Bal-Theoleyre Laurence, Lalande Alain, Kober Frank, Giorgi Roch, Collart Frederic, Piquet Philippe, Habib Gilbert, Avierinos Jean-François, Bernard Monique, Guye Maxime, Jacquier Alexis
CRMBM-CEMEREM, UMR 7339 CNRS, Aix-Marseille University, Marseille, France.
Department of Vascular Surgery and Vascular Medecine, La Timone Hospital, Marseille, France.
PLoS One. 2016 Jun 16;11(6):e0157704. doi: 10.1371/journal.pone.0157704. eCollection 2016.
Evaluation of the aortic "elastic reserve" might be a relevant marker to assess the risk of aortic event. Our aim was to compare regional aortic elasticity at rest and during supine bicycle exercise at 1.5 T MRI in healthy individuals.
Fifteen volunteers (8 men), with a mean age of 29 (23-41) years, completed the entire protocol. Images were acquired immediately following maximal exercise. Retrospective cine sequences were acquired to assess compliance, distensibility, maximum rates of systolic distension and diastolic recoil at four different locations: ascending aorta, proximal descending aorta, distal descending aorta and aorta above the coeliac trunk level. Segmental aortic pulse wave velocity (PWV) was assessed by through plane velocity-encoded MRI.
Exercise induced a significant decrease of aortic compliance and distensibility, and a significant increase of the absolute values of maximum rates of systolic distension and diastolic recoil at all sites (p<10-3). At rest and during stress, ascending aortic compliance was statistically higher compared to the whole descending aorta (p≤0.0007). We found a strong correlation between the rate pressure product and aortic distensibility at all sites (r = - 0.6 to -0.75 according to the site, p<10-4). PWV measured at the proximal and distal descending aorta increased significantly during stress (p = 0.02 and p = 0.008, respectively).
Assessment of regional aortic function during exercise is feasible using MRI. During stress, aortic elasticity decreases significantly in correlation with an increase of the PWV. Further studies are required to create thresholds for ascending aorta dysfunction among patients with aneurysms, and to monitor the impact of medication on aortic remodeling.
评估主动脉“弹性储备”可能是评估主动脉事件风险的一个相关指标。我们的目的是在1.5T磁共振成像(MRI)下比较健康个体静息状态及仰卧位自行车运动期间的局部主动脉弹性。
15名志愿者(8名男性),平均年龄29(23 - 41)岁,完成了整个实验方案。在最大运动后立即采集图像。采集回顾性电影序列以评估四个不同部位的顺应性、扩张性、收缩期最大扩张率和舒张期回缩率:升主动脉、降主动脉近端、降主动脉远端和腹腔干水平以上的主动脉。通过平面速度编码MRI评估节段性主动脉脉搏波速度(PWV)。
运动导致所有部位的主动脉顺应性和扩张性显著降低,收缩期最大扩张率和舒张期回缩率的绝对值显著增加(p<10⁻³)。静息状态和应激状态下,升主动脉的顺应性在统计学上高于整个降主动脉(p≤0.0007)。我们发现所有部位的心率血压乘积与主动脉扩张性之间存在强相关性(根据部位,r = -0.6至-0.75,p<10⁻⁴)。在应激状态下,降主动脉近端和远端测量的PWV显著增加(分别为p = 0.02和p = 0.008)。
使用MRI评估运动期间的局部主动脉功能是可行的。在应激状态下,主动脉弹性显著降低,与PWV增加相关。需要进一步研究以确定动脉瘤患者升主动脉功能障碍的阈值,并监测药物对主动脉重塑的影响。