Department of Neurology, Medical Center - University of Freiburg, 79106, Freiburg, Germany.
Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.
J Cardiovasc Magn Reson. 2018 Jun 21;20(1):43. doi: 10.1186/s12968-018-0461-z.
Increased aortic stiffness is an independent predictor of cardiovascular disease. Optimal measurement is highly beneficial for the detection of atherosclerosis and the management of patients at risk. Thus, it was our purpose to selectively measure aortic stiffness using a novel imaging method and to provide reference values from a population-based study.
One hundred twenty six inhabitants of Freiburg, Germany, between 20 and 80 years prospectively underwent 3 Tesla cardiovascular magnetic resonance (CMR) of the thoracic aorta. 4D flow CMR (spatial/temporal resolution 2mm/20ms) was executed to calculate aortic pulse wave velocity (PWV) in m/s using dedicated software. In addition, we calculated distensibility coefficients (DC) using 2D CINE CMR imaging of the ascending (AAo) and descending aorta (DAo). Segmental aortic diameter and thickness of aortic plaques were determined by 3D T1 weighted CMR (spatial resolution 1mm).
PWV increased from 4.93 ± 0.54 m/s in 20-30 year-old to 8.06 ± 1.03 m/s in 70-80 year-old subjects. PWV was significantly lower in women compared to men (p < 0.0001). Increased blood pressure (systolic r = 0.36, p < 0.0001; diastolic r = 0.33, p = 0.0001; mean arterial pressure r = 0.37, p < 0.0001) correlated with PWV after adjustment for age and gender. Finally, PWV increased with increasing diameter of the aorta (ascending aorta r = 0.20, p = 0.026; aortic arch r = 0.24, p = 0.009; descending aorta r = 0.26, p = 0.004). Correlation of PWV and DC of the AAo and DAo or the mean of both was high (r = 0.69, r = 0.68, r = 0.73; p < 0.001).
4D flow CMR was successfully applied to calculate aortic PWV and thus aortic stiffness. Findings showed a high correlation with distensibility coefficients representing local compliance of the aorta. Our novel method and reference data for PWV may provide a reliable biomarker for the identification of patients with underlying cardiovascular disease and optimal guidance of future treatment in studies or clinical routine.
主动脉僵硬度增加是心血管疾病的独立预测因子。最佳测量方法对动脉粥样硬化的检测和高危患者的管理非常有益。因此，我们的目的是使用一种新的成像方法选择性地测量主动脉僵硬度，并从基于人群的研究中提供参考值。
126 名德国弗赖堡居民前瞻性地接受了 3T 心脏磁共振（CMR）的胸主动脉检查。使用专用软件通过 4D 流量 CMR（空间/时间分辨率为 2mm/20ms）计算主动脉脉搏波速度（PWV），以 m/s 表示。此外，我们还使用升主动脉（AAo）和降主动脉（DAo）的 2D CINE CMR 成像计算了顺应性系数（DC）。通过 3D T1 加权 CMR（空间分辨率为 1mm）确定节段性主动脉直径和主动脉斑块厚度。
PWV 从 20-30 岁的 4.93±0.54m/s 增加到 70-80 岁的 8.06±1.03m/s。女性的 PWV 明显低于男性（p<0.0001）。血压升高（收缩压 r=0.36，p<0.0001；舒张压 r=0.33，p=0.0001；平均动脉压 r=0.37，p<0.0001）与年龄和性别调整后的 PWV 相关。最后，PWV 随着主动脉直径的增加而增加（升主动脉 r=0.20，p=0.026；主动脉弓 r=0.24，p=0.009；降主动脉 r=0.26，p=0.004）。PWV 与 AAo 和 DAo 的 DC 或两者的平均值之间存在高度相关性（r=0.69，r=0.68，r=0.73；p<0.001）。
4D 流量 CMR 成功地用于计算主动脉 PWV，从而测量主动脉僵硬度。结果与代表主动脉局部顺应性的顺应性系数高度相关。我们的新方法和 PWV 的参考数据可能为识别有潜在心血管疾病的患者提供可靠的生物标志物，并为研究或临床常规中的未来治疗提供最佳指导。
