Consistency of aortic distensibility and pulse wave velocity estimates with respect to the Bramwell-Hill theoretical model: a cardiovascular magnetic resonance study

Anas Dogui, Nadjia Kachenoura, Frédérique Frouin, Muriel Lefort, Alain De Cesare, Elie Mousseaux, Alain Herment, Anas Dogui, Nadjia Kachenoura, Frédérique Frouin, Muriel Lefort, Alain De Cesare, Elie Mousseaux, Alain Herment

Abstract

Background: Arterial stiffness is considered as an independent predictor of cardiovascular mortality, and is increasingly used in clinical practice. This study aimed at evaluating the consistency of the automated estimation of regional and local aortic stiffness indices from cardiovascular magnetic resonance (CMR) data.

Results: Forty-six healthy subjects underwent carotid-femoral pulse wave velocity measurements (CF_PWV) by applanation tonometry and CMR with steady-state free-precession and phase contrast acquisitions at the level of the aortic arch. These data were used for the automated evaluation of the aortic arch pulse wave velocity (Arch_PWV), and the ascending aorta distensibility (AA_Distc, AA_Distb), which were estimated from ascending aorta strain (AA_Strain) combined with either carotid or brachial pulse pressure. The local ascending aorta pulse wave velocity AA_PWVc and AA_PWVb were estimated respectively from these carotid and brachial derived distensibility indices according to the Bramwell-Hill theoretical model, and were compared with the Arch_PWV. In addition, a reproducibility analysis of AA_PWV measurement and its comparison with the standard CF_PWV was performed. Characterization according to the Bramwell-Hill equation resulted in good correlations between Arch_PWV and both local distensibility indices AA_Distc (r = 0.71, p < 0.001) and AA_Distb (r = 0.60, p < 0.001); and between Arch_PWV and both theoretical local indices AA_PWVc (r = 0.78, p < 0.001) and AA_PWVb (r = 0.78, p < 0.001). Furthermore, the Arch_PWV was well related to CF_PWV (r = 0.69, p < 0.001) and its estimation was highly reproducible (inter-operator variability: 7.1%).

Conclusions: The present work confirmed the consistency and robustness of the regional index Arch_PWV and the local indices AA_Distc and AA_Distb according to the theoretical model, as well as to the well established measurement of CF_PWV, demonstrating the relevance of the regional and local CMR indices.

Figures

Figure 1
Figure 1
Estimation of the aortic length. Estimation of the aortic length from the axial and coronal slices with a 3D Bezier curve interpolation
Figure 2
Figure 2
Determination of the aortic cross-sectional area during a cardiac cycle. (A): automatic contouring of the ascending aorta. (B): ascending aorta cross-sectional area versus time curve; Ss and Sd correspond to the ascending aorta systolic and diastolic areas, respectively.
Figure 3
Figure 3
Correlations between local ascending aorta distensibility and regional aortic arch PWV. (A): comparison between AA_Distc and 1/Arch_PWV2. (B): comparison between AA_Distb and 1/Arch_PWV2. AA_Distc and AA_Distb: local ascending aorta distensibility estimated from MRI aortic strain and carotid or brachial pulse pressures; Arch_PWV: regional aortic arch PWV assessed with MRI.
Figure 4
Figure 4
Correlations between local ascending aorta PWV and regional aortic arch PWV. (A): comparison between AA_PWVtc and Arch_PWV. (B): comparison between AA_PWVb and Arch_PWV. AA_PWVc and AA_PWVb: local ascending aorta PWV estimated according equation (1) from AA_Distc or AA_Distb; Arch_PWV: regional aortic arch PWV assessed with CMR.

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