Aortic Arch Pulse Wave Velocity Assessed by Magnetic Resonance Imaging as a Predictor of Incident Cardiovascular Events

Abstract

The predictive value of aortic arch pulse wave velocity (PWV) assessed by magnetic resonance imaging (MRI) for cardiovascular disease (CVD) events has not been fully established. The aim of the present study was to evaluate the association of arch PWV with incident CVD events in MESA. Aortic arch PWV was measured using MRI at baseline in 3,527 MESA participants (mean age = 62 ± 10 years at baseline, 47% male) free of overt CVD. Cox regression was used to evaluate the risk of incident CVD (coronary heart disease, stroke, transient ischemic attack, or heart failure) in relation to arch PWV adjusted for age, gender, race, and CVD risk factors. The median value of arch PWV was 7.4 (IQR; 5.6 to 10.2) m/s. There was significant interaction between arch PWV and age for outcomes, so analysis was stratified by age categories (45–54 and over 54 years). There were 456 CVD events over the 10-year follow-up. 45–54 year-old participants had significant association of arch PWV with incident CVD independent of CVD risk factors (HR, 1.44; 95% confidence interval, 1.07 to 1.95; p=0.018; per 1SD increase for logarithmically transformed PWV), whereas over 54 years group did not (p=0.93). Aortic arch PWV assessed by MRI is a significant predictor of CVD events among middle-aged (45 to 54 years old) individuals, whereas arch PWV is not associated with CVD among an elderly in a large multi-ethnic population.

The role of ventricular–arterial coupling in cardiac disease and heart failure: assessment, clinical implications and therapeutic interventions. A consensus document of the European Society of Cardiology Working Group on Aorta & Peripheral Vascular Diseases, European Association of Cardiovascular Imaging, and Heart Failure Association

“…Normal values for PWV (< 10/ms) and central systolic BP (< 130 mmHg) have been described and their predictive value for incident cardiovascular mortality and HF has been demonstrated ( Table ) …”

“…Increased PWV was related with reduced coronary flow reserve in CAD patients even after successful revascularization and with elevated N‐terminal pro BNP (NT‐proBNP) post‐myocardial infarction ( Table ) . Myocardial strain imaging (LV GLS < 20%) has shown to detect subclinical dysfunction in CAD patients and represents a more sensitive method of identifying LV performance . Increased aortic stiffness impairs LV function, mainly in the longitudinal axis, through inappropriate VAC with mechanisms discussed in detail above ( Figure ).…”

Ischemia-Modified Albumin Is Associated with Arterial Stiffness in Hemodialysis Patients

“…Arterial stiffness is a common pathological change in hemodialysis patients and is involved in the high morbidity of cardiovascular events. 20) Therefore, finding a simple and effective marker of arterial stiffness may help reducing cardiovascular morbidity in hemodialysis patients. 21,22) Previous studies have shown that traditional cardiovascular risk factors play some roles in the progression of arterial stiffness before development of ESRD.…”

Children with kawasaki disease present elevated stiffness of great arteries: Phase‐contrast MRI study

“…Phase‐contrast MRI (PC‐MRI) enables accurate noninvasive measurement of aortic pulse‐wave velocity (PWV), considered to be the most validated marker of central aortic stiffness . PC‐MRI computed PWV allows for segment‐specific analysis of vascular stiffness, and considers the heterogeneity in vessel wall composition, vessel branching, and backward wave reflections, all typically unevaluated in tonometry‐based studies . Importantly, central aortic and MPA stiffness assessed by PWV have been shown to be prognostic of cardiovascular events with respect to both systemic and pulmonary vasculatures, including hypertension, atherosclerosis, and aneurysmal processes .…”

“…12,13 PC-MRI computed PWV allows for segment-specific analysis of vascular stiffness, and considers the heterogeneity in vessel wall composition, vessel branching, and backward wave reflections, all typically unevaluated in tonometry-based studies. 12,[14][15][16] Importantly, central aortic and MPA stiffness assessed by PWV have been shown to be prognostic of cardiovascular events with respect to both systemic and pulmonary vasculatures, including hypertension, atherosclerosis, and aneurysmal processes. 17,18 Consequently, PC-MRI derived PWV in patients with a history of KD may provide more specific information on arterial health status and improve the prognostic ability of vascular stiffness in this patient population.…”