Stiffening and ventricular–arterial interaction in the ascending aorta using MRI: ageing effects in healthy humans

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Abstract

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Abstract

Objectives:

The aim of this study was to investigate the effect of age and sex on _nPWV and _nd I in the ascending aorta of healthy humans.

Background:

Local pulse wave velocity ( _nPWV) and wave intensity ( _nd I) in the human ascending aorta have not been studied adequately, because of the need for invasive pressure measurements. However, a recently developed technique made the noninvasive determination of _nPWV and _nd I possible using measurements of flow velocity and arterial diameter.

Methods:

Diameter and flow velocity were measured at the level of the ascending aorta in 144 healthy participants (aged 20–77 years, 66 men), using MRI. _nPWV, _nd I parameters; forward (FCW); backward (BCW) compression waves, forward decompression wave (FDW), local aortic distensibility ( _n D _s) and reflection index ( _nRI) were calculated.

Results:

_nPWV increased significantly with age from 4.7 ± 0.3 m/s for those 20–30 years to 6.4 ± 0.2 m/s for those 70–80 years ( P < 0.001) and did not differ between sexes. _n D _s decreased with age (5.3 ± 0.5 vs. 2.6 ± 0.2 10 ⁻⁵ 1/Pa, P < 0.001) and _nRI increased with age (0.17 ± 0.03 vs. 0.39 ± 0.06, P < 0.01) for those 20–30 and 70–80 years, respectively. FCW, BCW and FDW decreased significantly with age by 86.3, 71.3 and 74.2%, respectively ( P < 0.001), all compared to the lowest age-band.

Conclusion:

In healthy humans, ageing results in stiffer ascending aorta, with increase in _nPWV and decrease in _n D _s. A decrease in FCW and FDW indicates decline in left ventricular early and late systolic functions with age in healthy humans with no differences between sexes. _nRI is more sensitive than BCW in establishing the effects of ageing on reflected waves measured in the ascending aorta.

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Most cited references 34

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Aortic stiffness is an independent predictor of fatal stroke in essential hypertension.

Stephane Laurent, Sandrine Katsahian, Céline Fassot … (2003)

Pulse pressure is a stronger predictor of cardiovascular events than systolic or diastolic blood pressure in large cohorts of French and North American patients. However, its influence on stroke is controversial. Large-artery stiffness is the main determinant of pulse pressure. The influence of arterial stiffness on the occurrence of stroke has never been demonstrated. Our aim was to establish the relationship between aortic stiffness and stroke death in hypertensive patients. We included, in a longitudinal study, 1715 essential hypertensive patients who had a measurement of arterial stiffness at entry (ie, between 1980 and 2001) and no overt cardiovascular disease or symptoms. Mean follow-up was 7.9 years. At entry, aortic stiffness was assessed from the carotid-femoral pulse wave velocity. A Cox proportional hazard regression model was used to estimate the relative risk (RR) of stroke and coronary deaths. Mean+/-SD age at entry was 51+/-13 years. Twenty-five fatal strokes and 35 fatal coronary events occurred. Pulse wave velocity significantly predicted the occurrence of stroke death in the whole population. There was a RR increase of 1.72 (95% CI, 1.48 to 1.96; P<0.0001) for each SD increase in pulse wave velocity (4 m/s). The predictive value of pulse wave velocity remained significant (RR=1.39 [95% CI, 1.08 to 1.72]; P=0.02) after full adjustment for classic cardiovascular risk factors, including age, cholesterol, diabetes, smoking, mean blood pressure, and pulse pressure. In this population, pulse pressure significantly predicted stroke in univariate analysis, with a RR increase of 1.33 (95% CI, 1.16 to 1.51) for each 10 mm Hg of pulse pressure (P<0.0001) but not after adjustment for age (RR=1.19 [95% CI, 0.96 to 1.47]; P=0.10). This study provides the first evidence, in a longitudinal study, that aortic stiffness is an independent predictor of fatal stroke in patients with essential hypertension.

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Reduced ascending aortic strain and distensibility: earliest manifestations of vascular aging in humans.

Hsien-Chung Yu, Nadjia Kachenoura, Helena C. A. V. Lima … (2010)

Arterial stiffness predicts cardiovascular events beyond traditional risk factors. However, the relationship with aging of novel noninvasive measures of aortic function by MRI and their interrelationship with established markers of vascular stiffness remain unclear and currently limit their potential impact. Our aim was to compare age-related changes of central measures of aortic function with carotid distensibility, global carotid-femoral pulse wave velocity, and wave reflections. We determined aortic strain, distensibility, and aortic arch pulse wave velocity by MRI, carotid distensibility by ultrasound, and carotid-femoral pulse wave velocity by tonometry in 111 asymptomatic subjects (54 men, age range: 20 to 84 years). Central pressures were used to calculate aortic distensibility. Peripheral and central pulse pressure, augmentation index, and carotid-femoral pulse wave velocity increased with age, but aortic strain and aortic arch PWV were most closely and specifically related to aging. Ascending aortic (AA) strain and distensibility decreased, respectively, by 5.3+/-0.5% (R(2)=0.54, P<0.0001) and 13.6+/-1 kPa(-1)x10(-3) (R(2)=0.62, P<0.0001), and aortic arch pulse wave velocity increased by 1.6+/-0.13 m/sec (R(2)=0.60, P<0.0001) for each decade of age after adjustment for gender, body size, and heart rate. We demonstrate in this study a dramatic decrease in AA distensibility before the fifth decade of life in individuals with diverse prevalence of risk factors free of overt cardiovascular disease. In particular, compared with other measures of aortic function, the best markers of subclinical large artery stiffening, were AA distensibility in younger and aortic arch pulse wave velocity in older individuals.

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The relationship of age with regional aortic stiffness and diameter.

Lucas Hickson, Mark Butlin, Mark I. Wilkinson … (2010)

The purpose of this study was to determine the impact of age on regional aortic pulse wave velocity (aPWV). aPWV is an independent predictor of cardiovascular risk and increases exponentially with age. However, it is unclear whether such changes occur uniformly along the length of the aorta or vary by region. A total of 162 subjects, aged 18 to 77 years and free of cardiovascular disease and medication, were recruited from the Anglo-Cardiff Collaborative Trial. Cine phase contrast magnetic resonance imaging was performed at 5 aortic levels. Systolic diameter and average blood flow were measured at each level and regional aPWV (regional aPWV measured by cine phase contrast magnetic resonance imaging) determined in 4 aortic segments: the arch (R1), the thoracic-descending aorta (R2), mid-descending aorta (R3), and the abdominal aorta (R4) and across the entire aorta. Regional PWV measured by cine phase contrast magnetic resonance imaging values increased from the valve to the bifurcation in the 4 segments (PWV-R1- PWV-R4: 4.6 ± 1.5 m/s, 5.5 ± 2.0 m/s, 5.7 ± 2.3 m/s, 6.1 ± 2.9 m/s, respectively) and did not differ between genders. The greatest age-related difference in stiffness occurred in the abdominal aorta (+0.9 m/s per decade, p < 0.001) followed by the thoracic-descending region (+0.7 m/s, p < 0.001), the mid-descending region (+0.6 m/s, p < 0.001) and aortic arch (+0.4 m/s, p < 0.001). The average systolic diameters decreased moving distally (L1-5: 3.1 ± 0.4 cm, 2.3 ± 0.3 cm, 2.1 ± 0.3 cm, 1.9 ± 0.2 cm, and 1.7 ± 0.2 cm, respectively). The greatest variation in systolic diameter as a function of age occurred in the ascending region (+0.96 mm/decade, p < 0.001). Values of aPWV measured across the entire aorta were strongly correlated with PWV-tonometry (R = 0.71, p < 0.001), although they were significantly lower (mean difference 1.7 ± 1.6 m/s, p < 0.001). The greatest difference in aortic stiffness occurs in the abdominal region, whereas the greatest difference in diameter occurs in the ascending aorta, which may help offset an increase in wall stiffness. Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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Author and article information

Journal

Journal ID (nlm-ta): J Hypertens

Journal ID (iso-abbrev): J. Hypertens

Journal ID (publisher-id): JHYPE

Title: Journal of Hypertension

Publisher: Lippincott Williams & Wilkins

ISSN (Print): 0263-6352

ISSN (Electronic): 1473-5598

Publication date (Print): February 2019

Publication date (Electronic): 24 July 2018

Volume: 37

Issue: 2

Pages: 347-355

Affiliations

[a ]King's College London, British Heart Foundation Centre, London

[b ]Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge

[c ]Brunel Institute for Bioengineering, Brunel University, Uxbridge, Middlesex, UK

Author notes

Correspondence to Ashraf W. Khir, PhD, Brunel Institute for Bioengineering, Brunel University, Kingston Lane, Uxbridge, Middlesex UB8 3PH, UK. Tel: +44 1895265857; fax: +44 1895274608; e-mail: ashraf.khir@ 123456brunel.ac.uk

Article

Publisher ID: JH-D-18-00099

DOI: 10.1097/HJH.0000000000001886

PMC ID: 6365245

PubMed ID: 30645209

SO-VID: 129c90a2-888d-40fd-9b8e-bffb018b30bc

License:

This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

History

Date received : 31 January 2018

Date revision received : 6 June 2018

Date accepted : 4 July 2018

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Keywords: haemodynamics,local arterial properties,magnetic resonance imaging,pulse wave velocity,wave intensity analysis

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Keywords: haemodynamics, local arterial properties, magnetic resonance imaging, pulse wave velocity, wave intensity analysis

Stiffening and ventricular–arterial interaction in the ascending aorta using MRI: ageing effects in healthy humans

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Abstract

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Karger: Neurology and Neuroscience

Most cited references 34

Aortic stiffness is an independent predictor of fatal stroke in essential hypertension.

Reduced ascending aortic strain and distensibility: earliest manifestations of vascular aging in humans.

The relationship of age with regional aortic stiffness and diameter.

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