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Chen H, Zhao M, Li Y, Wang Q, Xing Y, Bian C, Li J. A study on the ultimate mechanical properties of middle-aged and elderly human aorta based on uniaxial tensile test. Front Bioeng Biotechnol 2024; 12:1357056. [PMID: 38576445 PMCID: PMC10991712 DOI: 10.3389/fbioe.2024.1357056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 03/07/2024] [Indexed: 04/06/2024] Open
Abstract
Background The mechanical properties of the aorta are particularly important in clinical medicine and forensic science, serving as basic data for further exploration of aortic disease or injury mechanisms. Objective To study the influence of various factors (age, gender, test direction, anatomical location, and pathological characteristics) on the mechanical properties and thickness of the aorta. Methods In this study, a total of 24 aortas (age range: 54-88 years old) were collected, one hundred and seventy-four dog-bone-shaped samples were made, and then the uniaxial tensile test was run, finally, pathological grouping was performed through histological staining. Results Atherosclerotic plaques were mainly distributed near the openings of blood vessel branches. The distribution was most severe in the abdominal aorta, followed by the aortic arch. Aortic atherosclerosis was a more severe trend in the male group. In the comparison of thickness, there were no significant differences in age (over 50 years) and test direction, the average thickness of the aorta was greater in the male group than the female group and decreased progressively from the ascending aorta to the abdominal aorta. Comparing the mechanical parameters, various parameters are mainly negatively correlated with age, especially in the circumferential ascending aorta (εp "Y = -0.01402*X + 1.762, R2 = 0.6882", εt "Y = -0.01062*X + 1.250, R2 = 0.6772"); the parameters of males in the healthy group were larger, while the parameters of females were larger in atherosclerosis group; the aorta has anisotropy, the parameters in the circumferential direction were greater than those in the axial direction; the parameters of the ascending aorta were the largest in the circumferential direction, the ultimate stress [σp "1.69 (1.08,2.32)"] and ultimate elastic modulus [E2"8.28 (6.67,10.25)"] of the abdominal aorta were significantly larger in the axial direction; In the circumferential direction, the stress [σp "2.2 (1.31,3.98)", σt "0.13 (0.09,0.31)"] and ultimate elastic modulus (E2 "14.10 ± 7.21") of adaptive intimal thickening were greater than those of other groups, the strain (εp "0.82 ± 0.17", εt "0.53 ± 0.14") of pathological intimal thickening was the largest in the pathological group. Conclusion The present study systematically analyzed the influence of age, sex, test direction, anatomical site, and pathological characteristics on the biomechanical properties of the aorta, described the distribution of aortic atherosclerosis, and illustrated the characteristics of aortic thickness changes. At the same time, new insights into the grouping of pathological features were presented.
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Affiliation(s)
- Hongbing Chen
- Department of Forensic Medicine, College of Basic Medicine, Chongqing Medical University, Chongqing, China
- Chongqing Engineering Research Center for Criminal Investigation Technology, Chongqing, China
- Chongqing Key Laboratory of Forensic Medicine, Chongqing, China
| | - Minzhu Zhao
- Department of Forensic Medicine, College of Basic Medicine, Chongqing Medical University, Chongqing, China
- Chongqing Engineering Research Center for Criminal Investigation Technology, Chongqing, China
- Chongqing Key Laboratory of Forensic Medicine, Chongqing, China
| | - Yongguo Li
- Department of Forensic Medicine, College of Basic Medicine, Chongqing Medical University, Chongqing, China
- Chongqing Engineering Research Center for Criminal Investigation Technology, Chongqing, China
- Chongqing Key Laboratory of Forensic Medicine, Chongqing, China
| | - Qi Wang
- Department of Forensic Medicine, College of Basic Medicine, Chongqing Medical University, Chongqing, China
- Chongqing Engineering Research Center for Criminal Investigation Technology, Chongqing, China
- Chongqing Key Laboratory of Forensic Medicine, Chongqing, China
| | - Yu Xing
- Department of Forensic Medicine, College of Basic Medicine, Chongqing Medical University, Chongqing, China
- Chongqing Engineering Research Center for Criminal Investigation Technology, Chongqing, China
- Chongqing Key Laboratory of Forensic Medicine, Chongqing, China
| | - Cunhao Bian
- Department of Forensic Medicine, College of Basic Medicine, Chongqing Medical University, Chongqing, China
- Chongqing Engineering Research Center for Criminal Investigation Technology, Chongqing, China
- Chongqing Key Laboratory of Forensic Medicine, Chongqing, China
| | - Jianbo Li
- Department of Forensic Medicine, College of Basic Medicine, Chongqing Medical University, Chongqing, China
- Chongqing Engineering Research Center for Criminal Investigation Technology, Chongqing, China
- Chongqing Key Laboratory of Forensic Medicine, Chongqing, China
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2
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Gheysen L, Maes L, Caenen A, Segers P, Peirlinck M, Famaey N. Uncertainty quantification of the wall thickness and stiffness in an idealized dissected aorta. J Mech Behav Biomed Mater 2024; 151:106370. [PMID: 38224645 DOI: 10.1016/j.jmbbm.2024.106370] [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: 03/27/2023] [Revised: 12/21/2023] [Accepted: 01/01/2024] [Indexed: 01/17/2024]
Abstract
Personalized treatment informed by computational models has the potential to markedly improve the outcome for patients with a type B aortic dissection. However, existing computational models of dissected walls significantly simplify the characteristic false lumen, tears and/or material behavior. Moreover, the patient-specific wall thickness and stiffness cannot be accurately captured non-invasively in clinical practice, which inevitably leads to assumptions in these wall models. It is important to evaluate the impact of the corresponding uncertainty on the predicted wall deformations and stress, which are both key outcome indicators for treatment optimization. Therefore, a physiology-inspired finite element framework was proposed to model the wall deformation and stress of a type B aortic dissection at diastolic and systolic pressure. Based on this framework, 300 finite element analyses, sampled with a Latin hypercube, were performed to assess the global uncertainty, introduced by 4 uncertain wall thickness and stiffness input parameters, on 4 displacement and stress output parameters. The specific impact of each input parameter was estimated using Gaussian process regression, as surrogate model of the finite element framework, and a δ moment-independent analysis. The global uncertainty analysis indicated minor differences between the uncertainty at diastolic and systolic pressure. For all output parameters, the 4th quartile contained the major fraction of the uncertainty. The parameter-specific uncertainty analysis elucidated that the material stiffness and relative thickness of the dissected membrane were the respective main determinants of the wall deformation and stress. The uncertainty analysis provides insight into the effect of uncertain wall thickness and stiffness parameters on the predicted deformation and stress. Moreover, it emphasizes the need for probabilistic rather than deterministic predictions for clinical decision making in aortic dissections.
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Affiliation(s)
- Lise Gheysen
- Institute for Biomedical Engineering and Technology, Electronics and Information Systems, Ghent University, Belgium.
| | - Lauranne Maes
- Biomechanics Section, Mechanical Engineering, KU Leuven, Belgium
| | - Annette Caenen
- Institute for Biomedical Engineering and Technology, Electronics and Information Systems, Ghent University, Belgium; Cardiovascular Imaging and Dynamics, Department of Cardiovascular Sciences, KU Leuven, Belgium
| | - Patrick Segers
- Institute for Biomedical Engineering and Technology, Electronics and Information Systems, Ghent University, Belgium
| | - Mathias Peirlinck
- Department of BioMechanical Engineering, Faculty of Mechanical Engineering, Delft University of Technology, the Netherlands
| | - Nele Famaey
- Biomechanics Section, Mechanical Engineering, KU Leuven, Belgium
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3
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Shetty V, Narayan P. Sex-based differences in acute type A aortic dissection-Biology or bias? J Card Surg 2022; 37:4348-4350. [PMID: 36183404 DOI: 10.1111/jocs.16986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 01/06/2023]
Affiliation(s)
- Varun Shetty
- Department of Cardiac Surgery, Narayana Institute of Cardiac Sciences, Narayan Health, Bengaluru, Karnataka, India
| | - Pradeep Narayan
- Department of Cardiac Surgery, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India
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4
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Wilson JS, Islam M, Oshinski JN. In Vitro Validation of Regional Circumferential Strain Assessment in a Phantom Aortic Model Using Cine Displacement Encoding With Stimulated Echoes MRI. J Magn Reson Imaging 2021; 55:1773-1784. [PMID: 34704637 DOI: 10.1002/jmri.27972] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/14/2021] [Accepted: 10/14/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND A novel application of cine Displacement ENcoding with Stimulated Echoes Magnetic Resonance Imaging (DENSE MRI) has recently been described to assess regional heterogeneities in circumferential strain around the aortic wall in vivo; however, validation is first required for successful clinical translation. PURPOSE To validate the quantification of regional circumferential strain around the wall of an aortic phantom using DENSE MRI. STUDY TYPE In vitro phantom study. POPULATION Three polyvinyl alcohol aortic phantoms with eight axially oriented nitinol wires embedded evenly around the walls. FIELD STRENGTH/SEQUENCE 3 T; gradient-echo aortic DENSE MRI with spiral cine readout, gradient-echo phase-contrast MRI (PCMR) with Cartesian cine readout. ASSESSMENT Phantoms were connected to a pulsatile flow loop and peak DENSE-derived regional circumferential Green strains at 16 equally spaced sectors around the wall were assessed according to previously published algorithms. "True" regional circumferential strains were calculated by manually tracking displacements of the nitinol wires by two independent observers. Normalized circumferential strains (NCS) were calculated by dividing regional strains by the mean strain. Finally, DENSE-derived regional strain was corrected by multiplying regional DENSE NCS by the mean strain calculated from the diameter change on the PCMR. STATISTICAL TESTS One-sample t-test, Paired-sample t-test, and analysis of variance with Bonferroni correction, coefficient of variation (CoV), Bland-Altman analysis; P < 0.05 was considered statistically significant. RESULTS Aortic DENSE MRI significantly overestimated circumferential strain compared to the wire-tracking method (mean difference and SD 0.030 ± 0.014, CoV 0.31). However, NCS demonstrated good agreement between DENSE and wire-tracking data (mean difference 0.000 ± 0.172, CoV 0.15). After correcting the DENSE-derived regional strain, the mean difference in regional circumferential strain between DENSE and wire-tracking was significantly reduced to 0.006 ± 0.008, and the CoV was reduced to 0.18. DATA CONCLUSION For aortic phantoms with mild spatial heterogeneity in circumferential strain, the previously published aortic DENSE MRI technique successfully assessed the regional NCS distribution but overestimated the mean strain. This overestimation is correctable by computing a more accurate mean circumferential strain using a separate cine scan. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- John S Wilson
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia, USA.,Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Muhammad Islam
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, USA
| | - John N Oshinski
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, USA.,Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA
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5
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Liu M, Liang L, Ismail Y, Dong H, Lou X, Iannucci G, Chen EP, Leshnower BG, Elefteriades JA, Sun W. Computation of a probabilistic and anisotropic failure metric on the aortic wall using a machine learning-based surrogate model. Comput Biol Med 2021; 137:104794. [PMID: 34482196 DOI: 10.1016/j.compbiomed.2021.104794] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/20/2021] [Accepted: 08/21/2021] [Indexed: 01/15/2023]
Abstract
Scalar-valued failure metrics are commonly used to assess the risk of aortic aneurysm rupture and dissection, which occurs under hypertensive blood pressures brought on by extreme emotional or physical stress. To compute failure metrics under an elevated blood pressure, a classical patient-specific computer model consists of multiple computation steps involving inverse and forward analyses. These classical procedures may be impractical for time-sensitive clinical applications that require prompt feedback to clinicians. In this study, we developed a machine learning-based surrogate model to directly predict a probabilistic and anisotropic failure metric, namely failure probability (FP), on the aortic wall using aorta geometries at the systolic and diastolic phases. Ascending thoracic aortic aneurysm (ATAA) geometries of 60 patients were obtained from their CT scans, and biaxial mechanical testing data of ATAA tissues from 79 patients were collected. Finite element simulations were used to generate datasets for training, validation, and testing of the ML-surrogate model. The testing results demonstrated that the ML-surrogate can compute the maximum FP failure metric, with 0.42% normalized mean absolute error, in 1 s. To compare the performance of the ML-predicted probabilistic FP metric with other isotropic or deterministic metrics, a numerical case study was performed using synthetic "baseline" data. Our results showed that the probabilistic FP metric had more discriminative power than the deterministic Tsai-Hill metric, isotropic maximum principal stress, and aortic diameter criterion.
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Affiliation(s)
- Minliang Liu
- Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Liang Liang
- Department of Computer Science, University of Miami, Coral Gables, FL, USA
| | - Yasmeen Ismail
- Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Hai Dong
- Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Xiaoying Lou
- Emory University School of Medicine, Atlanta, GA, USA
| | - Glen Iannucci
- Emory University School of Medicine, Atlanta, GA, USA
| | - Edward P Chen
- Emory University School of Medicine, Atlanta, GA, USA
| | | | | | - Wei Sun
- Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.
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6
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Wang Q, Liang T, Wu J, Li Z, Liu Z. Dye-Sensitized Rare Earth-Doped Nanoparticles with Boosted NIR-IIb Emission for Dynamic Imaging of Vascular Network-Related Disorders. ACS APPLIED MATERIALS & INTERFACES 2021; 13:29303-29312. [PMID: 34133138 DOI: 10.1021/acsami.1c04612] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Real-time dynamic vascular network imaging can provide accurate hemodynamic and anatomical information, facilitating the diagnosis of blood circulatory system-related diseases and achieving precise evaluation of therapeutic effects. In vivo luminescence imaging in the NIR-IIb biological window (1500-1700 nm) has developed into a next generation of optical imaging method with significantly improved temporal-spatial resolution and penetration depth. Unfortunately, an imaging contrast agent capable of emitting NIR-IIb luminescence with sufficient brightness in this region is lacking. Herein, we designed and proposed a type of dye-sensitized rare earth-doped nanoparticle (RENPs@Alk-pi) with obviously boosted NIR-IIb emission and high biocompatibility, which can be used to realize the real-time NIR-IIb luminescence imaging with high temporal-spatial resolution and contrast. The dye sensitization process provides a 40-fold enhanced brightness of the NIR-IIb emission at 1525 nm of Er3+. Consequently, the RENPs@Alk-pi was not only able to depict a vascular network but also applicable in noninvasively monitoring the dynamic vascular processes and changes in the vascular anatomy of two blood circulatory system-related disorders, including hindlimbs ischemia and atherosclerosis. Our research provides a powerful tool for evaluating vascular network-related dysfunction and physiological processes.
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Affiliation(s)
- Qirong Wang
- College of Chemistry and Chemical Engineering, Hubei University, Wuhan 430062, China
| | - Tao Liang
- Key Laboratory of Analytical Chemistry of the State Ethnic Affairs Commission, College of Chemistry and Materials Science, South-Central University for Nationalities, Wuhan 430074, China
| | - Junjie Wu
- College of Chemistry and Chemical Engineering, Hubei University, Wuhan 430062, China
| | - Zhen Li
- College of Chemistry and Chemical Engineering, Hubei University, Wuhan 430062, China
| | - Zhihong Liu
- College of Chemistry and Chemical Engineering, Hubei University, Wuhan 430062, China
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7
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Hardikar A, Harle R, Marwick TH. Aortic Thickness: A Forgotten Paradigm in Risk Stratification of Aortic Disease. AORTA : OFFICIAL JOURNAL OF THE AORTIC INSTITUTE AT YALE-NEW HAVEN HOSPITAL 2020; 8:132-140. [PMID: 33368098 PMCID: PMC7758112 DOI: 10.1055/s-0040-1715609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND This study aimed at risk-stratifying aortic dilatation using aortic wall thickness (AWT) and comparing methods of AWT assessment. METHODS Demographic, epidemiological, and perioperative data on 72 consecutive aortic surgeries (age = 62 years[standard deviation (SD) = 12] years) performed by a single surgeon were collected from hospital database. Aortic thickness was measured on computed tomography scans, as well as intraoperatively in four quadrants, at the level of aortic sinuses, as well as midascending aorta, using calipers. Aortic wall stress was calculated using standard mathematical formulae. RESULTS The ascending aorta was 48.2 (SD = 8) mm and the mean thickness at ascending aorta level was 1.9 (SD = 0.3) mm. There was congruence between imaging and intraoperative measurements of thickness, as well as between the radiologist and surgeon. Preoperatively, 16 patients had multiple imaging studies showing an average rate of growth of 1.2 mm per year without significant difference in thickness. The wider the aorta, the thinner was the lateral or convex wall. Aortic stenosis (p = 0.01), lateral to medial wall thickness ratio (p = 0.04), and history of hypertension (p = 0.00), all had protective effect on aortic root stress. The ascending aortic stress was directly affected by age (p = 0.03) and inversely related to lateral to medial wall thickness ratio (p = 0.03). CONCLUSION Aortic thickness can be measured preoperatively and easily confirmed intraoperatively. Risk stratification based on both aortic thickness and diameter (stress calculations) would better predict acute aortic events in dilated aortas and define aortic resection criteria more objectively.
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Affiliation(s)
- Ashutosh Hardikar
- Menzies Institute for Medical Research, University of Tasmania, Australia.,Department of Cardiothoracic Surgery, Royal Hobart Hospital, Hobart, Australia
| | - Robin Harle
- Department of Radiology, Royal Hobart Hospital, Hobart, Australia
| | - Thomas H Marwick
- Menzies Institute for Medical Research, University of Tasmania, Australia.,Baker Heart and Diabetes Institute, Melbourne, Australia
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8
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Doyle B. Response to "Re Biomechanical Assessment Predicts Aneurysm Related Events in Patients with Abdominal Aortic Aneurysm". Eur J Vasc Endovasc Surg 2020; 61:164. [PMID: 32703635 DOI: 10.1016/j.ejvs.2020.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/08/2020] [Accepted: 06/12/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Barry Doyle
- The University of Western Australia, Perth, Australia.
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9
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van Hout MJ, Scholte AJ, Juffermans JF, Westenberg JJ, Zhong L, Zhou X, Schalla SM, Hope MD, Bremerich J, Kramer CM, Dewey M, Ordovas KG, Bluemke DA, Lamb HJ. How to Measure the Aorta Using MRI: A Practical Guide. J Magn Reson Imaging 2020; 52:971-977. [PMID: 32374422 PMCID: PMC7540427 DOI: 10.1002/jmri.27183] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 01/16/2023] Open
Affiliation(s)
- Max J van Hout
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Arthur J Scholte
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Joe F Juffermans
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jos J Westenberg
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Liang Zhong
- National Heart Centre Singapore, National Heart Research Institute Singapore, Singapore, Singapore.,Cardiovascular Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Xuhui Zhou
- Department of Radiology, Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Simon M Schalla
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Michael D Hope
- Department of Radiology, University of California, San Francisco, California, USA
| | - Jens Bremerich
- Department of Radiology, Universitätsspital Basel, Basel, Switzerland
| | - Christopher M Kramer
- Cardiovascular Division, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Marc Dewey
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Karen G Ordovas
- Department of Radiology, University of California, San Francisco, California, USA
| | - David A Bluemke
- Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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10
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Hessenthaler A, Balmus M, Röhrle O, Nordsletten D. A class of analytic solutions for verification and convergence analysis of linear and nonlinear fluid-structure interaction algorithms. COMPUTER METHODS IN APPLIED MECHANICS AND ENGINEERING 2020; 362:112841. [PMID: 34093913 PMCID: PMC7610903 DOI: 10.1016/j.cma.2020.112841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Fluid-structure interaction (FSI) problems are pervasive in the computational engineering community. The need to address challenging FSI problems has led to the development of a broad range of numerical methods addressing a variety of applicationspecific demands. While a range of numerical and experimental benchmarks are present in the literature, few solutions are available that enable both verification and spatiotemporal convergence analysis. In this paper, we introduce a class of analytic solutions to FSI problems involving shear in channels and pipes. Comprised of 16 separate analytic solutions, our approach is permuted to enable progressive verification and analysis of FSI methods and implementations, in two and three dimensions, for static and transient scenarios as well as for linear and hyperelastic solid materials. Results are shown for a range of analytic models exhibiting progressively complex behavior. The utility of these solutions for analysis of convergence behavior is further demonstrated using a previously published monolithic FSI technique. The resulting class of analytic solutions addresses a core challenge in the development of novel FSI algorithms and implementations, providing a progressive testbed for verification and detailed convergence analysis.
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Affiliation(s)
- Andreas Hessenthaler
- Institute for Modelling and Simulation of Biomechanical Systems, University of Stuttgart, Pfaffenwaldring 5a, 70569 Stuttgart, Germany
| | - Maximilian Balmus
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th FL Rayne Institute, St. Thomas Hospital, London, SE1 7EH, United Kingdom of Great Britain and Northern Ireland
| | - Oliver Röhrle
- Institute for Modelling and Simulation of Biomechanical Systems, University of Stuttgart, Pfaffenwaldring 5a, 70569 Stuttgart, Germany
| | - David Nordsletten
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th FL Rayne Institute, St. Thomas Hospital, London, SE1 7EH, United Kingdom of Great Britain and Northern Ireland
- Department of Biomedical Engineering and Cardiac Surgery, University of Michigan, NCRC B20, 2800 Plymouth Rd, Ann Arbor, 48109, United States of America
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11
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Amemiya K, Mousseaux E, Ishibashi-Ueda H, Achouh P, Ochiai M, Bruneval P. Impact of histopathological changes in ascending aortic diseases. Int J Cardiol 2020; 311:91-96. [PMID: 32331910 DOI: 10.1016/j.ijcard.2020.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 03/03/2020] [Accepted: 04/01/2020] [Indexed: 01/16/2023]
Abstract
AIMS To better understand relationship between histological medial degenerative changes (MDC), pathological status [thoracic aorta aneurysm (TAA), thoracic aorta dissection (TAD), bicuspid aortic valve (BAV), and non-BAV] and aortic size at imaging. METHODS AND RESULTS We collected 496 ascending aorta surgical specimens from patients with degenerative aortic diseases (mean age, 61 years) whose imaging data were available, including BAV in 191 (TAD 4%, TAA 96%) and with non-BAV in 305 (TAD 45%, TAA 55%). We analyzed them according to the pathology consensus statement and scored MDC [elastic fiber fragmentation and/or loss (EFFL); smooth muscle nuclei loss (SMNL); mucoid extracellular matrix accumulation (MEMA), intralamellar (I) or translamellar (T)] and measured medial wall thickness on correlation with imaging data and the status (TAA, TAD, BAV, or non-BAV). In TAA subset, EFFL, SMNL and MEMA-T scores were lower in BAV than in non-BAV. In relation to the aortic diameter, EFFL, SMNL and MEMA-T scores were more important in TAD subset than in TAA at the small aortic diameters. Independent predictors of aortic dissection included thicker medial wall (odds ratio [OR], 6.3; 95% confidence interval [CI], 2.4 to 17.6; p < 0.0001) and greater SMNL score (OR, 1.2; 95% CI, 1.1 to 1.3; p = 0.003). CONCLUSIONS This large cohort study confirms that non-BAV aortas present higher MDC scores than BAV aortas. Higher MDC scores are correlated with increased aortic diameter. TAD can occur not infrequently in smaller aortas associated with high MDC scores. This suggests that risk stratification of aortic dissection based on aorta dimensions is imperfect.
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Affiliation(s)
- Kisaki Amemiya
- Department of Cardiology, Showa University Northern Yokohama Hospital, Yokohama, Japan; Department of Pathology, National Cerebral and Cardiovascular Center, Osaka, Japan; INSERM U970 PARCC, Paris, France
| | - Elie Mousseaux
- Department of Radiology, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | | | - Paul Achouh
- Department of Cardiovascular Surgery, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Masahiko Ochiai
- Department of Cardiology, Showa University Northern Yokohama Hospital, Yokohama, Japan
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12
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Munshi B, Parker LP, Norman PE, Doyle BJ. The application of computational modeling for risk prediction in type B aortic dissection. J Vasc Surg 2019; 71:1789-1801.e3. [PMID: 31831314 DOI: 10.1016/j.jvs.2019.09.032] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 09/04/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE New tools are urgently needed to help with surgical decision-making in type B aortic dissection (TBAD) that is uncomplicated at the time of initial presentation. This narrative review aims to answer the clinical question, Can computational modeling be used to predict risk in acute and chronic Stanford TBAD? METHODS The review (PROSPERO 2018 CRD42018104472) focused on risk prediction in TBAD. A comprehensive search of the Ovid MEDLINE database, using terms related to computational modeling and aortic dissection, was conducted to find studies of any form published between 1998 and 2018. Cohort studies, case series, and case reports of adults (older than 18 years) with computed tomography or magnetic resonance imaging diagnosis of TBAD were included. Computational modeling was applied in all selected studies. RESULTS There were 37 studies about computational modeling of TBAD identified from the search, and the findings were synthesized into a narrative review. Computational modeling can produce numerically calculated values of stresses, pressures, and flow velocities that are difficult to measure in vivo. Hemodynamic parameters-high or low wall shear stress, high pressure gradient between lumens during the cardiac cycle, and high false lumen flow rate-have been linked to the pathogenesis of branch malperfusion and aneurysm formation by numerous studies. Considering the major outcomes of end-organ failure, aortic rupture, and stabilization and remodeling, hypotheses have been generated about inter-relationships of measurable parameters in computational models with observable anatomic and pathologic changes, resulting in specific clinical outcomes. CONCLUSIONS There is consistency in study findings about computational modeling in TBAD, although a limited number of patients have been analyzed using various techniques. The mechanistic patterns of association found in this narrative review should be investigated in larger cohort prospective studies to further refine our understanding. It highlights the importance of patient-specific computational hemodynamic parameters in clinical decision-making algorithms. The current challenge is to develop and to test a risk assessment method that can be used by clinicians for TBAD.
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Affiliation(s)
- Bijit Munshi
- Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Australia; Centre for Medical Research, The University of Western Australia, Perth, Australia; Medical School, The University of Western Australia, Perth, Australia; Department of Vascular Surgery, Fiona Stanley Hospital, Perth, Australia
| | - Louis P Parker
- Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Australia; Centre for Medical Research, The University of Western Australia, Perth, Australia; School of Engineering, The University of Western Australia, Perth, Australia
| | - Paul E Norman
- Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Australia; Centre for Medical Research, The University of Western Australia, Perth, Australia; Medical School, The University of Western Australia, Perth, Australia; Department of Vascular Surgery, Fiona Stanley Hospital, Perth, Australia
| | - Barry J Doyle
- Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Australia; Centre for Medical Research, The University of Western Australia, Perth, Australia; School of Engineering, The University of Western Australia, Perth, Australia.
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13
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Padoan R, Crimì F, Felicetti M, Padovano F, Lacognata C, Stramare R, Quaia E, Cecchin D, Bui F, Zucchetta P, Schiavon F. Fully integrated 18F-FDG PET/MR in large vessel vasculitis. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF... 2019; 66:272-279. [PMID: 31602964 DOI: 10.23736/s1824-4785.19.03184-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND To evaluate the usefulness of [18F] fluorodeoxyglucose (FDG) positron emission tomography (PET)/magnetic resonance (MR) in large vessels vasculitis (LVV) patients. METHODS We performed an observational retrospective study based on our records. Images were acquired on a PET/MR scanner using 18F-FDG-PET whole body imaging. For each PET scan, a qualitative analysis and a semi-quantitative measure using the maximum of the standardized uptake value (SUVMax) were performed. SUVMax measurements normalized to the liver uptake were categorized using a grading scale. Vessel's wall thickness (WT) was measured at five fixed points (inferior margin of T5, T9, T12, L3, thickest area-max WT). RESULTS 23 LVV patients were included, 56.5% giant cells arteritis, 34.8% Takayasu's arteritis and 8.7% isolated aortitis, all Caucasian, mostly females (82%). We considered 32 PET scans for the LVV group (from min. 1 to max. 3 scans/patient) mainly during follow-up (29/32 scans), and 23 PET scans from a control group of non-metastatic malignancies patients. We found higher SUVMax compared to controls, in all sites, irrespective of clinical disease activity. Mean WT resulted higher in patients than in controls but was not correlated to SUVMax. Mean WT positively correlated with age in both cohorts, inversely correlated to disease duration, while no correlation with SUVMax was observed. The concordance between clinically active disease and PET hypermetabolism was poor (K Cohen 0.33). CONCLUSIONS PET/MR is a safe imaging technique capable of detecting inflammation in aortic wall. Low radiological exposure of PET/MR should be considered especially in young women receiving follow-up studies.
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Affiliation(s)
- Roberto Padoan
- Rheumatology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy -
| | - Filippo Crimì
- Radiology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - Mara Felicetti
- Rheumatology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - Federica Padovano
- Nuclear Medicine Unit, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - Carmelo Lacognata
- Radiology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - Roberto Stramare
- Radiology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - Emilio Quaia
- Radiology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - Diego Cecchin
- Nuclear Medicine Unit, Department of Medicine DIMED, University of Padua, Padua, Italy.,Padova Neuroscience Center, University of Padua, Padua, Italy
| | - Franco Bui
- Nuclear Medicine Unit, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - Pietro Zucchetta
- Nuclear Medicine Unit, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - Franco Schiavon
- Rheumatology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy
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14
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Maurus S, Sommer NN, Kooijman H, Coppenrath E, Witt M, Schulze-Koops H, Czihal M, Hoffmann U, Saam T, Treitl KM. 3D black-blood 3T-MRI for the diagnosis of abdominal large vessel vasculitis. Eur Radiol 2019; 30:1041-1044. [PMID: 31529250 DOI: 10.1007/s00330-019-06432-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 08/27/2019] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To assess the value of a T1-3D black-blood turbo spin echo (TSE) sequence for the diagnosis of abdominal large vessel vasculitis (LVV). MATERIALS AND METHODS The study included 20 patients with abdominal LVV and 17 controls, who underwent a 3T-MRI scan using a modified T1-3D volumetric isotropic TSE acquisition and a segmented T1-3D turbo field echo sequence (T1-mVISTA/T1-eTHRIVE). Two radiologists independently analyzed the aorta for concentric contrast enhancement, concentric wall thickening, image quality, and flow artifact intensity (CCE/CWT/IQ/FAI; 4-point scales). The mean aortic wall thickness (MAWT) in post-contrast T1-mVISTA was compared between patients and controls. RESULTS IQ of T1-mVISTA was rated good to excellent in 91.5% of 282 evaluated vessel segments with no or minor FAI present in 85.5%. The inter-observer reproducibility for the identification of CCE/CWT on T1-mVISTA was 0.92 and 0.93 (p < 0.001). The distribution of segmental inflammation in T1-mVISTA significantly correlated with T1-eTHRIVE (CCE, κ = 0.768; CWT, κ = 0.715; p < 0.001), resulting in a sensitivity, specificity, and positive predictive value of 100%, 81.3%, and 83.3%. The MAWT significantly differed between patients and controls (3.29 ± 0.81 vs. 2.24 ± 0.45 mm; p < 0.001). CONCLUSIONS T1-mVISTA enables the evaluation of the MAWT and allows the detection of abdominal LVV. KEY POINTS • 3D T1w-mVISTA accurately depicted the large abdominal vessels. • 3D T1w-mVISTA enables accurate measurements of the abdominal aortic wall thickness. • 3D T1w-mVISTA is useful for the detection of abdominal LVV.
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Affiliation(s)
- Stefan Maurus
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
| | - Nora N Sommer
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | | | - Eva Coppenrath
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Matthias Witt
- Division of Rheumatology and Clinical Immunology, Medical Clinic and Policlinic IV, University Hospital, LMU Munich, Munich, Germany
| | - Hendrik Schulze-Koops
- Division of Rheumatology and Clinical Immunology, Medical Clinic and Policlinic IV, University Hospital, LMU Munich, Munich, Germany
| | - Michael Czihal
- Division of Vascular Medicine, Medical Clinic and Policlinic IV, University Hospital, LMU Munich, Munich, Germany
| | - Ulrich Hoffmann
- Division of Vascular Medicine, Medical Clinic and Policlinic IV, University Hospital, LMU Munich, Munich, Germany
| | - Tobias Saam
- Radiologisches Zentrum Rosenheim, Rosenheim, Germany
| | - Karla M Treitl
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.,German Center for Cardiovascular Disease Research (DZHK e. V.), Munich, Germany
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15
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Groenendyk JW, Shukla P, Dey AK, Elnabawi YA, Aksentijevich M, Choi H, Genovese LD, Harrington CL, Natarajan B, Goyal A, Reddy AS, Rodante J, Kabbany MT, Sadek A, Al Najafi M, Playford MP, Joshi AA, Ahlman MA, Gelfand JM, Bluemke DA, Mehta NN. Association of aortic vascular uptake of 18FDG by PET/CT and aortic wall thickness by MRI in psoriasis: a prospective observational study. Eur J Nucl Med Mol Imaging 2019; 46:2488-2495. [PMID: 31385013 DOI: 10.1007/s00259-019-04454-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/18/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND The contribution of inflammation to the incidence of cardiovascular disease (CVD) has been increasingly recognized in recent years. We investigated the relationship of aortic vascular uptake of 18F-FDG by PET/CT and aortic wall thickness (AWT) by MRI in psoriasis, a chronic inflammatory disease with increased incidence of CVD. One hundred sixty-five patients with plaque psoriasis participated in an ongoing longitudinal cohort study. Subclinical atherosclerosis was assessed as aortic uptake of 18F-FDG by PET/CT reported as target-to-background ratio (TBR) and AWT by MRI reported as maximal thickness. RESULTS Patients with psoriasis were middle aged, predominantly male, and had mild CV risk by traditional risk factors. Psoriasis severity as measured by PASI score was a notable determinant of AWT (ρ = 0.20, p = 0.01). Moreover, aortic vascular uptake of 18F-FDG associated with AWT by MRI at baseline in unadjusted analysis (β = 0.27 p = 0.001) and following adjustment for traditional cardiovascular risk factors, waist-to-hip ratio, and statin use (β = 0.21 p = 0.01). Finally, following 1 year of psoriasis treatment, a decrease in aortic vascular uptake of 18F-FDG was associated with a reduction in AWT in fully adjusted models (β = 0.33, p = 0.02). CONCLUSION In conclusion, we demonstrate that psoriasis severity and aortic vascular uptake of 18F-FDG in the aorta were associated with AWT. Following treatment of psoriasis, a decrease in aortic vascular uptake of 18F-FDG was associated with a reduction in AWT at 1 year. These findings suggest that aortic vascular uptake of 18F-FDG is associated with early evidence of vascular disease assessed by aortic wall thickness. Prospective studies in larger populations including other inflammatory diseases are warranted.
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Affiliation(s)
- Jacob W Groenendyk
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Parag Shukla
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Amit K Dey
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Youssef A Elnabawi
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Milena Aksentijevich
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Harry Choi
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Leonard D Genovese
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Charlotte L Harrington
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Balaji Natarajan
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Aditya Goyal
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Aarthi S Reddy
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Justin Rodante
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Mohammad Tarek Kabbany
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Ahmed Sadek
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Mina Al Najafi
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Martin P Playford
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Aditya A Joshi
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA
| | - Mark A Ahlman
- National Institutes of Health Clinical Center, 10 Center Drive, Clinical Research Center, Bethesda, MD, 20892, USA
| | - Joel M Gelfand
- University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - David A Bluemke
- University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI, 53792, USA
| | - Nehal N Mehta
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, MD, 20892, USA.
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Gade JL, Stålhand J, Thore CJ. An in vivo parameter identification method for arteries: numerical validation for the human abdominal aorta. Comput Methods Biomech Biomed Engin 2019; 22:426-441. [PMID: 30806081 DOI: 10.1080/10255842.2018.1561878] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A method for identifying mechanical properties of arterial tissue in vivo is proposed in this paper and it is numerically validated for the human abdominal aorta. Supplied with pressure-radius data, the method determines six parameters representing relevant mechanical properties of an artery. In order to validate the method, 22 finite element arteries are created using published data for the human abdominal aorta. With these in silico abdominal aortas, which serve as mock experiments with exactly known material properties and boundary conditions, pressure-radius data sets are generated and the mechanical properties are identified using the proposed parameter identification method. By comparing the identified and pre-defined parameters, the method is quantitatively validated. For healthy abdominal aortas, the parameters show good agreement for the material constant associated with elastin and the radius of the stress-free state over a large range of values. Slightly larger discrepancies occur for the material constants associated with collagen, and the largest relative difference is obtained for the in situ axial prestretch. For pathological abdominal aortas incorrect parameters are identified, but the identification method reveals the presence of diseased aortas. The numerical validation indicates that the proposed parameter identification method is able to identify adequate parameters for healthy abdominal aortas and reveals pathological aortas from in vivo-like data.
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Affiliation(s)
- Jan-Lucas Gade
- a Solid Mechanics, Department of Management and Engineering, Faculty of Science & Engineering , Linköping University , Linköping , Sweden
| | - Jonas Stålhand
- a Solid Mechanics, Department of Management and Engineering, Faculty of Science & Engineering , Linköping University , Linköping , Sweden
| | - Carl-Johan Thore
- a Solid Mechanics, Department of Management and Engineering, Faculty of Science & Engineering , Linköping University , Linköping , Sweden
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Chandy E, Ivanov A, Dabiesingh DS, Grossman A, Sunkesula P, Velagapudi L, Sales VL, Colombo EJ, Klem I, Sacchi TJ, Heitner JF. Systemic involvement in ACS: Using CMR imaging to compare the aortic wall in patients with and without acute coronary syndrome. PLoS One 2018; 13:e0203514. [PMID: 30540752 PMCID: PMC6291123 DOI: 10.1371/journal.pone.0203514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 08/22/2018] [Indexed: 12/05/2022] Open
Abstract
Background/Objectives Previous studies have demonstrated that in acute coronary syndrome (ACS), plaque destabilization and vessel inflammation, represented by vessel edema, often occur simultaneously in multiple coronaries, as well as extend to the cerebrovascular system. Our aim was to determine whether the inflammatory vascular processes occurring within the coronaries during ACS extend simultaneously to the descending aorta. Methods We prospectively enrolled 111 patients (56 ACS patients and 55 non-ACS patients with known coronary artery disease) to undergo cardiac magnetic resonance of the thoracic aortic wall at presentation and at three-month follow-up. The primary outcome was change in aortic wall area (AWA) and maximal aortic wall thickness (AWT) from baseline to three-month follow-up. Secondary outcomes were baseline and follow-up differences in AWA and AWT, and changes in C-reactive protein (CRP). Results There was a significant reduction in mean AWA (p = 0.01) and AWT (p = 0.01) between index and follow up scans in ACS group, with no significant changes in non ACS group (both p>0.1) and no difference between ACS and non-ACS groups (p = 0.22). There was no significant difference in AWA and AWT at baseline (p>0.36) and follow-up (p>0.2) between groups. There was a significant reduction in CRP in both groups (p<0.01), with higher reduction in ACS patients (p<0.01) Conclusions There was a reduction in aortic wall size, aortic wall area, and aortic wall thickness in patients presenting with ACS, and no change in non-ACS patients. There were no interval between-group differences in these measurements. We observed a reduction in C-reactive protein in both groups, with higher reduction noted in ACS patients.
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Affiliation(s)
- Elizabeth Chandy
- Division of Cardiology, Institute for Cardiology and Cardiac Surgery, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, United States of America
| | - Alexander Ivanov
- Division of Cardiology, Institute for Cardiology and Cardiac Surgery, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, United States of America
| | - Devindra S. Dabiesingh
- Division of Cardiology, Institute for Cardiology and Cardiac Surgery, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, United States of America
| | - Alexandra Grossman
- Division of Cardiology, Institute for Cardiology and Cardiac Surgery, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, United States of America
| | - Prasanthi Sunkesula
- Division of Cardiology, Institute for Cardiology and Cardiac Surgery, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, United States of America
| | - Lakshmi Velagapudi
- Division of Cardiology, Institute for Cardiology and Cardiac Surgery, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, United States of America
| | - Virna L. Sales
- Division of Cardiology, Institute for Cardiology and Cardiac Surgery, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, United States of America
| | - Edward J. Colombo
- Division of Cardiology, Institute for Cardiology and Cardiac Surgery, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, United States of America
| | - Igor Klem
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Terrence J. Sacchi
- Division of Cardiology, Institute for Cardiology and Cardiac Surgery, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, United States of America
| | - John F. Heitner
- Division of Cardiology, Institute for Cardiology and Cardiac Surgery, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, United States of America
- * E-mail:
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18
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Bissell LA, Erhayiem B, Fent G, Hensor EMA, Burska A, Donica H, Plein S, Buch MH, Greenwood JP, Andrews J. Carotid artery volumetric measures associate with clinical ten-year cardiovascular (CV) risk scores and individual traditional CV risk factors in rheumatoid arthritis; a carotid-MRI feasibility study. Arthritis Res Ther 2018; 20:266. [PMID: 30509325 PMCID: PMC6278168 DOI: 10.1186/s13075-018-1761-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Common carotid artery intima-media thickness (CIMT), as measured by ultrasound, has utility in stratification of the accelerated cardiovascular risk seen in rheumatoid arthritis (RA); however, the technique has limitations. Carotid magnetic resonance imaging (MRI) is emerging as a useful research tool in the general population, but has yet to be applied in RA populations. Our objectives were to describe the utility of carotid artery MRI (carotid-MRI) in patients with RA in comparison to healthy controls and to describe the association with RA disease phenotype. METHODS Sixty-four patients with RA and no history of cardiovascular (CV) disease/diabetes mellitus were assessed for RA and CV profile, including homeostasis model assessment-estimated insulin resistance (HOMA-IR) and N-terminal pro-brain natriuretic peptide (NT-proBNP). All underwent carotid-MRI (3 T), and were compared to 24 healthy controls. Univariable analysis (UVA) and multivariable linear regression models (MVA) were used to determine associations between disease phenotype and carotid-MRI measures. RESULTS There were no significant differences in carotid arterial wall measurements between patients with RA and controls. Wall and luminal volume correlated with 10-year CV risk scores (adjusted as per 2017 European League Against Rheumatism (EULAR) guidance); rho = 0.33 (p = 0.012) and rho = 0.35 (p = 0.008), respectively, for Joint British Societies-2 risk score. In UVA, carotid-MRI volumetric measures predominantly were associated with traditional CV risk factors including age, ever-smoking and HOMA-IR (p < 0.05). Lower body mass index was associated with wall maximum thickness (r = - 0.25 p = 0.026). In MVA, age was independently associated with wall volume (B 1.13 (95% CI 0.32, 1.93), p = 0.007) and luminal volume (B 3.69 (95% CI 0.55, 6.83, p = 0.022), and RA disease duration was associated with luminal volume (B 3.88 (95% CI 0.80, 6.97), p = 0.015). CONCLUSIONS This study demonstrates the utility of carotid-MRI in RA, reporting an association between three-dimensional measures in particular and CV risk scores, individual traditional CV risk factors and RA disease duration. Carotid-MRI in RA is a promising research tool in the investigation of CVD.
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Affiliation(s)
- Lesley-Anne Bissell
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Bara Erhayiem
- Multidisciplinary Cardiovascular Research Centre & The Division of Biomedical Imaging, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Graham Fent
- Multidisciplinary Cardiovascular Research Centre & The Division of Biomedical Imaging, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Elizabeth M A Hensor
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Agata Burska
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,NIHR Leeds Biomedical Research Centre, Leeds, UK
| | | | - Sven Plein
- Multidisciplinary Cardiovascular Research Centre & The Division of Biomedical Imaging, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Maya H Buch
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - John P Greenwood
- Multidisciplinary Cardiovascular Research Centre & The Division of Biomedical Imaging, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Jacqueline Andrews
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. .,NIHR Leeds Biomedical Research Centre, Leeds, UK.
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19
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Pre-procedural fit-testing of TAVR valves using parametric modeling and 3D printing. J Cardiovasc Comput Tomogr 2018; 13:21-30. [PMID: 30322772 DOI: 10.1016/j.jcct.2018.09.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 09/02/2018] [Accepted: 09/29/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Successful transcatheter aortic valve replacement (TAVR) requires an understanding of how a prosthetic valve will interact with a patient's anatomy in advance of surgical deployment. To improve this understanding, we developed a benchtop workflow that allows for testing of physical interactions between prosthetic valves and patient-specific aortic root anatomy, including calcified leaflets, prior to actual prosthetic valve placement. METHODS This was a retrospective study of 30 patients who underwent TAVR at a single high volume center. By design, the dataset contained 15 patients with a successful annular seal (defined by an absence of paravalvular leaks) and 15 patients with a sub-optimal seal (presence of paravalvular leaks) on post-procedure transthoracic echocardiogram (TTE). Patients received either a balloon-expandable (Edwards Sapien or Sapien XT, n = 15), or a self-expanding (Medtronic CoreValve or Core Evolut, n = 14, St. Jude Portico, n = 1) valve. Pre-procedural computed tomography (CT) angiograms, parametric geometry modeling, and multi-material 3D printing were utilized to create flexible aortic root physical models, including displaceable calcified valve leaflets. A 3D printed adjustable sizing device was then positioned in the aortic root models and sequentially opened to larger valve sizes, progressively flattening the calcified leaflets against the aortic wall. Optimal valve size and fit were determined by visual inspection and quantitative pressure mapping of interactions between the sizer and models. RESULTS Benchtop-predicted "best fit" valve size showed a statistically significant correlation with gold standard CT measurements of the average annulus diameter (n = 30, p < 0.0001 Wilcoxon matched-pairs signed rank test). Adequateness of seal (presence or absence of paravalvular leak) was correctly predicted in 11/15 (73.3%) patients who received a balloon-expandable valve, and in 9/15 (60%) patients who received a self-expanding valve. Pressure testing provided a physical map of areas with an inadequate seal; these corresponded to areas of paravalvular leak documented by post-procedural transthoracic echocardiography. CONCLUSION We present and demonstrate the potential of a workflow for determining optimal prosthetic valve size that accounts for aortic annular dimensions as well as the active displacement of calcified valve leaflets during prosthetic valve deployment. The workflow's open source framework offers a platform for providing predictive insights into the design and testing of future prosthetic valves.
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20
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Emmott A, Alzahrani H, Alreshidan M, Therrien J, Leask RL, Lachapelle K. Transesophageal echocardiographic strain imaging predicts aortic biomechanics: Beyond diameter. J Thorac Cardiovasc Surg 2018; 156:503-512.e1. [DOI: 10.1016/j.jtcvs.2018.01.107] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/09/2018] [Accepted: 01/16/2018] [Indexed: 02/07/2023]
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21
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Cecelja M, Jiang B, Keehn L, Hussain T, Silva Vieira M, Phinikaridou A, Greil G, Spector TD, Chowienczyk P. Arterial stiffening is a heritable trait associated with arterial dilation but not wall thickening: a longitudinal study in the twins UK cohort. Eur Heart J 2018; 39:2282-2288. [PMID: 29590330 PMCID: PMC6012080 DOI: 10.1093/eurheartj/ehy165] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 12/15/2017] [Accepted: 03/07/2018] [Indexed: 01/19/2023] Open
Abstract
Aims Vascular ageing is characterized by arterial stiffening, dilation, and arterial wall thickening. We investigated the extent to which these changes are related and their heritability during 5 year follow-up in the Twins UK cohort. Methods and results Carotid-femoral pulse wave velocity (PWVcf), carotid diameter, carotid distensibility, and carotid intima-media thickness (IMT) were measured in 762 female twins (mean age 57.9 ± 8.6 years) at two time-points over an average follow-up of 4.9 ± 1.5 years. Magnetic resonance imaging (MRI) was performed in a sub-sample of 38 women to measure aortic pulse wave velocity (PWVaorta), diameter, and wall thickness. Heritability of changes in arterial wall properties was estimated using structural equation modelling. Annual increases in PWVcf, carotid diameter, distensibility, and IMT were 0.139 m/s, 0.028 mm, -0.4 kPa-1, and 0.011 mm per year, respectively. In regression analysis, predictors of progression in PWVcf included age, mean arterial pressure (MAP), and heart rate (HR) at baseline, and progression in MAP, HR, and body mass index (BMI). Predictors of progression in IMT included progression in MAP, BMI, and triglyceride levels. Progression of PWV and distensibility correlated with progression in carotid diameter but not with IMT. Heritability of progression of PWVcf, diameter, and IMT was 55%, 21%, and 8%, respectively. In a sub-sample of women that underwent MRI, aortic wall thickness increased by 0.19 mm/year, but aortic wall thickening was not correlated with an increase in lumen diameter or PWVaorta. Conclusion Arterial stiffening, as measured by PWVcf, and dilation are heritable but independent of arterial wall thickening. Genetic and cardiovascular risk factors contribute differently to progression of PWV and IMT.
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Affiliation(s)
- Marina Cecelja
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital, Lambeth Palace Road, London, UK
| | - Benyu Jiang
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital, Lambeth Palace Road, London, UK
| | - Louise Keehn
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital, Lambeth Palace Road, London, UK
| | - Tarique Hussain
- Division of Cardiology, Department of Pediatrics, UT Southwestern Medical Center, 1935 Medical District Drive B3.09, Dallas, TX, USA
| | - Miguel Silva Vieira
- Division of Imaging Sciences and Biomedical Engineering, King’s College London, St Thomas’ Hospital, London, UK
| | - Alkystis Phinikaridou
- Division of Imaging Sciences and Biomedical Engineering, King’s College London, St Thomas’ Hospital, London, UK
| | - Gerald Greil
- Division of Cardiology, Department of Pediatrics, UT Southwestern Medical Center, 1935 Medical District Drive B3.09, Dallas, TX, USA
| | - Tim D Spector
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas’ Hospital, Lambeth Palace Road, London, UK
| | - Phil Chowienczyk
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital, Lambeth Palace Road, London, UK
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22
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Harteveld AA, Denswil NP, Van Hecke W, Kuijf HJ, Vink A, Spliet WGM, Daemen MJ, Luijten PR, Zwanenburg JJM, Hendrikse J, van der Kolk AG. Ex vivo vessel wall thickness measurements of the human circle of Willis using 7T MRI. Atherosclerosis 2018; 273:106-114. [PMID: 29715587 DOI: 10.1016/j.atherosclerosis.2018.04.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/30/2018] [Accepted: 04/18/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND AIMS MRI can detect intracranial vessel wall thickening before any luminal stenosis is present. Apart from representing a vessel wall lesion, wall thickening could also reflect normal (age-related) variations in vessel wall thickness present throughout the intracranial arterial vasculature. The aim of this study was to perform vessel wall thickness measurements of the major intracranial arteries in ex vivo circle of Willis (CoW) specimens using 7T MRI, to obtain more detailed information about wall thickness variations of the intracranial arteries. METHODS Fifteen human CoW specimens were scanned at 7T MRI with an ultrahigh-resolution T1-weighted sequence. Five specimens were used for validation of MRI measurements with histology and evaluation of inter-rater reliability and agreement. The other 10 specimens from patients with (n = 5) and without (n = 5) cerebrovascular disease were used for vessel wall thickness measurements over the entire length of the major arterial segments of the CoW using MRI only. RESULTS MRI measurements showed excellent agreement with histology. Mean wall thickness varied from 0.45 to 0.66 mm, minimum wall thickness from 0.31 to 0.42 mm, maximum wall thickness from 0.52 to 0.86 mm, and normalized wall index from 0.64 to 0.75. On average, vessel walls were thicker for symptomatic patients compared to asymptomatic patients. CONCLUSIONS High-resolution MRI enables accurate measurement of vessel wall thickness in ex vivo CoW specimens. Vessel wall thickness measurements over the entire length of segments showed considerable variation both within and between arterial segments of patients.
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Affiliation(s)
- Anita A Harteveld
- Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands.
| | - Nerissa P Denswil
- Department of Pathology, Academic Medical Center, Postbox 22660, 1100 DD, Amsterdam, The Netherlands
| | - Wim Van Hecke
- Department of Pathology, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands
| | - Hugo J Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands
| | - Aryan Vink
- Department of Pathology, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands
| | - Wim G M Spliet
- Department of Pathology, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands
| | - Mat J Daemen
- Department of Pathology, Academic Medical Center, Postbox 22660, 1100 DD, Amsterdam, The Netherlands
| | - Peter R Luijten
- Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands
| | - Jaco J M Zwanenburg
- Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands
| | - Jeroen Hendrikse
- Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands
| | - Anja G van der Kolk
- Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA, Utrecht, The Netherlands
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23
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Doyle BJ, Norman PE, Hoskins PR, Newby DE, Dweck MR. Wall Stress and Geometry of the Thoracic Aorta in Patients With Aortic Valve Disease. Ann Thorac Surg 2018; 105:1077-1085. [DOI: 10.1016/j.athoracsur.2017.11.061] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 11/07/2017] [Accepted: 11/27/2017] [Indexed: 10/18/2022]
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24
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Shavik SM, Jiang Z, Baek S, Lee LC. High Spatial Resolution Multi-Organ Finite Element Modeling of Ventricular-Arterial Coupling. Front Physiol 2018; 9:119. [PMID: 29551977 PMCID: PMC5841309 DOI: 10.3389/fphys.2018.00119] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Accepted: 02/05/2018] [Indexed: 11/13/2022] Open
Abstract
While it has long been recognized that bi-directional interaction between the heart and the vasculature plays a critical role in the proper functioning of the cardiovascular system, a comprehensive study of this interaction has largely been hampered by a lack of modeling framework capable of simultaneously accommodating high-resolution models of the heart and vasculature. Here, we address this issue and present a computational modeling framework that couples finite element (FE) models of the left ventricle (LV) and aorta to elucidate ventricular-arterial coupling in the systemic circulation. We show in a baseline simulation that the framework predictions of (1) LV pressure-volume loop, (2) aorta pressure-diameter relationship, (3) pressure-waveforms of the aorta, LV, and left atrium (LA) over the cardiac cycle are consistent with the physiological measurements found in healthy human. To develop insights of ventricular-arterial interactions, the framework was then used to simulate how alterations in the geometrical or, material parameter(s) of the aorta affect the LV and vice versa. We show that changing the geometry and microstructure of the aorta model in the framework led to changes in the functional behaviors of both LV and aorta that are consistent with experimental observations. On the other hand, changing contractility and passive stiffness of the LV model in the framework also produced changes in both the LV and aorta functional behaviors that are consistent with physiology principles.
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Affiliation(s)
- Sheikh Mohammad Shavik
- Department of Mechanical Engineering, Michigan State University, East Lansing, MI, United States
| | - Zhenxiang Jiang
- Department of Mechanical Engineering, Michigan State University, East Lansing, MI, United States
| | - Seungik Baek
- Department of Mechanical Engineering, Michigan State University, East Lansing, MI, United States
| | - Lik Chuan Lee
- Department of Mechanical Engineering, Michigan State University, East Lansing, MI, United States
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25
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Reichenbach S, Adler S, Bonel H, Cullmann JL, Kuchen S, Bütikofer L, Seitz M, Villiger PM. Magnetic resonance angiography in giant cell arteritis: results of a randomized controlled trial of tocilizumab in giant cell arteritis. Rheumatology (Oxford) 2018. [DOI: 10.1093/rheumatology/key015] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Stephan Reichenbach
- Department of Rheumatology, Immunology and Allergology, University Hospital, Bern, Switzerland
- Institute for Social and Preventive Medicine, Bern, Switzerland
| | - Sabine Adler
- Department of Rheumatology, Immunology and Allergology, University Hospital, Bern, Switzerland
| | - Harald Bonel
- Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern, Switzerland
| | - Jennifer L Cullmann
- Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern, Switzerland
| | - Stefan Kuchen
- Department of Rheumatology, Immunology and Allergology, University Hospital, Bern, Switzerland
| | - Lukas Bütikofer
- Institute for Social and Preventive Medicine, Bern, Switzerland
- CTU Bern, University of Bern, Bern, Switzerland
| | - Michael Seitz
- Department of Rheumatology, Immunology and Allergology, University Hospital, Bern, Switzerland
| | - Peter M Villiger
- Department of Rheumatology, Immunology and Allergology, University Hospital, Bern, Switzerland
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26
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Simulation of arterial dissection by a penetrating external body using cohesive zone modelling. J Mech Behav Biomed Mater 2017; 71:95-105. [DOI: 10.1016/j.jmbbm.2017.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 02/23/2017] [Accepted: 03/05/2017] [Indexed: 11/19/2022]
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27
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Eikendal ALM, den Ruijter HM, Haaring C, Saam T, van der Geest RJ, Westenberg JJM, Bots ML, Hoefer IE, Leiner T. Sex, body mass index, and blood pressure are related to aortic characteristics in healthy, young adults using magnetic resonance vessel wall imaging: the AMBITYON study. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2017; 31:173-182. [PMID: 28569376 PMCID: PMC5813077 DOI: 10.1007/s10334-017-0626-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 05/12/2017] [Accepted: 05/12/2017] [Indexed: 12/31/2022]
Abstract
Objectives More detailed evaluation of atherosclerosis and its key determinants in young individuals is warranted to improve knowledge on the pathophysiology of its development and progression. This study evaluated associations of magnetic resonance imaging (MRI)-derived aortic wall area, wall thickness, and pulse wave velocity (PWV) with cardiovascular risk factors in asymptomatic, young adults. Materials and methods In 124 adults (age: 25–35 years) from the general population-based Atherosclerosis Monitoring and Biomarker Measurements in the Young study, demography, anthropometry, and blood samples were collected. The studied MRI-parameters were measured using a 3.0T MRI system. Relations between cardiovascular risk factors and aortic characteristics were assessed using multivariable linear regression analyses. Results Mean age was 31.8 years, 47.6% was male. Aortic wall area was positively associated with age [β = 0.01, (95% confidence interval (CI) 2.00 × 10−3, 0.02), p = 0.01] and BMI [β = 0.01, (0.01, 0.02), p = 0.003] and negatively associated with sex (reference: men) [β = −0.06, (−0.11, −0.01), p = 0.02]. Natural logarithm transformed (ln) aortic wall thickness was positively associated with BMI [β = 0.01, (1.00 × 10−3, 0.02), p = 0.02]. Ln aortic PWV was positively associated with 10 mmHg increment of SBP [β = 0.06, (0.03, 0.09), p < 0.001] and DBP [β = 0.06, (0.02, 0.09), p = 0.006]. No relations were observed for smoking and lipids. Conclusions Already in early adulthood, aortic wall geometry and stiffness vary by age, sex, BMI, and blood pressure.
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Affiliation(s)
- Anouk L M Eikendal
- Department of Radiology (E01.132), University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
| | - Hester M den Ruijter
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Cees Haaring
- Department of Radiology (E01.132), University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Tobias Saam
- Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital, Marchioninistrasse 15, 81377, Munich, Germany
| | - Rob J van der Geest
- Division of Image Processing, Department of Radiology, 1-C2S Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - Jos J M Westenberg
- Division of Image Processing, Department of Radiology, 1-C2S Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Imo E Hoefer
- Laboratory of Clinical Chemistry and Hematology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Tim Leiner
- Department of Radiology (E01.132), University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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28
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Wang Y, Seguro F, Kao E, Zhang Y, Faraji F, Zhu C, Haraldsson H, Hope M, Saloner D, Liu J. Segmentation of lumen and outer wall of abdominal aortic aneurysms from 3D black-blood MRI with a registration based geodesic active contour model. Med Image Anal 2017; 40:1-10. [PMID: 28549310 DOI: 10.1016/j.media.2017.05.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 05/05/2017] [Accepted: 05/12/2017] [Indexed: 11/24/2022]
Abstract
Segmentation of the geometric morphology of abdominal aortic aneurysm is important for interventional planning. However, the segmentation of both the lumen and the outer wall of aneurysm in magnetic resonance (MR) image remains challenging. This study proposes a registration based segmentation methodology for efficiently segmenting MR images of abdominal aortic aneurysms. The proposed methodology first registers the contrast enhanced MR angiography (CE-MRA) and black-blood MR images, and then uses the Hough transform and geometric active contours to extract the vessel lumen by delineating the inner vessel wall directly from the CE-MRA. The proposed registration based geometric active contour is applied to black-blood MR images to generate the outer wall contour. The inner and outer vessel wall are then fused presenting the complete vessel lumen and wall segmentation. The results obtained from 19 cases showed that the proposed registration based geometric active contour model was efficient and comparable to manual segmentation and provided a high segmentation accuracy with an average Dice value reaching 89.79%.
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Affiliation(s)
- Yan Wang
- Radiology and Biomedical Imaging, University of California,San Francisco, San Francisco, United States.
| | - Florent Seguro
- Radiology and Biomedical Imaging, University of California,San Francisco, San Francisco, United States
| | - Evan Kao
- Radiology and Biomedical Imaging, University of California,San Francisco, San Francisco, United States; University of California, Berkeley; San Francisco, United States
| | - Yue Zhang
- Veterans Affairs Medical Center, San Francisco, United States
| | - Farshid Faraji
- Radiology and Biomedical Imaging, University of California,San Francisco, San Francisco, United States
| | - Chengcheng Zhu
- Radiology and Biomedical Imaging, University of California,San Francisco, San Francisco, United States
| | - Henrik Haraldsson
- Radiology and Biomedical Imaging, University of California,San Francisco, San Francisco, United States
| | - Michael Hope
- Radiology and Biomedical Imaging, University of California,San Francisco, San Francisco, United States
| | - David Saloner
- Radiology and Biomedical Imaging, University of California,San Francisco, San Francisco, United States; Veterans Affairs Medical Center, San Francisco, United States
| | - Jing Liu
- Radiology and Biomedical Imaging, University of California,San Francisco, San Francisco, United States
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29
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Zhou C, Qiao H, He L, Yuan C, Chen H, Zhang Q, Li R, Wang W, Du F, Li C, Zhao X. Characterization of atherosclerotic disease in thoracic aorta: A 3D, multicontrast vessel wall imaging study. Eur J Radiol 2016; 85:2030-2035. [DOI: 10.1016/j.ejrad.2016.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 09/01/2016] [Accepted: 09/10/2016] [Indexed: 01/25/2023]
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30
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Reference Values for Cardiac and Aortic Magnetic Resonance Imaging in Healthy, Young Caucasian Adults. PLoS One 2016; 11:e0164480. [PMID: 27732640 PMCID: PMC5061387 DOI: 10.1371/journal.pone.0164480] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 09/26/2016] [Indexed: 12/04/2022] Open
Abstract
Background Reference values for morphological and functional parameters of the cardiovascular system in early life are relevant since they may help to identify young adults who fall outside the physiological range of arterial and cardiac ageing. This study provides age and sex specific reference values for aortic wall characteristics, cardiac function parameters and aortic pulse wave velocity (PWV) in a population-based sample of healthy, young adults using magnetic resonance (MR) imaging. Materials and Methods In 131 randomly selected healthy, young adults aged between 25 and 35 years (mean age 31.8 years, 63 men) of the general-population based Atherosclerosis-Monitoring-and-Biomarker-measurements-In-The-YOuNg (AMBITYON) study, descending thoracic aortic dimensions and wall thickness, thoracic aortic PWV and cardiac function parameters were measured using a 3.0T MR-system. Age and sex specific reference values were generated using dedicated software. Differences in reference values between two age groups (25–30 and 30–35 years) and both sexes were tested. Results Aortic diameters and areas were higher in the older age group (all p<0.007). Moreover, aortic dimensions, left ventricular mass, left and right ventricular volumes and cardiac output were lower in women than in men (all p<0.001). For mean and maximum aortic wall thickness, left and right ejection fraction and aortic PWV we did not observe a significant age or sex effect. Conclusion This study provides age and sex specific reference values for cardiovascular MR parameters in healthy, young Caucasian adults. These may aid in MR guided pre-clinical identification of young adults who fall outside the physiological range of arterial and cardiac ageing.
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31
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Praveen Kumar G, Jafary-Zadeh M, Cui F. Deployment of a Bulk Metallic Glass-Based Self-Expandable Stent in a Patient-Specific Descending Aorta. ACS Biomater Sci Eng 2016; 2:1951-1958. [DOI: 10.1021/acsbiomaterials.6b00342] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Gideon Praveen Kumar
- Institute
of High Performance Computing, A*STAR, 1 Fusionopolis Way #16-16 Connexis, Singapore 138632
| | - Mehdi Jafary-Zadeh
- Institute
of High Performance Computing, A*STAR, 1 Fusionopolis Way #16-16 Connexis, Singapore 138632
| | - Fangsen Cui
- Institute
of High Performance Computing, A*STAR, 1 Fusionopolis Way #16-16 Connexis, Singapore 138632
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Treitl KM, Maurus S, Sommer NN, Kooijman-Kurfuerst H, Coppenrath E, Treitl M, Czihal M, Hoffmann U, Dechant C, Schulze-Koops H, Saam T. 3D-black-blood 3T-MRI for the diagnosis of thoracic large vessel vasculitis: A feasibility study. Eur Radiol 2016; 27:2119-2128. [PMID: 27510630 DOI: 10.1007/s00330-016-4525-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 07/19/2016] [Accepted: 07/21/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To evaluate the feasibility of T1w-3D black-blood turbo spin echo (TSE) sequence with variable flip angles for the diagnosis of thoracic large vessel vasculitis (LVV). METHODS Thirty-five patients with LVV, diagnosed according to the current standard of reference, and 35 controls were imaged at 3.0T using 1.2 × 1.3 × 2.0 mm3 fat-suppressed, T1w-3D, modified Volumetric Isotropic TSE Acquisition (mVISTA) pre- and post-contrast. Applying a navigator and peripheral pulse unit triggering (PPU), the total scan time was 10-12 min. Thoracic aorta and subclavian and pulmonary arteries were evaluated for image quality (IQ), flow artefact intensity, diagnostic confidence, concentric wall thickening and contrast enhancement (CWT, CCE) using a 4-point scale. RESULTS IQ was good in all examinations (3.25 ± 0.72) and good to excellent in 342 of 408 evaluated segments (83.8 %), while 84.1 % showed no or minor flow artefacts. The interobserver reproducibility for the identification of CCE and CWT was 0.969 and 0.971 (p < 0.001) with an average diagnostic confidence of 3.47 ± 0.64. CCE and CWT were strongly correlated (Cohen's k = 0.87; P < 0.001) and significantly more frequent in the LVV-group (52.8 % vs. 1.0 %; 59.8 % vs. 2.4 %; P < 0.001). CONCLUSIONS Navigated fat-suppressed T1w-3D black-blood MRI with PPU-triggering allows diagnosis of thoracic LVV. KEY POINTS • Cross-sectional imaging is frequently applied in the diagnosis of LVV. • Navigated, PPU-triggered, T1w-3D mVISTA pre- and post contrast takes 10-12 min. • In this prospective, single-centre study, T1w-3D mVISTA accurately depicted large thoracic vessels. • T1w-3D mVISTA visualized CWT/CCW as correlates of mural inflammation in LVV. • T1w-3D mVISTA might be an alternative diagnostic tool without ionizing radiation.
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Affiliation(s)
- Karla Maria Treitl
- Institute for Clinical Radiology, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany. .,German Center for Cardiovascular Disease Research (DZHK e. V.), Pettenkoferstr. 8a, 80336, Munich, Germany.
| | - Stefan Maurus
- Institute for Clinical Radiology, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - Nora Narvina Sommer
- Institute for Clinical Radiology, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | | | - Eva Coppenrath
- Institute for Clinical Radiology, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - Marcus Treitl
- Institute for Clinical Radiology, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - Michael Czihal
- Division of Vascular Medicine, Medical Clinic and Policlinic IV, LMU Munich, Pettenkoferstr. 8a, D-80336, Munich, Germany
| | - Ulrich Hoffmann
- Division of Vascular Medicine, Medical Clinic and Policlinic IV, LMU Munich, Pettenkoferstr. 8a, D-80336, Munich, Germany
| | - Claudia Dechant
- Division of Rheumatology and Clinical Immunology, Medical Clinic and Policlinic IV, LMU Munich, Pettenkoferstr. 8a, D-80336, Munich, Germany
| | - Hendrik Schulze-Koops
- Division of Rheumatology and Clinical Immunology, Medical Clinic and Policlinic IV, LMU Munich, Pettenkoferstr. 8a, D-80336, Munich, Germany
| | - Tobias Saam
- Institute for Clinical Radiology, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany.,German Center for Cardiovascular Disease Research (DZHK e. V.), Pettenkoferstr. 8a, 80336, Munich, Germany
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33
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Eikendal ALM, Blomberg BA, Haaring C, Saam T, van der Geest RJ, Visser F, Bots ML, den Ruijter HM, Hoefer IE, Leiner T. 3D black blood VISTA vessel wall cardiovascular magnetic resonance of the thoracic aorta wall in young, healthy adults: reproducibility and implications for efficacy trial sample sizes: a cross-sectional study. J Cardiovasc Magn Reson 2016; 18:20. [PMID: 27075677 PMCID: PMC4831203 DOI: 10.1186/s12968-016-0237-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 03/22/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Pre-clinical detection of atherosclerosis enables personalized preventive strategies in asymptomatic individuals. Cardiovascular magnetic resonance (CMR) has evolved as an attractive imaging modality for studying atherosclerosis in vivo. Yet, the majority of aortic CMR studies and proposed sequences to date have been performed at 1.5 tesla using 2D BB techniques and a slice thickness of 4-5 mm. Here, we evaluate for the first time the reproducibility of an isotropic, T1-weighted, three-dimensional, black-blood, CMR VISTA sequence (3D-T1-BB-VISTA) for quantification of aortic wall characteristics in healthy, young adults. METHODS In 20 healthy, young adults (10 males, mean age 31.3 years) of the AMBITYON cohort study the descending thoracic aorta was imaged with a 3.0 T MR system using the 3D-T1-BB-VISTA sequence. The inter-scan, inter-rater and intra-rater reproducibility of aortic lumen, total vessel and wall area and mean and maximum wall thickness was evaluated using Bland-Altman analyses and Intraclass Correlation Coefficients (ICC). Based on these findings, sample sizes for detecting differences in aortic wall characteristics between groups were calculated. RESULTS For each studied parameter, the inter-scan, inter-rater and intra-rater reproducibility was excellent as indicated by narrow limits of agreement and high ICCs (ranging from 0.76 to 0.99). Sample sizes required to detect a 5% difference in aortic wall characteristics between two groups were 203, 126, 136, 68 and 153 per group for lumen area, total vessel area and vessel wall area and for mean and maximum vessel wall thickness, respectively. CONCLUSION The 3D-T1-BB-VISTA sequence provides excellent reproducibility for quantification of aortic wall characteristics and can detect small differences between groups with reasonable sample sizes. Hence, it may be a valuable tool for assessment of the subtle vascular wall changes of early atherosclerosis in asymptomatic populations.
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Affiliation(s)
- Anouk L. M. Eikendal
- />Department of Radiology (E01.132), University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Björn A. Blomberg
- />Department of Radiology (E01.132), University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Cees Haaring
- />Department of Radiology (E01.132), University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Tobias Saam
- />Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital, Marchioninistrasse 15, 81377 Munich, Germany
| | - Rob J. van der Geest
- />Division of Image Processing, Department of Radiology, 1-C2S Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Fredy Visser
- />Department of Radiology (E01.132), University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
- />Philips Healthcare, Veenpluis 4-6, 5684PC Best, The Netherlands
| | - Michiel L. Bots
- />Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Hester M. den Ruijter
- />Laboratory of Experimental Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Imo E. Hoefer
- />Laboratory of Clinical Chemistry and Hematology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Tim Leiner
- />Department of Radiology (E01.132), University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
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Wang Y, Zhang Y, Navarro L, Eker OF, Corredor Jerez RA, Chen Y, Zhu Y, Courbebaisse G. Multilevel segmentation of intracranial aneurysms in CT angiography images. Med Phys 2016; 43:1777. [DOI: 10.1118/1.4943375] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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Krüger T, Veseli K, Lausberg H, Vöhringer L, Schneider W, Schlensak C. Regional and directional compliance of the healthy aorta: an ex vivo study in a porcine model. Interact Cardiovasc Thorac Surg 2016; 23:104-11. [PMID: 26993474 DOI: 10.1093/icvts/ivw053] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 01/25/2016] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES To gain differential knowledge about the physiological compliance and wall strength of the different regions of the aorta, including the ascending aorta, arch and descending aorta in both the circumferential and longitudinal directions, and to generate a hypothesis on the pathophysiological mechanisms that lead to Type A aortic dissection. METHODS Fresh tissue specimens from 22 ex vivo porcine aortas were analysed on a tensile tester. Regional and directional compliance, failure stress and failure strain were recorded. RESULTS Aortic compliance appeared as a linear function of the natural logarithm (ln) of wall stress. Compliance significantly decreased along the length of the aorta. In the ascending aorta, longitudinal compliance significantly (P = 0.003) exceeded circumferential compliance, and the outer curvature was more compliant than the inner curvature (P = 0.03). In the descending aorta, this relationship is reversed: the circumferential compliance exceeded the longitudinal compliance, and the outer aspect was more compliant (P = 0.003). The median circumferential failure stress of all aortic segments was in the range of 2000-2750 kPa, whereas the longitudinal failure stress in the ascending aorta and the arch had values of 750-1000 kPa, which were significantly lower (P < 0.05). Surprisingly, the longitudinal failure stress of the inner aspect of the descending aorta was extraordinarily high (2000 kPa). Failure strain, similar to compliance, was highest in the ascending aorta and decreased along the aorta. CONCLUSION The aorta appears to be a complex organ with distinct regional and directional differences in compliance and wall strength that is designed to effectively absorb the kinetic energy of cardiac systole and to cushion the momentum of systolic impact. Under normotensive conditions and a preconditioned physiological morphology, the aortic wall works in the steep part of the logarithmic strain-stress function; under hypertensive conditions and pathological morphology, the wall reacts in an non-compliant manner. The high longitudinal compliance and low failure stress of the ascending aorta and subsequent pathological changes may be the main determinants of the recurrent patho-anatomy of Type A aortic dissection.
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Affiliation(s)
- Tobias Krüger
- Department of Thoracic and Cardiovascular Surgery, University Medical Center Tübingen, Tübingen, Germany
| | - Kujtim Veseli
- Department of Thoracic and Cardiovascular Surgery, University Medical Center Tübingen, Tübingen, Germany
| | - Henning Lausberg
- Department of Thoracic and Cardiovascular Surgery, University Medical Center Tübingen, Tübingen, Germany
| | - Luise Vöhringer
- Department of Thoracic and Cardiovascular Surgery, University Medical Center Tübingen, Tübingen, Germany
| | - Wilke Schneider
- Department of Thoracic and Cardiovascular Surgery, University Medical Center Tübingen, Tübingen, Germany
| | - Christian Schlensak
- Department of Thoracic and Cardiovascular Surgery, University Medical Center Tübingen, Tübingen, Germany
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Emmott A, Garcia J, Chung J, Lachapelle K, El-Hamamsy I, Mongrain R, Cartier R, Leask RL. Biomechanics of the Ascending Thoracic Aorta: A Clinical Perspective on Engineering Data. Can J Cardiol 2016; 32:35-47. [DOI: 10.1016/j.cjca.2015.10.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 10/17/2015] [Accepted: 10/18/2015] [Indexed: 12/14/2022] Open
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Slobodin G, Nakhleh A, Rimar D, Wolfson V, Rosner I, Odeh M. Increased aortic wall thickness for the diagnosis of aortitis: a computed tomography-based study. Int J Rheum Dis 2015; 19:82-6. [DOI: 10.1111/1756-185x.12742] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Gleb Slobodin
- Department of Internal Medicine A; Bnai Zion Medical Center; Haifa Israel
- Ruth & Bruce Rappaport Faculty of Medicine; Technion; Haifa Israel
| | - Afif Nakhleh
- Department of Internal Medicine A; Bnai Zion Medical Center; Haifa Israel
| | - Doron Rimar
- Ruth & Bruce Rappaport Faculty of Medicine; Technion; Haifa Israel
- Rheumatology Unit; Bnai Zion Medical Center; Haifa Israel
| | - Vladimir Wolfson
- Interventional Radiology Unit; Bnai Zion Medical Center; Haifa Israel
| | - Itzhak Rosner
- Ruth & Bruce Rappaport Faculty of Medicine; Technion; Haifa Israel
- Rheumatology Unit; Bnai Zion Medical Center; Haifa Israel
| | - Majed Odeh
- Department of Internal Medicine A; Bnai Zion Medical Center; Haifa Israel
- Ruth & Bruce Rappaport Faculty of Medicine; Technion; Haifa Israel
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Rossetti HC, Weiner M, Hynan LS, Cullum CM, Khera A, Lacritz LH. Subclinical atherosclerosis and subsequent cognitive function. Atherosclerosis 2015; 241:36-41. [PMID: 25957568 DOI: 10.1016/j.atherosclerosis.2015.04.813] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 04/23/2015] [Accepted: 04/25/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the relationship between measures of subclinical atherosclerosis and subsequent cognitive function. METHOD Participants from the Dallas Heart Study (DHS), a population-based multiethnic study of cardiovascular disease pathogenesis, were re-examined 8 years later (DHS-2) with the Montreal Cognitive Assessment (MoCA); N = 1904, mean age = 42.9, range 8-65. Associations of baseline measures of subclinical atherosclerosis (coronary artery calcium, abdominal aortic plaque, and abdominal aortic wall thickness) with MoCA scores measured at follow-up were examined in the group as a whole and in relation to age and ApoE4 status. RESULTS A significant linear trend of successively lower MoCA scores with increasing numbers of atherosclerotic indicators was observed (F(3, 1150) = 5.918, p = .001). CAC was weakly correlated with MoCA scores (p = .047) and MoCA scores were significantly different between participants with and without CAC (M = 22.35 vs 23.69, p = 0.038). With the exception of a small association between abdominal AWT and MoCA in subjects over age 50, abdominal AWT and abdominal aortic plaque did not correlate with MoCA total score (p ≥ .052). Cognitive scores and atherosclerosis measures were not impacted by ApoE4 status (p ≥ .455). CONCLUSION In this ethnically diverse population-based sample, subclinical atherosclerosis was minimally associated with later cognitive function in middle-aged adults.
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Affiliation(s)
| | - Myron Weiner
- Department of Psychiatry, UT Southwestern Medical Center, USA
| | - Linda S Hynan
- Department of Psychiatry, UT Southwestern Medical Center, USA; Department of Clinical Science, UT Southwestern Medical Center, USA
| | - C Munro Cullum
- Department of Psychiatry, UT Southwestern Medical Center, USA; Department of Neurology and Neurotherapeutics, UT Southwestern Medical Center, USA
| | - Amit Khera
- Internal Medicine, UT Southwestern Medical Center, USA
| | - Laura H Lacritz
- Department of Psychiatry, UT Southwestern Medical Center, USA; Department of Neurology and Neurotherapeutics, UT Southwestern Medical Center, USA
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Liu CY, Chen D, Bluemke DA, Wu CO, Teixido-Tura G, Chugh A, Vasu S, Lima JAC, Hundley WG. Evolution of aortic wall thickness and stiffness with atherosclerosis: long-term follow up from the multi-ethnic study of atherosclerosis. Hypertension 2015; 65:1015-9. [PMID: 25776078 DOI: 10.1161/hypertensionaha.114.05080] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 01/24/2015] [Indexed: 11/16/2022]
Abstract
The study was performed to determine age, sex, and time-dependent changes in aortic wall thickness (AWT) and to evaluate cross-sectional associations between AWT and arterial stiffness in older adults. Three hundred seventy-one longitudinal and 426 cross-sectional measurements of AWT from cardiovascular magnetic resonance imaging studies conducted within the Multi-Ethnic Study of Atherosclerosis were analyzed at 2 points in time, in 2000 to 2002 and then again from follow-up examinations in 2010 to 2012. Aortic wall thickness was determined from a double inversion recovery black-blood fast spin-echo sequence, and aortic stiffness was measured from a phase-contrast cine gradient echo sequence. The thickness of the midthoracic descending aortic wall was measured and correlated to distensibility of the ascending aorta and aortic pulse wave velocity. The average rate of AWT change was 0.032 mm/y. The increase in AWT was greater for those aged 45 to 54 years relative to individuals older than 55 years (P trend<0.001). Ascending aortic distensibility was lower (P<0.001) and pulse wave velocity was higher (P=0.012) for hypertensive subjects. After adjustment for traditional risk factors, distensibility of the ascending aorta was significantly related to AWT in participants without hypertension. Hypertension was associated with increased aortic stiffness independent of aortic wall thickness.
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Affiliation(s)
- Chia-Ying Liu
- From the Department of Radiology and Imaging Sciences, National Institutes of Health (NIH), Bethesda, MD (C.-Y.L., D.A.B.); Department of Radiology, Johns Hopkins Hospital, Baltimore, MD (D.C., D.A.B., J.A.C.L.); Office of Biostatistics Research, National Heart, Lung, and Blood Institutes (NHLBI), Bethesda, MD (C.O.W.); Department of Cardiology, Hospital General Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain (G.T.-T.); Division of Cardiovascular Medicine, University of Louisville School of Medicine, KY (A.C.); and Division of Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University, Winston-Salem, NC (S.V., W.G.H.)
| | - Doris Chen
- From the Department of Radiology and Imaging Sciences, National Institutes of Health (NIH), Bethesda, MD (C.-Y.L., D.A.B.); Department of Radiology, Johns Hopkins Hospital, Baltimore, MD (D.C., D.A.B., J.A.C.L.); Office of Biostatistics Research, National Heart, Lung, and Blood Institutes (NHLBI), Bethesda, MD (C.O.W.); Department of Cardiology, Hospital General Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain (G.T.-T.); Division of Cardiovascular Medicine, University of Louisville School of Medicine, KY (A.C.); and Division of Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University, Winston-Salem, NC (S.V., W.G.H.)
| | - David A Bluemke
- From the Department of Radiology and Imaging Sciences, National Institutes of Health (NIH), Bethesda, MD (C.-Y.L., D.A.B.); Department of Radiology, Johns Hopkins Hospital, Baltimore, MD (D.C., D.A.B., J.A.C.L.); Office of Biostatistics Research, National Heart, Lung, and Blood Institutes (NHLBI), Bethesda, MD (C.O.W.); Department of Cardiology, Hospital General Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain (G.T.-T.); Division of Cardiovascular Medicine, University of Louisville School of Medicine, KY (A.C.); and Division of Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University, Winston-Salem, NC (S.V., W.G.H.)
| | - Colin O Wu
- From the Department of Radiology and Imaging Sciences, National Institutes of Health (NIH), Bethesda, MD (C.-Y.L., D.A.B.); Department of Radiology, Johns Hopkins Hospital, Baltimore, MD (D.C., D.A.B., J.A.C.L.); Office of Biostatistics Research, National Heart, Lung, and Blood Institutes (NHLBI), Bethesda, MD (C.O.W.); Department of Cardiology, Hospital General Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain (G.T.-T.); Division of Cardiovascular Medicine, University of Louisville School of Medicine, KY (A.C.); and Division of Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University, Winston-Salem, NC (S.V., W.G.H.)
| | - Gisela Teixido-Tura
- From the Department of Radiology and Imaging Sciences, National Institutes of Health (NIH), Bethesda, MD (C.-Y.L., D.A.B.); Department of Radiology, Johns Hopkins Hospital, Baltimore, MD (D.C., D.A.B., J.A.C.L.); Office of Biostatistics Research, National Heart, Lung, and Blood Institutes (NHLBI), Bethesda, MD (C.O.W.); Department of Cardiology, Hospital General Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain (G.T.-T.); Division of Cardiovascular Medicine, University of Louisville School of Medicine, KY (A.C.); and Division of Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University, Winston-Salem, NC (S.V., W.G.H.)
| | - Atul Chugh
- From the Department of Radiology and Imaging Sciences, National Institutes of Health (NIH), Bethesda, MD (C.-Y.L., D.A.B.); Department of Radiology, Johns Hopkins Hospital, Baltimore, MD (D.C., D.A.B., J.A.C.L.); Office of Biostatistics Research, National Heart, Lung, and Blood Institutes (NHLBI), Bethesda, MD (C.O.W.); Department of Cardiology, Hospital General Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain (G.T.-T.); Division of Cardiovascular Medicine, University of Louisville School of Medicine, KY (A.C.); and Division of Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University, Winston-Salem, NC (S.V., W.G.H.)
| | - Sujethra Vasu
- From the Department of Radiology and Imaging Sciences, National Institutes of Health (NIH), Bethesda, MD (C.-Y.L., D.A.B.); Department of Radiology, Johns Hopkins Hospital, Baltimore, MD (D.C., D.A.B., J.A.C.L.); Office of Biostatistics Research, National Heart, Lung, and Blood Institutes (NHLBI), Bethesda, MD (C.O.W.); Department of Cardiology, Hospital General Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain (G.T.-T.); Division of Cardiovascular Medicine, University of Louisville School of Medicine, KY (A.C.); and Division of Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University, Winston-Salem, NC (S.V., W.G.H.)
| | - João A C Lima
- From the Department of Radiology and Imaging Sciences, National Institutes of Health (NIH), Bethesda, MD (C.-Y.L., D.A.B.); Department of Radiology, Johns Hopkins Hospital, Baltimore, MD (D.C., D.A.B., J.A.C.L.); Office of Biostatistics Research, National Heart, Lung, and Blood Institutes (NHLBI), Bethesda, MD (C.O.W.); Department of Cardiology, Hospital General Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain (G.T.-T.); Division of Cardiovascular Medicine, University of Louisville School of Medicine, KY (A.C.); and Division of Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University, Winston-Salem, NC (S.V., W.G.H.)
| | - W Gregory Hundley
- From the Department of Radiology and Imaging Sciences, National Institutes of Health (NIH), Bethesda, MD (C.-Y.L., D.A.B.); Department of Radiology, Johns Hopkins Hospital, Baltimore, MD (D.C., D.A.B., J.A.C.L.); Office of Biostatistics Research, National Heart, Lung, and Blood Institutes (NHLBI), Bethesda, MD (C.O.W.); Department of Cardiology, Hospital General Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain (G.T.-T.); Division of Cardiovascular Medicine, University of Louisville School of Medicine, KY (A.C.); and Division of Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University, Winston-Salem, NC (S.V., W.G.H.).
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Lorbeer R, Schneider T, Quadrat A, Kühn JP, Dörr M, Völzke H, Lieb W, Hegenscheid K, Mensel B. Cardiovascular risk factors and thoracic aortic wall thickness in a general population. J Vasc Interv Radiol 2015; 26:635-41. [PMID: 25704225 DOI: 10.1016/j.jvir.2014.12.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 12/10/2014] [Accepted: 12/14/2014] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To evaluate the association of cardiovascular risk factors with wall thickness of the ascending and descending thoracic aorta in the general population. MATERIALS AND METHODS The study included 1,176 individuals (523 women) 21-83 years old from the Study of Health in Pomerania without history of stroke or myocardial infarction. Aortic wall thickness (AWT) was determined by cine magnetic resonance imaging. The associations of AWT with the cardiovascular risk factors male sex, age, smoking, body mass index (BMI), systolic and diastolic blood pressure, hemoglobin A1c, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides were assessed by multivariable linear regression models, and interaction effects were tested. RESULTS Male sex (β = .086, P < .001), age (β = .006, P < .001), and BMI (β = .013, P < .001) were positively associated with the AWT of the ascending aorta. Male sex (β = .105, P < .001), age (β = .006, P < .001), current smoker (β = .044, P = .010), BMI (β = .013, P < .001), and HDL-C (β = .057, P = .008) revealed a positive association with AWT of the descending aorta. LDL-C (β = -.024, P = .009; β = -.018, P = .010) was inversely associated with the AWT of the ascending and descending aorta, respectively. Triglyceride levels (β = .024, P = .027; β = .018, P = .024) showed a positive association with the AWT of the ascending and descending aorta, respectively, in men, but not in women. CONCLUSIONS Established cardiovascular risk factors, including male sex, older age, smoking, high BMI, and high triglyceride levels, were associated with increasing thoracic AWT of the ascending and descending aorta. High HDL-C and low LDL-C levels were correlated with AWT.
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Affiliation(s)
- Roberto Lorbeer
- Institute for Community Medicine, Section SHIP-KEF, University Medicine Greifswald, Walther-Rathenau-Straße 48, 17475 Greifswald, Germany.
| | - Tobias Schneider
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Walther-Rathenau-Straße 48, 17475 Greifswald, Germany
| | - Alexander Quadrat
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Walther-Rathenau-Straße 48, 17475 Greifswald, Germany
| | - Jens-Peter Kühn
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Walther-Rathenau-Straße 48, 17475 Greifswald, Germany
| | - Marcus Dörr
- Department of Internal Medicine, University Medicine Greifswald, Walther-Rathenau-Straße 48, 17475 Greifswald, Germany; German Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, Section SHIP-KEF, University Medicine Greifswald, Walther-Rathenau-Straße 48, 17475 Greifswald, Germany; German Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology, Christian Albrechts University, Kiel, Germany
| | - Katrin Hegenscheid
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Walther-Rathenau-Straße 48, 17475 Greifswald, Germany
| | - Birger Mensel
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Walther-Rathenau-Straße 48, 17475 Greifswald, Germany
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Exact monitoring of aortic diameters in Marfan patients without gadolinium contrast: intraindividual comparison of 2D SSFP imaging with 3D CE-MRA and echocardiography. Eur Radiol 2014; 25:872-82. [DOI: 10.1007/s00330-014-3457-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 08/28/2014] [Accepted: 09/29/2014] [Indexed: 10/24/2022]
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Mensel B, Quadrat A, Schneider T, Kühn JP, Dörr M, Völzke H, Lieb W, Hegenscheid K, Lorbeer R. MRI-based determination of reference values of thoracic aortic wall thickness in a general population. Eur Radiol 2014; 24:2038-44. [PMID: 24816934 DOI: 10.1007/s00330-014-3188-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 03/13/2014] [Accepted: 04/14/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To provide age- and sex-specific reference values for MRI-derived wall thickness of the ascending and descending aorta in the general population. MATERIALS AND METHODS Data of 753 subjects (311 females) aged 21-81 years were analysed. MRI was used to determine the aortic wall thickness (AWT). Equations for reference value calculation according to age were established for females and males. RESULTS Median wall thickness of the ascending aorta was 1.46 mm (5th-95th range: 1.15-1.88 mm) for females and 1.56 mm (1.22-1.99 mm) for males. Median wall thickness of the descending aorta was 1.26 mm (0.97-1.58 mm) in females and 1.36 mm (1.04-1.75 mm) in males. While median and 5th and 95th percentiles for the ascending and descending aorta increased with age in both sexes, the association between age and median AWT was stronger in males than in females for both the ascending and descending aorta. CONCLUSIONS Reference values for the ascending and descending AWT are provided. In a healthy sample from the general population, the wall of the ascending aorta is thicker than the wall of the descending aorta, and both walls are thicker in males than females. The increase in wall thickness with age is greater in males. KEY POINTS Ascending aortic wall thickness is greater than descending aortic wall thickness. Ascending and descending aortic wall thickness is greater in males. Thoracic aortic wall thickness increases with age in both sexes. The age-related increase in aortic wall thickness is stronger in males.
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Affiliation(s)
- Birger Mensel
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany,
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Chiu KWH, Ling L, Tripathi V, Ahmed M, Shrivastava V. Ultrasound measurement for abdominal aortic aneurysm screening: a direct comparison of the three leading methods. Eur J Vasc Endovasc Surg 2014; 47:367-73. [PMID: 24491283 DOI: 10.1016/j.ejvs.2013.12.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 12/24/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Ultrasound (US) is non-invasive and cost-effective for screening abdominal aortic aneurysms (AAAs) but there is no universally accepted method to measure the aortic diameter. This study evaluates the accuracy, reproducibility, and repeatability of three methods: inner-to-inner (ITI), leading-to-leading edge (LTL), and outer-to-outer (OTO). The secondary objective of this study was to determine whether aneurysm size or grade of operator had any effect on either intra- or inter-observer variability. METHODS Fifty static US images were measured by six assessors (2 vascular radiologists, 2 interventional radiology trainees, and 2 sonographers) on two separate occasions 6 weeks apart. Repeatability and reproducibility were calculated and compared with computed tomography (CT) as the gold standard. RESULTS All three methods have high repeatability and reproducibility when static images are used. The inter-observer reproducibility coefficients between assessors were 0.48 cm, 0.35 cm, and 0.34 cm for ITI, LTL and OTO, respectively. The intra-observer repeatability coefficients between assessors were 0.30 cm, 0.20 cm, and 0.19 cm for ITI, LTL and OTO, respectively. The mean difference between CT and OTO, LTL, and ITI was 1 mm, 3 mm, and 5 mm, respectively (all underestimations) (p < .0001). CONCLUSIONS US consistently underestimates aortic size when compared with CT, with ITI demonstrating the greatest underestimation (on average 5 mm). In the UK, this underestimation by the NHS Abdominal Aortic Aneurysm screening programme reduces the sensitivity of the screening test and may impact on the way in which vascular specialists interpret the findings of the screening programme.
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Affiliation(s)
- K W H Chiu
- Department of Radiology, Hull and East Yorkshire NHS Trust, Hull, UK
| | - L Ling
- Department of Radiology, Hull and East Yorkshire NHS Trust, Hull, UK
| | - V Tripathi
- Department of Mathematics & Statistics, University of West Indies, Trinidad and Tobago
| | - M Ahmed
- Department of Radiology, Hull and East Yorkshire NHS Trust, Hull, UK
| | - V Shrivastava
- Department of Radiology, Hull and East Yorkshire NHS Trust, Hull, UK.
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Haraldsson H, Hope M, Acevedo-Bolton G, Tseng E, Zhong X, Epstein FH, Ge L, Saloner D. Feasibility of asymmetric stretch assessment in the ascending aortic wall with DENSE cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2014; 16:6. [PMID: 24400865 PMCID: PMC3895850 DOI: 10.1186/1532-429x-16-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 12/27/2013] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Vessel diameter is the principal imaging parameter assessed clinically for aortic disease, but adverse events can occur at normal diameters. Aortic stiffness has been studied as an additional imaging-based risk factor, and has been shown to be an independent predictor of cardiovascular morbidity and all-cause mortality. Reports suggest that some aortic pathology is asymmetric around the vessel circumference, a feature which would not be identified with current imaging approaches. We propose that this asymmetry may be revealed using Displacement Encoding with Stimulated Echoes (DENSE). The objective of this study is to investigate the feasibility of assessing asymmetric stretch in healthy and diseased ascending aortas using DENSE. METHODS Aortic wall displacement was assessed with DENSE cardiovascular magnetic resonance (CMR) in 5 volunteers and 15 consecutive patients. Analysis was performed in a cross-sectional plane through the ascending aorta at the pulmonary artery. Displacement data was used to determine the wall stretch between the expanded and resting states of the aorta, in four quadrants around the aortic circumference. RESULTS Analysis of variance (ANOVA) did not only show significant differences in stretch between groups of volunteers (p<0.001), but also significant differences in stretch along the circumference of the aorta (p<0.001), indicating an asymmetric stretch pattern. Furthermore, there is a significant difference in the asymmetry between volunteers and different groups of patients (p<0.01). CONCLUSIONS Evaluation of asymmetric stretch is feasible in the ascending aorta with DENSE CMR. Clear differences in stretch are seen between patients and volunteers, with asymmetric patterns demonstrated around the aortic circumference.
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Affiliation(s)
- Henrik Haraldsson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
- VAMC/UCSF, Radiology 114-D, Bldg 203, Rm BA-51, 4150 Clement Street, San Francisco, CA 94530, USA
| | - Michael Hope
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Gabriel Acevedo-Bolton
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Elaine Tseng
- Veterans Affairs Medical Center, San Francisco, CA, USA
- Department of Surgery, University of California, San Francisco, CA, USA
| | - Xiaodong Zhong
- MR R&D Collaborations, Siemens Healthcare, Atlanta, GA, USA
| | - Frederick H Epstein
- Department of Biomedical Engineering, University of Virginia, Charlotteville, VA, USA
| | - Liang Ge
- Department of Surgery, University of California, San Francisco, CA, USA
| | - David Saloner
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
- Veterans Affairs Medical Center, San Francisco, CA, USA
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45
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Cardiovascular aging: Insights from local and regional measures of aortic stiffness using magnetic resonance imaging. Artery Res 2014. [DOI: 10.1016/j.artres.2014.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Yan H, Ranadive SM, Heffernan KS, Lane AD, Kappus RM, Cook MD, Wu PT, Sun P, Harvey IS, Woods JA, Wilund KR, Fernhall B. Hemodynamic and arterial stiffness differences between African-Americans and Caucasians after maximal exercise. Am J Physiol Heart Circ Physiol 2013; 306:H60-8. [PMID: 24186094 DOI: 10.1152/ajpheart.00710.2013] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
African-American (AA) men have higher arterial stiffness and augmentation index (AIx) than Caucasian-American (CA) men. Women have greater age-associated increases in arterial stiffness and AIx than men. This study examined racial and sex differences in arterial stiffness and central hemodynamics at rest and after an acute bout of maximal exercise in young healthy individuals. One hundred young, healthy individuals (28 AA men, 24 AA women, 25 CA men, and 23 CA women) underwent measurements of aortic blood pressure (BP) and arterial stiffness at rest and 15 and 30 min after an acute bout of graded maximal aerobic exercise. Aortic BP and AIx were derived from radial artery applanation tonometry. Aortic stiffness (carotid-femoral) was measured via pulse wave velocity. Aortic stiffness was increased in AA subjects but not in CA subjects (P < 0.05) after an acute bout of maximal cycling exercise, after controlling for body mass index. Aortic BP decreased after exercise in CA subjects but not in AA subjects (P < 0.05). Women exhibited greater reductions in AIx after maximal aerobic exercise compared with men (P < 0.05). In conclusion, race and sex impact vascular and central hemodynamic responses to exercise. Young AA and CA subjects exhibited differential responses in central stiffness and central BP after acute maximal exercise. Premenopausal women had greater augmented pressure at rest and after maximal aerobic exercise than men. Future research is needed to examine the potential mechanisms.
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Affiliation(s)
- Huimin Yan
- Department of Kinesiology and Community Health, University of Illinois, Urbana, Illinois
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Yogo M, Sasaki M, Ayaori M, Kihara T, Sato H, Takiguchi S, Uto-Kondo H, Yakushiji E, Nakaya K, Komatsu T, Momiyama Y, Nagata M, Mochio S, Iguchi Y, Ikewaki K. Intensive lipid lowering therapy with titrated rosuvastatin yields greater atherosclerotic aortic plaque regression: Serial magnetic resonance imaging observations from RAPID study. Atherosclerosis 2013; 232:31-9. [PMID: 24401214 DOI: 10.1016/j.atherosclerosis.2013.10.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Revised: 08/22/2013] [Accepted: 10/08/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Although previous randomized clinical trials established a basis for lipid guidelines worldwide, they employed fixed doses of statins throughout trials (fire-and-forget approach). In the real clinical setting, however, statin doses are titrated to achieve target low-density lipoprotein cholesterol (LDL-C) levels (treat-to-target approach). The major objective was to investigate whether intensive lipid-lowering therapy using the treat-to-target approach yielded greater regression of aortic plaques. METHODS We therefore performed a prospective, randomized trial comparing the effects of standard (achieve LDL-C levels recommended by the Japanese guidelines) and intensive (achieve 30% lower LDL-C levels than standard) rosuvastatin therapy for 1 year in 60 hypercholesterolemic patients with a primary endpoint of aortic atherosclerotic plaques evaluated by non-invasive magnetic resonance imaging (MRI). RESULTS Average doses were 2.9 ± 3.1 and 6.5 ± 5.1 mg/day for standard (n = 29) and intensive therapy group (n = 31), respectively. Although both therapies significantly reduced LDL-C and high-sensitivity C-reactive protein (hsCRP) levels, LDL-C reduction was significantly greater in the intensive group (-46 vs. -34%). MRI study showed that thoracic aortic plaques were significantly regressed in both groups, with greater regression of thoracic plaque in the intensive group (-9.1 vs. -3.2%, p = 0.01). Multivariate analyses revealed that thoracic plaque regression was significantly correlated with hsCRP reduction, but not with changes in serum lipids, endothelial function, or doses of rosuvastatin. CONCLUSION Intensive statin therapy with titration targeting lower LDL-C levels resulted in greater thoracic aortic plaque regression compared to standard therapy, which was correlated with hsCRP reduction, suggesting that intensive statin therapy could provide better clinical outcomes.
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Affiliation(s)
- Makiko Yogo
- Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan; Department of Neurology, The Jikei University School of Medicine, Japan
| | - Makoto Sasaki
- Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Makoto Ayaori
- Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan.
| | | | - Hiroki Sato
- Department of Public Health and Preventive Medicine, National Defense Medical College, Japan
| | - Shunichi Takiguchi
- Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Harumi Uto-Kondo
- Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Emi Yakushiji
- Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Kazuhiro Nakaya
- Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Tomohiro Komatsu
- Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Yukihiko Momiyama
- Department of Cardiology, National Hospital Organization Tokyo Medical Center, Japan
| | | | - Soichiro Mochio
- Department of Neurology, The Jikei University School of Medicine, Japan
| | - Yasuyuki Iguchi
- Department of Neurology, The Jikei University School of Medicine, Japan
| | - Katsunori Ikewaki
- Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
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Saba L, Gao H, Raz E, Sree SV, Mannelli L, Tallapally N, Molinari F, Bassareo PP, Acharya UR, Poppert H, Suri JS. Semiautomated analysis of carotid artery wall thickness in MRI. J Magn Reson Imaging 2013; 39:1457-67. [DOI: 10.1002/jmri.24307] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2012] [Accepted: 06/18/2013] [Indexed: 01/17/2023] Open
Affiliation(s)
- Luca Saba
- Department of Radiology; Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato; Cagliari Italy
| | - Hao Gao
- Centre for Excellence in Signal and Image Processing; Department of Electronic and Electrical, University of Strathclyde; Strathclyde UK
| | - Eytan Raz
- Department of Radiology; New York University School of Medicine; New York New York USA
| | - S. Vinitha Sree
- Visiting Scientist; Global Biomedical Technologies; Roseville California USA
| | | | | | - Filippo Molinari
- Biolab, Department of Electronics; Politecnico di Torino; Torino Italy
| | - Pier Paolo Bassareo
- Department of Cardiology; Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato; Cagliari Italy
| | | | - Holger Poppert
- Neurologische Klinik und Poliklinik Technische Universität München; München Germany
| | - Jasjit S. Suri
- Diagnostic and Monitoring Division, AtheroPoint LLC, Roseville, California, and Department of Biomedical Engineering, Idaho State University (Aff.); Pocatello Idaho USA
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Mensel B, Kühn JP, Schneider T, Quadrat A, Hegenscheid K. Mean thoracic aortic wall thickness determination by cine MRI with steady-state free precession: validation with dark blood imaging. Acad Radiol 2013; 20:1004-8. [PMID: 23830606 DOI: 10.1016/j.acra.2013.03.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 03/14/2013] [Accepted: 03/20/2013] [Indexed: 10/26/2022]
Abstract
RATIONALE AND OBJECTIVES To assess the validity and reliability of measuring mean aortic wall thickness (MAWT) of the ascending and descending aorta using cine steady-state free precession (SSFP) imaging compared to dark blood (DB) imaging. MATERIALS AND METHODS DB and SSFP images of the thoracic aorta acquired at 1.5 T in 50 volunteers (26 women, 24 men; mean age: 50.2 ± 13.1 years) were used. MAWT was calculated on DB and SSFP images for the ascending and descending aorta at the level of the right pulmonary artery by two independent observers. Validity was assessed using Bland-Altman analysis, Passing-Bablok regression, and Spearman correlation. Reliability was assessed using Bland-Altman analysis and intraclass coefficients (ICCs). RESULTS The mean MAWT of the ascending aorta on DB and SSFP images was 1.89 ± 0.21 mm and 1.87 ± 0.20 mm. The measurements for the descending aorta were 1.60 ± 0.22 and 1.63 ± 0.20 mm, respectively. Comparison of DB and SSFP measurements revealed a mean bias of 1.3% (95% limits of agreement (LOA): -7.9, 10.5%) for the ascending and of -2.1% (LOA: -10.5, 6.3%) for the descending aorta. The corresponding regression equation was y = 0.042 + 0.960 × (r = 0.91; P < .0001) and y = 0.118 + 0.939 × (r = 0.95; P < .0001), respectively. Intra- and interobserver variability showed a mean bias of less than 2.0% and LOA of less than ±15.0%. ICCs were greater than or equal to 0.85. CONCLUSIONS MAWT determination in the ascending and descending aorta using cine SSFP sequences is highly valid and reliable compared to DB imaging.
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50
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Maroules CD, Rosero E, Ayers C, Peshock RM, Khera A. Abdominal aortic atherosclerosis at MR imaging is associated with cardiovascular events: the Dallas heart study. Radiology 2013; 269:84-91. [PMID: 23781118 DOI: 10.1148/radiol.13122707] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To determine the value of two abdominal aortic atherosclerosis measurements at magnetic resonance (MR) imaging for predicting future cardiovascular events. MATERIALS AND METHODS This study was approved by the institutional review board and complied with HIPAA regulations. The study consisted of 2122 participants from the multiethnic, population-based Dallas Heart Study who underwent abdominal aortic MR imaging at 1.5 T. Aortic atherosclerosis was measured by quantifying mean aortic wall thickness (MAWT) and aortic plaque burden. Participants were monitored for cardiovascular death, nonfatal cardiac events, and nonfatal extracardiac vascular events over a mean period of 7.8 years ± 1.5 (standard deviation [SD]). Cox proportional hazards regression was used to assess independent associations of aortic atherosclerosis and cardiovascular events. RESULTS Increasing MAWT was positively associated with male sex (odds ratio, 3.66; P < .0001), current smoking (odds ratio, 2.53; P < .0001), 10-year increase in age (odds ratio, 2.24; P < .0001), and hypertension (odds ratio, 1.66; P = .0001). A total of 143 participants (6.7%) experienced a cardiovascular event. MAWT conferred an increased risk for composite events (hazard ratio, 1.28 per 1 SD; P = .001). Aortic plaque was not associated with increased risk for composite events. Increasing MAWT and aortic plaque burden both conferred an increased risk for nonfatal extracardiac events (hazard ratio of 1.52 per 1 SD [P < .001] and hazard ratio of 1.46 per 1 SD [P = .03], respectively). CONCLUSION MR imaging measures of aortic atherosclerosis are predictive of future adverse cardiovascular events.
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Affiliation(s)
- Christopher D Maroules
- Departments of Radiology, Anesthesiology, Clinical Sciences, and Internal Medicine, Division of Cardiology and the Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8896
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