Departments of Cardiology/Medicine and Radiology, Johns Hopkins University, Baltimore, MD (Y.O., B.A.V., J.A.C.L.). Sorbonne Universités, UPMC University Paris 06, INSERM 1146, CNRS 7371, Laboratoire d'Imagerie Biomédicale, Paris, France (A.R., N.K.). Department of Cardiovascular Imaging and Interventional Radiology, Institute of Cardiology, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France (A.R.). Clinical Investigation and Research Unit, Gunma University Hospital, Maebashi, Japan (Y.O.).
Circ Cardiovasc Imaging. 2018 Apr;11(4):e005617. doi: 10.1161/CIRCIMAGING.117.005617.
The aorta has 2 main functions, conduit and cushion, and is designed to transmit blood to the periphery and buffer pulsatile stress from ventricular contraction. In the interaction between the structural and functional changes of the aorta, aging and disease processes impact on aortic material properties and hemodynamics. For a comprehensive assessment of changes in aortic structure and function associated with aging and disease, noninvasive cardiovascular imaging techniques, especially magnetic resonance imaging, have recently been developed. Magnetic resonance imaging allows for direct and accurate measurement of different aortic characteristics including structural measures such as aortic area or volume, aortic length, curvature, and aortic wall thickness and functional measures such as aortic strain, distensibility, and pulse wave velocity. Excellent reproducibility of magnetic resonance imaging methods allows us to assess the response of the whole aorta to both pharmacological and nonpharmacological therapies. Aortic flow and functional assessment could be added to clinical routine cardiac magnetic resonance as a comprehensive imaging modality primarily performed for the noninvasive evaluation of left ventricular function, left ventricular load, and vascular/ventricular coupling. New techniques such as 4-dimensional flow could provide and further elucidate the combined age-related effects of altered aortic geometry and function. This following review will describe the pathophysiological aspects of the aorta and the ability, value, and prospects of cardiovascular imaging, especially magnetic resonance imaging, to study age-related changes in aortic structure and function and assess the relationship between these alterations and cardiovascular disease.
主动脉具有两个主要功能，即输送和缓冲，旨在将血液输送到外周，并缓冲心室收缩引起的脉动压力。在主动脉的结构和功能变化的相互作用中，衰老和疾病过程会影响主动脉的材料特性和血液动力学。为了全面评估与衰老和疾病相关的主动脉结构和功能变化，最近已经开发出了非侵入性心血管成像技术，特别是磁共振成像。磁共振成像允许直接和准确地测量不同的主动脉特征，包括结构测量，如主动脉面积或体积、主动脉长度、曲率和主动脉壁厚度，以及功能测量，如主动脉应变、顺应性和脉搏波速度。磁共振成像方法的出色可重复性使我们能够评估整个主动脉对药物和非药物治疗的反应。主动脉血流和功能评估可以作为一种综合成像方式添加到临床常规心脏磁共振中，主要用于对左心室功能、左心室负荷和血管/心室偶联进行非侵入性评估。新的技术，如 4 维血流，可以提供并进一步阐明改变的主动脉几何形状和功能的与年龄相关的综合影响。下面的综述将描述主动脉的病理生理学方面，以及心血管成像（特别是磁共振成像）研究主动脉结构和功能随年龄变化的能力、价值和前景，并评估这些改变与心血管疾病之间的关系。
