Associations of CMR-based pulse wave velocity and aortic distensibility with infrarenal ultrasound-based aortic parameters in the Hamburg City Health Study.

Abstract

Background: Although pulse wave velocity (PWV) and aortic distensibility (AD) can be readily obtained from cardiac magnetic resonance imaging (CMR), there is a paucity of data on their use for screening for abdominal aortic aneurysm (AAA) and cardiovascular risk stratification.

Methods: Data from the Hamburg City Health Study (HCHS) were used: PWV, AD of the ascending (AD AoAsc) and descending aorta (AD AoDesc) were quantified using 2D-phase-contrast-velocity-encoding-CMR-sequences. The maximum diameter and peak flow velocity of the infrarenal aorta were quantified by ultrasound-measurements. Diameter thresholds for infrarenal ectasia (25-29 mm) and aneurysm (≥ 30 mm) were defined in accordance with current guidelines.

Results: The cohort consisted of 2,093 participants (median age 66 years, 42% women). Median infrarenal aortic diameter was 18.1 mm [IQR 16.4, 19.9] and peak flow velocity 98.6 cm/s [IQR 83.6,115.9]. After adjustment for age and sex, there were significant associations of diameter with AD AoDesc (Coefficient -0.572 p = 0.009) and of peak flow velocity with PWV (Coefficient -0.399, p = 0.029). Participants with infrarenal ectasia or aneurysm (n = 55) had significantly higher median PWV, whereas AD AoAsc, AD AoDesc and peak flow velocity were significantly lower (p = 0.004, p = 0.042, p = 0.039, p < 0.001) compared with normal aortic diameter cohort. After adjustment for covariates, PWV and AD showed a significant predictive value neither for prevalent infrarenal ectasia or nor for aneurysm.

Conclusion: CMR-based aortic stiffness parameters such as PWV and AD were associated with infrarenal aortic parameters. Their diagnostic, screening, and prognostic value remains to be investigated.