Juffermans Joe F, Westenberg Jos J M, van den Boogaard Pieter J, Lamb Hildo J
Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
Eur Heart J Case Rep. 2023 Apr 10;7(4):ytad130. doi: 10.1093/ehjcr/ytad130. eCollection 2023 Apr.
It has been demonstrated that the rate of aortic dilatation is influenced by alteration of aortic hemodynamics, such as normalized flow displacement (FD) and wall shear stress (WSS). However, the effects of ageing on aortic hemodynamics have not yet been described.
4D-Flow MRI derived aorta hemodynamics were derived in the ascending aorta of a patient with ascending aortic aneurysm (mean ± standard deviation: 46 ± 1 mm) and a healthy volunteer (aortic diameter 30 ± 1 mm) with long-term follow-up of ten and eight years, respectively. At all timepoints, compared to the healthy volunteer, the patient demonstrated higher magnitudes of FD (7% ± 1% vs. 3% ± 1%) and WSS angle (36° ± 3° vs. 24° ± 6°), and lower WSS magnitude (565 ± 100 mPa vs. 910 ± 115 mPa), axial WSS (426 ± 71 mPa vs. 800 ± 108 mPa) and circumferential WSS (297 ± 64 mPa vs. 340 ± 85 mPa). The patient and healthy volunteer demonstrated different aortic dilatation rates (regression slope ± standard error: 0.2 ± 0.1 vs. 0.1 ± 0.2 mm per year) and trends in FD (0.1% ± 0.1% vs. 0.1% ± 0.2% per year), WSS magnitude (22 ± 9 vs. 35 ± 13 mPa per year), axial WSS (19 ± 4 vs. 37 ± 7 mPa per year), circumferential WSS (9 ± 8 vs. 5 ± 15 mPa per year), and WSS angle (-0.5° ± 0.4° vs. -0.8° ± 1.0° per year).
Aortic hemodynamic parameters are marginally affected by ageing and the aortic diameter in this case series. Since aortic hemodynamic parameters have been associated with aortic dilation by previous studies, the outcomes of the two subjects suggest that the aortic dilatation rate will remain constant while individuals are ageing and dilating.
已证实主动脉扩张速率受主动脉血流动力学改变的影响,如归一化血流位移(FD)和壁面剪应力(WSS)。然而,衰老对主动脉血流动力学的影响尚未见报道。
对一名升主动脉瘤患者(平均±标准差:46±1 mm)和一名健康志愿者(主动脉直径30±1 mm)的升主动脉进行了基于4D血流MRI的主动脉血流动力学分析,分别进行了10年和8年的长期随访。在所有时间点,与健康志愿者相比,该患者的FD幅度更高(7%±1%对3%±1%)和WSS角度更大(36°±3°对24°±6°),而WSS幅度更低(565±100 mPa对910±115 mPa)、轴向WSS(426±71 mPa对800±108 mPa)和周向WSS(297±64 mPa对340±85 mPa)。该患者和健康志愿者表现出不同的主动脉扩张速率(回归斜率±标准误差:0.2±0.1对0.1±0.2 mm/年)以及FD(0.1%±0.1%对0.1%±0.2%/年)、WSS幅度(22±9对35±13 mPa/年)、轴向WSS(19±4对37±7 mPa/年)、周向WSS(9±8对5±15 mPa/年)和WSS角度(-0.5°±0.4°对-0.8°±1.0°/年)的变化趋势。
在本病例系列中,主动脉血流动力学参数受衰老和主动脉直径的影响较小。由于先前研究已将主动脉血流动力学参数与主动脉扩张相关联,这两名受试者的结果表明,在个体衰老和主动脉扩张过程中,主动脉扩张速率将保持恒定。