A cross-sectional comparison of invasive and noninvasive aortic pulse wave velocity measurement in patients with or at risk for heart failure with preserved ejection fraction.

IF 2.2 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular diagnosis and therapy Pub Date : 2025-10-31 Epub Date: 2025-10-23 DOI:10.21037/cdt-24-137

Anum Asif, Michael D Nelson, Chrisandra Shufelt, T Jake Samuel, Galen Cook-Wiens, Judy Luu, Benita Tjoe, Balaji Tamarappoo, Daniel S Berman, C Noel Bairey Merz, Janet Wei

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Abstract

Background: Increased aortic pulse wave velocity (aPWV), a marker of arterial stiffness, is associated with poor prognosis in patients with or at risk for heart failure with preserved ejection fraction (HFpEF). Increasingly, advanced imaging using cardiac magnetic resonance imaging (MRI) is used to evaluate cardiac dysfunction, including coronary microvascular dysfunction (CMD). To facilitate investigation linking CMD with HFpEF, we compared MRI-measured aPWV with traditional invasive or noninvasive measurements of aPWV.

Methods: We studied 118 participants (90.7% women) with or at risk for HFpEF due to suspected CMD in a cross-sectional design at Cedars-Sinai Medical Center between October 2025 and February 2022. aPWV was measured by: (I) MRI through-plane phase-contrast imaging at the ascending and distal descending aorta (MRI-aPWV) (n=78), (II) invasively via catheter pullback (cath-aPWV) (n=68), and (III) carotid-femoral applanation tonometry (cf-aPWV; SphygmoCor XCEL, Atcor Medical) (n=87). MRI-aPWV was compared to cath-aPWV and cf-aPWV using Pearson correlation and Bland-Altman plots.

Results: Mean age was 58±11.8 years, and mean aPWV were 8.48±3.21 m/s (MRI-PWV), 7.51±2.79 m/s (cath-aPWV), and 8.68±1.83 m/s (cf-aPWV). MRI-aPWV strongly correlated with cf-aPWV with r=0.74 [95% confidence interval (CI): 0.61-0.83, P<0.001] with mean difference -0.18 and standard deviation (SD) 2.14. Comparison of MRI-aPWV to cath-aPWV showed a modest correlation of 0.52 (95% CI: 0.29-0.69, P<0.001) with a mean difference of -0.74 and SD 2.78.

Conclusions: MRI measurement of aPWV shows good agreement with traditional invasive and noninvasive measurements in participants with or at risk for HFpEF. Reliable measurement of arterial stiffness combined with cardiac MRI measures of ventricular remodeling, fibrosis, scar and perfusion may offer pathophysiology insights and treatment targets for HFpEF.

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有创和无创主动脉脉搏波速度测量在保留射血分数的心力衰竭患者或有风险患者中的横断面比较

背景：主动脉脉波速度（aPWV）升高是动脉僵硬度的标志，与具有保留射血分数（HFpEF）的心力衰竭患者或有心力衰竭风险的患者预后不良相关。越来越多的先进成像技术应用于心脏磁共振成像（MRI）来评估心功能障碍，包括冠状动脉微血管功能障碍（CMD）。为了便于研究CMD与HFpEF之间的联系，我们将mri测量的aPWV与传统的有创或无创aPWV测量进行了比较。方法：我们在2025年10月至2022年2月期间在雪松-西奈医学中心进行了一项横断面设计，研究了118名因疑似CMD而患有或有患HFpEF风险的参与者（90.7%为女性）。aPWV的测量方法为：(I)升主动脉和远降主动脉MRI透平面相位对比成像（MRI-aPWV）（n=78），（II）有创导管回拉（cat -aPWV）（n=68），（III）颈-股动脉压平血压计（cf-aPWV; sphygmoor XCEL, Atcor Medical）（n=87）。采用Pearson相关和Bland-Altman图将MRI-aPWV与cath-aPWV和cf-aPWV进行比较。结果：平均年龄为58±11.8岁，平均aPWV分别为8.48±3.21 m/s （MRI-PWV）、7.51±2.79 m/s （cat -aPWV）和8.68±1.83 m/s （cf-aPWV）。MRI-aPWV与cf-aPWV强相关，r=0.74[95%可信区间（CI）： 0.61-0.83]，结论：MRI测量的aPWV与传统的有创和无创测量在HFpEF患者或有风险的参与者中表现出良好的一致性。可靠的动脉硬度测量与心室重构、纤维化、疤痕和灌注的心脏MRI测量相结合，可能为HFpEF提供病理生理学见解和治疗靶点。

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来源期刊

Cardiovascular diagnosis and therapy Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

4.20%

发文量

期刊介绍： The journal ''Cardiovascular Diagnosis and Therapy'' (Print ISSN: 2223-3652; Online ISSN: 2223-3660) accepts basic and clinical science submissions related to Cardiovascular Medicine and Surgery. The mission of the journal is the rapid exchange of scientific information between clinicians and scientists worldwide. To reach this goal, the journal will focus on novel media, using a web-based, digital format in addition to traditional print-version. This includes on-line submission, review, publication, and distribution. The digital format will also allow submission of extensive supporting visual material, both images and video. The website www.thecdt.org will serve as the central hub and also allow posting of comments and on-line discussion. The web-site of the journal will be linked to a number of international web-sites (e.g. www.dxy.cn), which will significantly expand the distribution of its contents.