department of Medicine, and Vanderbilt Genetics Institute (T.J.H.), Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Neurochemistry (K.B., H.Z.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Molndal, Sweden; Department of Neurodegenerative Disease (H.Z.), University College London Institute of Neurology, Queen Square; and United Kingdom Dementia Research Institute at University College London (H.Z.), UK
| | - Timothy J Hohman
- From the Vanderbilt Memory & Alzheimer's Center (E.E.M., D.L., J.L., S.J.S., F.E.C., K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Department of Biostatistics (D.L.), Radiology & Radiological Sciences (J.G.T., S.N., J.J.C.), Department of Neurology (K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Division of Cardiovascular Medicine (S.P.B., J.A.B., A.L.J.), Department of Medicine, and Vanderbilt Genetics Institute (T.J.H.), Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Neurochemistry (K.B., H.Z.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Molndal, Sweden; Department of Neurodegenerative Disease (H.Z.), University College London Institute of Neurology, Queen Square; and United Kingdom Dementia Research Institute at University College London (H.Z.), UK
| | - Kaj Blennow
- From the Vanderbilt Memory & Alzheimer's Center (E.E.M., D.L., J.L., S.J.S., F.E.C., K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Department of Biostatistics (D.L.), Radiology & Radiological Sciences (J.G.T., S.N., J.J.C.), Department of Neurology (K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Division of Cardiovascular Medicine (S.P.B., J.A.B., A.L.J.), Department of Medicine, and Vanderbilt Genetics Institute (T.J.H.), Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Neurochemistry (K.B., H.Z.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Molndal, Sweden; Department of Neurodegenerative Disease (H.Z.), University College London Institute of Neurology, Queen Square; and United Kingdom Dementia Research Institute at University College London (H.Z.), UK
| | - Henrik Zetterberg
- From the Vanderbilt Memory & Alzheimer's Center (E.E.M., D.L., J.L., S.J.S., F.E.C., K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Department of Biostatistics (D.L.), Radiology & Radiological Sciences (J.G.T., S.N., J.J.C.), Department of Neurology (K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Division of Cardiovascular Medicine (S.P.B., J.A.B., A.L.J.), Department of Medicine, and Vanderbilt Genetics Institute (T.J.H.), Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Neurochemistry (K.B., H.Z.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Molndal, Sweden; Department of Neurodegenerative Disease (H.Z.), University College London Institute of Neurology, Queen Square; and United Kingdom Dementia Research Institute at University College London (H.Z.), UK
| | - John Jeffrey Carr
- From the Vanderbilt Memory & Alzheimer's Center (E.E.M., D.L., J.L., S.J.S., F.E.C., K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Department of Biostatistics (D.L.), Radiology & Radiological Sciences (J.G.T., S.N., J.J.C.), Department of Neurology (K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Division of Cardiovascular Medicine (S.P.B., J.A.B., A.L.J.), Department of Medicine, and Vanderbilt Genetics Institute (T.J.H.), Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Neurochemistry (K.B., H.Z.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Molndal, Sweden; Department of Neurodegenerative Disease (H.Z.), University College London Institute of Neurology, Queen Square; and United Kingdom Dementia Research Institute at University College London (H.Z.), UK
| | - Angela L Jefferson
- From the Vanderbilt Memory & Alzheimer's Center (E.E.M., D.L., J.L., S.J.S., F.E.C., K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Department of Biostatistics (D.L.), Radiology & Radiological Sciences (J.G.T., S.N., J.J.C.), Department of Neurology (K.R.P., M.E.M., K.A.G., T.J.H., A.L.J.), Division of Cardiovascular Medicine (S.P.B., J.A.B., A.L.J.), Department of Medicine, and Vanderbilt Genetics Institute (T.J.H.), Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Neurochemistry (K.B., H.Z.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Molndal, Sweden; Department of Neurodegenerative Disease (H.Z.), University College London Institute of Neurology, Queen Square; and United Kingdom Dementia Research Institute at University College London (H.Z.), UK.
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Jarvis K, Soulat G, Scott M, Vali A, Pathrose A, Syed AA, Kinno M, Prabhakaran S, Collins JD, Markl M. Investigation of Aortic Wall Thickness, Stiffness and Flow Reversal in Patients With Cryptogenic Stroke: A 4D Flow MRI Study. J Magn Reson Imaging 2021; 53:942-952. [PMID: 32864836 DOI: 10.1002/jmri.27345] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 08/08/2020] [Accepted: 08/11/2020] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Stroke etiology is undetermined in approximately one-sixth to one-third of patients. The presence of aortic flow reversal and plaques in the descending aorta (DAo) has been identified as a potential retrograde embolic mechanism. PURPOSE To assess the relationships between aortic stiffness, wall thickness, and flow reversal in patients with cryptogenic stroke and healthy controls. STUDY TYPE Prospective. POPULATION Twenty one patients with cryptogenic stroke and proven DAo plaques (69 ± 9 years, 43% female), 18 age-matched controls (age: 65 ± 8 years, 61% female), and 14 younger controls (36 ± 9 years, 57% female). FIELD STRENGTH/SEQUENCE 1.5T; 4D flow MRI and 3D dark blood T1 -weighted turbo spin echo MRI of the aorta. ASSESSMENT Noncontrast aortic 4D flow MRI to measure 3D flow dynamics and 3D dark blood aortic wall MRI to assess wall thickness. 4D flow MRI analysis included automated quantification of aortic stiffness by pulse wave velocity (PWV) and voxelwise mapping of the flow reversal fraction (FRF). STATISTICAL TESTS Analysis of variance (ANOVA) or Kruskal-Wallis tests, Student's unpaired t-tests or Wilcoxon rank-sum tests, regression analysis. RESULTS Aortic PWV and FRF were statistically higher in patients (8.9 ± 1.7 m/s, 18.4 ± 7.7%) than younger controls (5.3 ± 0.8 m/s, P < 0.0167; 8.5 ± 2.9%, P < 0.0167), but not age-matched controls (8.2 ± 1.6 m/s, P = 0.22; 15.6 ± 5.8%, P = 0.22). Maximum aortic wall thickness was higher in patients (3.1 ± 0.7 mm) than younger controls (2.2 ± 0.2 mm, P < 0.0167) and age-matched controls (2.7 ± 0.5 mm) (P < 0.0167). For all subjects, positive relationships were found between PWV and age (R2 = 0.71, P < 0.05), aortic wall thickness (R2 = 0.20, P < 0.05), and FRF (R2 = 0.47, P < 0.05). Patients demonstrated relationships between PWV and FRF in the ascending aorta (R2 = 0.32, P < 0.05) and arch (R2 = 0.24, P < 0.05). DATA CONCLUSION This study showed the utility of 4D flow MRI for evaluating aortic PWV and voxelwise flow reversal. Positive relationships between aortic PWV, wall thickness, and flow reversal support the hypothesis that aortic stiffness is involved in this retrograde embolic mechanism. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
- Kelly Jarvis
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Gilles Soulat
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Michael Scott
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois, USA
| | - Alireza Vali
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ashitha Pathrose
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Amer Ahmed Syed
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Menhel Kinno
- Department of Cardiology, Loyola University Medical Center, Maywood, Illinois, USA
| | - Shyam Prabhakaran
- Department of Neurology, University of Chicago Biological Sciences, Chicago, Illinois, USA
| | | | - Michael Markl
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois, USA
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Andelovic K, Winter P, Jakob PM, Bauer WR, Herold V, Zernecke A. Evaluation of Plaque Characteristics and Inflammation Using Magnetic Resonance Imaging. Biomedicines 2021; 9:185. [PMID: 33673124 PMCID: PMC7917750 DOI: 10.3390/biomedicines9020185] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/19/2022] Open
Abstract
Atherosclerosis is an inflammatory disease of large and medium-sized arteries, characterized by the growth of atherosclerotic lesions (plaques). These plaques often develop at inner curvatures of arteries, branchpoints, and bifurcations, where the endothelial wall shear stress is low and oscillatory. In conjunction with other processes such as lipid deposition, biomechanical factors lead to local vascular inflammation and plaque growth. There is also evidence that low and oscillatory shear stress contribute to arterial remodeling, entailing a loss in arterial elasticity and, therefore, an increased pulse-wave velocity. Although altered shear stress profiles, elasticity and inflammation are closely intertwined and critical for plaque growth, preclinical and clinical investigations for atherosclerosis mostly focus on the investigation of one of these parameters only due to the experimental limitations. However, cardiovascular magnetic resonance imaging (MRI) has been demonstrated to be a potent tool which can be used to provide insights into a large range of biological parameters in one experimental session. It enables the evaluation of the dynamic process of atherosclerotic lesion formation without the need for harmful radiation. Flow-sensitive MRI provides the assessment of hemodynamic parameters such as wall shear stress and pulse wave velocity which may replace invasive and radiation-based techniques for imaging of the vascular function and the characterization of early plaque development. In combination with inflammation imaging, the analyses and correlations of these parameters could not only significantly advance basic preclinical investigations of atherosclerotic lesion formation and progression, but also the diagnostic clinical evaluation for early identification of high-risk plaques, which are prone to rupture. In this review, we summarize the key applications of magnetic resonance imaging for the evaluation of plaque characteristics through flow sensitive and morphological measurements. The simultaneous measurements of functional and structural parameters will further preclinical research on atherosclerosis and has the potential to fundamentally improve the detection of inflammation and vulnerable plaques in patients.
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Affiliation(s)
- Kristina Andelovic
- Institute of Experimental Biomedicine, University Hospital Würzburg, 97080 Würzburg, Germany
- Experimental Physics V, University of Würzburg, 97074 Würzburg, Germany; (P.W.); (P.M.J.); (V.H.)
| | - Patrick Winter
- Experimental Physics V, University of Würzburg, 97074 Würzburg, Germany; (P.W.); (P.M.J.); (V.H.)
- Internal Medicine I, Cardiology, University Hospital Würzburg, 97080 Würzburg, Germany;
| | - Peter Michael Jakob
- Experimental Physics V, University of Würzburg, 97074 Würzburg, Germany; (P.W.); (P.M.J.); (V.H.)
| | - Wolfgang Rudolf Bauer
- Internal Medicine I, Cardiology, University Hospital Würzburg, 97080 Würzburg, Germany;
| | - Volker Herold
- Experimental Physics V, University of Würzburg, 97074 Würzburg, Germany; (P.W.); (P.M.J.); (V.H.)
| | - Alma Zernecke
- Institute of Experimental Biomedicine, University Hospital Würzburg, 97080 Würzburg, Germany
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20
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Heidari Pahlavian S, Cen SY, Bi X, Wang DJJ, Chui HC, Yan L. Assessment of carotid stiffness by measuring carotid pulse wave velocity using a single-slice oblique-sagittal phase-contrast MRI. Magn Reson Med 2021; 86:442-455. [PMID: 33543788 DOI: 10.1002/mrm.28677] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/14/2020] [Accepted: 12/18/2020] [Indexed: 11/06/2022]
Abstract
PURPOSE Increased arterial stiffness has been shown to be one of the earliest markers of cerebrovascular dysfunction. As a surrogate marker of arterial stiffness, pulse wave velocity (PWV) quantifications are generally carried out on central and peripheral arteries. The purpose of this study was to develop and evaluate an MRI approach to assess carotid stiffness by measuring carotid PWV (cPWV) using a fast oblique-sagittal phase-contrast MRI sequence. METHODS In 29 volunteers, a single-slice oblique-sagittal phase-contrast MRI sequence with retrospective cardiac gating was used to quantify blood velocity waveforms along a vessel segment covering the common carotid artery (CCA) and the internal carotid artery (ICA). The CCA-ICA segment length was measured from a region of interest selected on the magnitude image. Phase-contrast MRI-measured velocities were also used to quantify the ICA pulsatility index along with cPWV quantification. RESULTS The mean value of cPWV calculated using the middle upslope area algorithm was 2.86 ± 0.71 and 3.97 ± 1.14 m/s in young and elderly subjects, respectively. Oblique-sagittal phase-contrast MRI-derived cPWV measurements showed excellent intrascan and interscan repeatability. cPWV and ICA pulsatility index were significantly greater in older subjects compared to those in the young subjects (P < .01 and P = .01, respectively). Also, increased cPWV values were associated with elevated systolic blood pressure (β = 0.05, P = .03). CONCLUSION This study demonstrated that oblique-sagittal phase-contrast MRI is a feasible technique for the quantification of both cPWV and ICA pulsatility index and showed their potential utility in evaluating cerebroarterial aging and age-related neurovascular disorders.
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Affiliation(s)
- Soroush Heidari Pahlavian
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Steven Yong Cen
- Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Xiaoming Bi
- Siemens Medical Solutions USA, Inc., Los Angeles, California, USA
| | - Danny J J Wang
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Helena Chang Chui
- Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Lirong Yan
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Department of Neurology, University of Southern California, Los Angeles, California, USA
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Dietenbeck T, Houriez-Gombaud-Saintonge S, Charpentier E, Gencer U, Giron A, Gallo A, Boussouar S, Pasi N, Soulat G, Mousseaux E, Redheuil A, Kachenoura N. Quantitative magnetic resonance imaging measures of three-dimensional aortic morphology in healthy aging and hypertension. J Magn Reson Imaging 2021; 53:1471-1483. [PMID: 33426700 DOI: 10.1002/jmri.27502] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 12/18/2020] [Accepted: 12/18/2020] [Indexed: 01/16/2023] Open
Abstract
Automated segmentation of three-dimensional (3D) aortic magnetic resonance imaging (MRI) renders a possible retrospective selection of any location to perform quantification of aortic caliber perpendicular to its centerline and provides regional and global 3D biomarkers such as length, diameter, or volume. However, normative age-related values of such measures are still lacking. The aim of this study was to provide normal values for 3D aortic morphological measures and investigate their changes in aging and hypertension. This was a retrospective study, in which 119 healthy controls (HC: 48 ± 14 years, 61 men) and 82 hypertensive patients (HT: 60 ± 14 years, 43 men) were enrolled. 1.5 and 3 T/3D steady state free precession or spoiled gradient echo were used. Automated 3D aortic segmentation provided aortic length, diameter, volume for the ascending (AAo), and descending aorta (DAo), along with cross-sectional diameters at three aortic landmarks. Age, sex, body surface area (BSA), smoking, and blood pressures were recorded. Both groups were divided into two subgroups (≤50 years, >50 years). Statistical tests performed were linear regression for age-related normal values and confidence intervals, Wilcoxon rank sum test for differences between groups (HC or HT), and multivariate analysis to identify main determinants of aortic morphological changes. In HC, linear regression revealed an increase in the AAo (respectively DAo) length by 2.84 mm (7.78 mm), maximal diameter by 1.36 mm (1.29 mm), and volume by 4.28 ml (8.71 ml) per decade. AAo morphological measures were higher in HT patients than in HC both ≤50 years but did not reach statistical significance (length: +2 mm, p = 0.531; diameter: +1.4 mm, p = 0.2936; volume:+6.8 ml, p = 0.1857). However, length (+6 mm, p = 0.003), maximal diameter (+4 mm, p < 0.001) and volume (+12 ml, p < 0.001) were significantly higher in HT patients than in HC, both >50 years. In a multivariate analysis, age, sex, and BSA were the major determinants of aortic morphology, irrespective of the presence of hypertension. Global and segmental aortic length, volume, and diameters at specific landmarks were automatically measured from 3D MRI to serve as normative measures of 3D aortic morphology. Such indices increased significantly with age and hypertension among the elderly subjects. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY STAGE: 3.
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Affiliation(s)
- Thomas Dietenbeck
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, Paris, France.,Institute of Cardiometabolism and Nutrition (ICAN), Groupe Hospitalier Pitié Salpêtrière APHP, Paris, France
| | - Sophia Houriez-Gombaud-Saintonge
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, Paris, France.,Institute of Cardiometabolism and Nutrition (ICAN), Groupe Hospitalier Pitié Salpêtrière APHP, Paris, France.,ESME Sudria Research Lab, Paris, France
| | - Etienne Charpentier
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, Paris, France.,Institute of Cardiometabolism and Nutrition (ICAN), Groupe Hospitalier Pitié Salpêtrière APHP, Paris, France
| | - Umit Gencer
- PARCC, Université de Paris, INSERM, Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Alain Giron
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, Paris, France
| | - Antonio Gallo
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, Paris, France.,Institute of Cardiometabolism and Nutrition (ICAN), Groupe Hospitalier Pitié Salpêtrière APHP, Paris, France
| | - Samia Boussouar
- Département d'Imagerie Cardiovasculaire DICVRIT, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière APHP, Paris, France
| | - Nicoletta Pasi
- Département d'Imagerie Cardiovasculaire DICVRIT, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière APHP, Paris, France
| | - Gilles Soulat
- PARCC, Université de Paris, INSERM, Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Elie Mousseaux
- PARCC, Université de Paris, INSERM, Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Alban Redheuil
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, Paris, France.,Institute of Cardiometabolism and Nutrition (ICAN), Groupe Hospitalier Pitié Salpêtrière APHP, Paris, France.,Département d'Imagerie Cardiovasculaire DICVRIT, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière APHP, Paris, France
| | - Nadjia Kachenoura
- Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, Paris, France.,Institute of Cardiometabolism and Nutrition (ICAN), Groupe Hospitalier Pitié Salpêtrière APHP, Paris, France
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22
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Age-related values of aortic pulse wave velocity in healthy subjects measured by Doppler echocardiography. J Hum Hypertens 2021; 35:1081-1087. [PMID: 33414505 DOI: 10.1038/s41371-020-00466-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 11/04/2020] [Accepted: 12/07/2020] [Indexed: 11/08/2022]
Abstract
Aortic pulse wave velocity (aPWV) is a measure of aortic stiffness, which is an indicator of vascular aging and prognostic marker for cardiovascular complications. aPWV can be measured with various methods, but with different reference values depending on the technique used. Therefore, we decided to evaluate age-related values of aPWV, measured by Doppler echocardiography. We included 134 healthy adults (mean age 44.1 ± 13.2 years, 54% of females) divided into five groups based on age decades (D1 21-30 years, n = 29; D2 31-40 years, n = 24; D3 41-50 years, n = 34; D4 51-60 years, n = 25; and D5 61-70 years, n = 22). With the use of a cardiac probe and ECG tracing, ten Doppler waveforms were sequentially recorded, first in the distal aortic arch, and than in the left external iliac artery. Transit time was measured as a delay of the foot of the Doppler waveform in the distal, relative to the proximal location. The distance was measured over the body surface. aPWV was calculated as distance/transit time. Median aPWV in the whole group was 5.05 m/s [4.55-5.99] and did not differ according to sex (females, 5.28 m/s [4.50-6.1] vs. males, 4.95 m/s [4.59-5.77], p = 0.46). Mean aPWV values with 95% confidence intervals (95% CI) for each decade were as follows: D1, 4.54 m/s (4.37-4.72), D2, 4.61 m/s (4.36-4.87), D3, 5.11 m/s (4.89-5.33), D4, 6.04 m/s (5.63-6.45), and D5, 6.77 m/s (6.35-7.19). We report age-related values of aPWV, in a healthy population, measured by Doppler echocardiography. This may be helpful in future research exploring the associations between aortic stiffness, cardiac function, and cardiovascular risk.
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23
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Pascaner AF, Houriez-Gombaud-Saintonge S, Craiem D, Gencer U, Casciaro ME, Charpentier E, Bouaou K, Cesare AD, Dietenbeck T, Chenoune Y, Kachenoura N, Mousseaux E, Soulat G, Bollache E. Comprehensive assessment of local and regional aortic stiffness in patients with tricuspid or bicuspid aortic valve aortopathy using magnetic resonance imaging. Int J Cardiol 2020; 326:206-212. [PMID: 33259874 DOI: 10.1016/j.ijcard.2020.11.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 10/27/2020] [Accepted: 11/09/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND We aimed to provide a comprehensive aortic stiffness description using magnetic resonance imaging (MRI) in patients with ascending thoracic aorta aneurysm and tricuspid (TAV-ATAA) or bicuspid (BAV) aortic valve. METHODS This case-control study included 18 TAV-ATAA and 19 BAV patients, with no aortic valve stenosis/severe regurgitation, who were 1:1 age-, gender- and central blood pressures (BP)-matched to healthy volunteers. Each underwent simultaneous aortic MRI and BP measurements. 3D anatomical MRI provided aortic diameters. Stiffness indices included: regional ascending (AA) and descending (DA) aorta pulse wave velocity (PWV) from 4D flow MRI; local AA and DA strain, distensibility and theoretical Bramwell-Hill (BH) model-based PWV, as well as regional arch PWV from 2D flow MRI. RESULTS Patient groups had significantly higher maximal AA diameter (median[interquartile range], TAV-ATAA: 47.5[42.0-51.3]mm, BAV: 45.0[41.0-47.0]mm) than their respective controls (29.1[26.8-31.8] and 28.1[26.0-32.0]mm, p < 0.0001), while BP were similar (p ≥ 0.25). Stiffness indices were significantly associated with age (ρ ≥ 0.33), mean BP (arch PWV: ρ = 0.25, p = 0.05; DA distensibility: ρ = -0.30, p = 0.02) or AA diameter (arch PWV: ρ = 0.28, p = 0.03; DA PWV: ρ = 0.32, p = 0.009). None of them, however, was significantly different between TAV-ATAA or BAV patients and their matched controls. Finally, while direct PWV measures were significantly correlated to BH-PWV estimates in controls (ρ ≥ 0.40), associations were non-significant in TAV-ATAA and BAV groups (p ≥ 0.18). CONCLUSIONS The overlap of MRI-derived aortic stiffness indices between patients with TAV or BAV aortopathy and matched controls highlights another heterogeneous feature of aortopathy, and suggests the urgent need for more sensitive indices which might help better discriminate such diseases.
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Affiliation(s)
- Ariel F Pascaner
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMETTyB), Universidad Favaloro - CONICET, Buenos Aires, Argentina
| | - Sophia Houriez-Gombaud-Saintonge
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; ESME Sudria Research Lab, Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Damian Craiem
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMETTyB), Universidad Favaloro - CONICET, Buenos Aires, Argentina
| | - Umit Gencer
- Département de Radiologie Cardiovasculaire, Hôpital Européen Georges Pompidou - INSERM U970, PARCC, Paris, France
| | - Mariano E Casciaro
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMETTyB), Universidad Favaloro - CONICET, Buenos Aires, Argentina
| | - Etienne Charpentier
- Département de Radiologie Cardiovasculaire, Hôpital Européen Georges Pompidou - INSERM U970, PARCC, Paris, France
| | - Kevin Bouaou
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Alain De Cesare
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Thomas Dietenbeck
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | | | - Nadjia Kachenoura
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Elie Mousseaux
- Département de Radiologie Cardiovasculaire, Hôpital Européen Georges Pompidou - INSERM U970, PARCC, Paris, France
| | - Gilles Soulat
- Département de Radiologie Cardiovasculaire, Hôpital Européen Georges Pompidou - INSERM U970, PARCC, Paris, France
| | - Emilie Bollache
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.
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