Aortic stiffness parameter in an infrarenal aortic sub-aneurysm and aneurysm cohort: a magnetic resonance imaging study

K. A. Riedl (Hamburg)¹, E. Di Carluccio (Davos)², G. K. Lund (Hamburg)³, M. Hüllebrand (Berlin)⁴, A. Hennemuth (Berlin)⁵, R. Braren (Hamburg)⁶, P. Kirchhof (Hamburg)⁷, S. Blankenberg (Hamburg)¹, A. Ziegler (Davos)², C. A. Behrendt (Hamburg)⁸, K. Müllerleile (Hamburg)⁹, T. Kölbel (Hamburg)^10
1Universitäres Herz- und Gefäßzentrum Hamburg Klinik für Kardiologie Hamburg, Deutschland; ²Cardio-CARE Davos, Schweiz; ³Universitätsklinikum Hamburg Eppendorf Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin Hamburg, Deutschland; ⁴Charité Institute of Cardiovascular Computer-Assisted Medicine Berlin, Deutschland; ⁵Charité - Universitätsmedizin Berlin Institut für kardiovaskuläre Computer-Assistierte Medizin Berlin, Deutschland; ⁶Universitätsklinikum Hamburg-Eppendorf Klinik für diagnostische und interventionelle Radiologie und Nuklearmedizin Hamburg, Deutschland; ⁷Universitäres Herz- und Gefäßzentrum Hamburg Klinik für Kardiologie Lübeck, Deutschland; ⁸Asklepios Klinik Wandsbek Allgemeine und endovaskuläre Gefäßchirurgie Hamburg, Deutschland; ⁹Kardiologische Praxis Orchideenstieg Hamburg, Deutschland; ¹⁰Universitätsklinikum Hamburg-Eppendorf Klinik und Poliklinik für Gefäßchirurgie Hamburg, Deutschland

Introduction: Cardiovascular magnetic resonance (CMR)-based aortic stiffness (AS) parameter can be quantified by pulse wave velocity (PWV) and aortic distensibility (AD). AS parameter might be used for prediction of the development of aortic aneurysm as a marker for structural and functional changes within the aortic vessel wall.

Purpose: The purpose of this study was to identify possible associations of PWV and AD with the infrarenal aortic diameter and peak flow velocity in a population-based cohort who underwent CMR and aortic ultrasound examination.

Methods: This study cohort consisted of 2,093 participants who were enrolled in a prospective epidemiological cohort study in Germany. Aortic PWV, AD of the ascending (AD AoAsc) and AD of the descending aorta (AD AoDesc) were measured via 3 Tesla MRI using a 2D phase-contrast-velocity-encoding sequence. The maximum infrarenal aortic diameter and the peak flow velocity of the infrarenal aorta were quantified by standardized ultrasound measurement. Infrarenal sub-aneurysm and aneurysm were defined by a diameter between 25-29 mm and ≥30mm according to the current guidelines, respectively.

Results: The median age of this cohort was 66 [58, 71] years and 42% were female. 55 participants had an infrarenal aortic sub-aneurysm or aneurysm. PWV was significantly higher (p=0.004) and AD AoAsc and AD AoDesc were significantly lower (p=0.042, p=0.039) in these participants compared to participants without infrarenal aortic sub-aneurysm or aneurysm. After adjustment for age and sex, PWV was significantly associated with the infrarenal, aortic peak flow velocity (OR 0.671 [0.47, 0.96], p=0.029). AD AoDesc was significantly associated with the maximum aortic diameter after adjustment for age and sex (OR 0.564 [0.366, 0.869], p=0.009. No significant predictive value of PWV, AD AoAsc and AD AoDesc was found for prevalent infrarenal aortic sub-aneurysms or aneurysms after adjustment for age and sex (p=0.073, p=0.198 and p=0.058).

Conclusion: AS parameters by CMR are associated with infrarenal aortic diameter and peak flow velocities. Longitudinal studies are required to evaluate the potential of AS parameters to tailor preventive strategies in order to avoid the development of infrarenal aortic aneurysm.