Age dependence of pulmonary artery blood flow measured by 4D flow cardiovascular magnetic resonance: results of a population-based study

Abstract

BackgroundIt was our aim to systematically analyze pulmonary artery blood flow within different age-groups in the general population using 4D flow cardiovascular magnetic resonance (CMR) in order to provide a context for interpreting results of future studies (e.g., in pulmonary hypertension) using this technique.MethodsAn age-stratified sample (n = 126) of the population of the city of Freiburg, Germany, underwent ECG-triggered and navigator-gated 4D flow CMR at 3 T of the pulmonary arteries and the thoracic aorta. Analysis planes were placed in the main, left, and right pulmonary artery using dedicated software. Study participants were divided into three groups (1:20–39; 2:40–59; and 3:60–80 years of age). Subsequently, pulmonary blood flow was visualized, quantified and compared between groups.ResultsTime-to-peak of systolic antegrade flow was shorter, peak and average velocities and flow volumes were lower in older subjects. At the end of systole, retrograde flow in the main pulmonary artery was observed in all but one subject. Subsequently, a second antegrade flow peak occurred in diastole which was lower in older subjects. Age was an independent predictor of hemodynamic change after adjustment for cardiovascular risk factors and body-mass-index. During systole, abnormal vortices occurred in the main pulmonary artery in four male subjects.ConclusionsComprehensive analysis of pulmonary blood flow was feasible in all subjects. We were able to detect an independent effect of ageing on pulmonary hemodynamics reflecting increased vessel stiffness and reduced pulmonary circulation. Findings of this study may be helpful for discriminating physiological from pathological flow in patients with pulmonary diseases in the future.Electronic supplementary materialThe online version of this article (doi:10.1186/s12968-016-0252-3) contains supplementary material, which is available to authorized users.

Age-related changes of right atrial morphology and inflow pattern assessed using 4D flow cardiovascular magnetic resonance: results of a population-based study

“…We performed a cross-sectional observational study of an age-stratified sample of the population of the city of Freiburg, Germany (for details see [ 14 ]). The cohort was established on the basis of data obtained from the German Civil Registration System.…”

“…Furthermore, it can be used to evaluate indices of RV systolic function from volume segmentation [ 11 ]. Despite its inherent potential to comprehensively assess right heart filling and associated pathologic conditions, most applications of cardiac 4D flow CMR, however, have focused on the left heart [ 12 , 13 ] or the pulmonary arteries [ 11 , 14 ].…”

Four-Dimensional Flow Magnetic Resonance Imaging for Cardiovascular Imaging: from Basic Concept to Clinical Application

“…The main pulmonary artery of patients with pulmonary hypertension shows secondary morphological changes including dilatation that may induce vortical formation of the blood flow. In a general population-based study using 4D flow MRI, abnormal vortices occurred in the main pulmonary artery in 3% of subjects with no history of pulmonary hypertension [41]. The geometry of the main pulmonary artery dividing into the bilateral pulmonary arteries may influence the formation of an abnormal vortical flow even in healthy subjects.…”

“…Table 1 summarizes the selected clinical applications of 4D flow MRI in various vascular fields. Past studies have also demonstrated hemodynamics of normal cohorts, various hemodynamic changes in cardiovascular diseases, and comparisons before and after interventions for cardiovascular diseases [26,41,52,53]. This article focuses on the clinical application of 4D flow MRI in the field of the great arteries, including aortic diseases, adult congenital heart diseases (CHDs), and pulmonary hypertension.…”

Review of Journal of Cardiovascular Magnetic Resonance (JCMR) 2015-2016 and transition of the JCMR office to Boston

“…Population based pulmonary artery blood flow is unknown. In this prospective study, Wehrum et al [ 56 ] studied 126 age-stratified subjects (at least 20 subjects (10 M/10F) per decade) and found time-to-peak systolic antegrade flow was shorter and peak and average velocities and flow volumes were lower in older subjects. At the end of systole, retrograde flow in the main pulmonary artery was present in all but one subject.…”