https://doi.org/10.1007/s00392-025-02737-x
1Universitäres Herz- und Gefäßzentrum Hamburg Klinik für Kardiologie Hamburg, Deutschland; 2Cardio-CARE Davos, Schweiz; 3Universitätsklinikum Hamburg-Eppendorf Diagnostische und Interventionelle Radiologie und Nuklearmedizin Hamburg, Deutschland; 4Deutsches Herzzentrum der Charite (DHZC) Berlin, Deutschland; 5Asklepios Klinik Wandsbek Allgemeine und endovaskuläre Gefäßchirurgie Hamburg, Deutschland; 6Kardiologische Praxis Orchideenstieg Hamburg, Deutschland; 7Universitätsklinikum Hamburg-Eppendorf Klinik für Gefäßchirurgie Hamburg, Deutschland
Cardiovascular magnetic resonance (CMR)-based aortic stiffness (AS) parameters might predict development of aortic aneurysm and long-term outcomes associated with that disease. AS is a marker for structural and functional changes within the aortic vessel wall and can be quantified by both pulse wave velocity (PWV) and aortic distensibility (AD).
Purpose:
The purpose of this study was to analyze possible associations of PWV and AD with the infrarenal aortic diameter and peak flow velocity in a population-based cohort who underwent CMR.
Methods:
This study cohort consisted of 2,093 participants who were enrolled in a prospective epidemiological cohort study in Germany. Aortic PWV and AD of the ascending (AD AoAsc) and AD of the descending aorta (AD AoDesc) were measured using a 3 Tesla MRI scanner and a 2D phase-contrast velocity-encoding sequence. The maximum aortic diameter and the aortic peak flow velocity of the infrarenal aorta were quantified by standardized ultrasound measurement.
Results:
The median age of this cohort was 66 [58, 71] years and 41.9% were female. The median aortic diameter was 18.1 [16.4, 19.9] mm and the median peak flow velocity was 98.6 [83.6,115.9] cm/s. Median PWV was 7.6 [6.2, 9.8] m/s, median AD AoAsc 0.4 [0.3, 0.6] 1/(10^3*kPa) and median AD AoDesc 0.4 [0.3, 0.6] 1/(10^3*kPa). Significant associations of aortic diameter with PWV (CI 0.044 [0.003, 0.085], p=0.037);, AD AoASc (CI -0.535 [-0.955, -0.115], p=0.012) and AD AoDesc (CI -0.697 [-1.164, -0.230], p=0.003) as well as of peak flow velocity were found with PWV (CI -0.715 [-1.034, -0.396], p<0.001), AD AoAsc (CI 4.464 [1.198, 7.731], p=0.007) and AD AoDesc (CI 2.048 [-1.591, 5.687], p=0.270). After adjustment for age and sex, the associations of the aortic diameter with AD AoDesc (CI -0.602 [-1.081, -0.123], p=0.014) and of peak flow velocity with PWV (CI -0.399 [-0.756, -0.041], p=0.029) remained statistically significant. The effect of the adjustment was predominantly driven by sex (p<0.001).
Conclusion:
AS parameters were associated with both infrarenal aortic diameter and peak flow velocities. AD AoDesc might be used for predicting the development of aortic aneurysms due to the association with the maximum diameter and PWV for risk stratification due to the association with the maximum flow. Further prospective studies investigating preventive and early detection strategies as well as risk stratification are needed to improve the outcome and clinical routine.