Reproducibility of pulse wave velocity measurements with phase contrast magnetic resonance and applanation tonometry

Suever, Jonathan D.; Oshinski, John N.; Rojas–Campos, Enrique; Huneycutt, David; Cardarelli, Francesca; Stillman, Arthur E.; Raggi, Paolo

doi:10.1007/s10554-011-9929-8

Cited by 18 publications

(11 citation statements)

References 23 publications

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“…The current study showed lower PWV in the younger healthy cohort compared with older patients at risk for CVD, as expected [ 1 , 8 ]. The current study also showed slightly higher PWV for the healthy young cohort compared with data from an equivalent age group in a recent study including PWV in only the aortic arch (4 m/s), [ 10 ] but lower than a study also including parts of the abdominal aorta (5.6 m/s) [ 17 ]. This difference may be explained by that measurements for PWV are related to the elastic properties of the vessels, which vary along the arterial tree, with more elastic proximal segments and stiffer distal segments.…”

Section: Discussioncontrasting

confidence: 46%

Required temporal resolution for accurate thoracic aortic pulse wave velocity measurements by phase-contrast magnetic resonance imaging and comparison with clinical standard applanation tonometry

Dorniak

Heiberg

Hellmann

et al. 2016

BMC Cardiovasc Disord

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BackgroundPulse wave velocity (PWV) is a biomarker for arterial stiffness, clinically assessed by applanation tonometry (AT). Increased use of phase-contrast cardiac magnetic resonance (CMR) imaging allows for PWV assessment with minor routine protocol additions. The aims were to investigate the acquired temporal resolution needed for accurate and precise measurements of CMR-PWV, and develop a tool for CMR-PWV measurements.MethodsComputer phantoms were generated for PWV = 2–20 m/s based on human CMR-PWV data. The PWV measurements were performed in 13 healthy young subjects and 13 patients at risk for cardiovascular disease. The CMR-PWV was measured by through-plane phase-contrast CMR in the ascending aorta and at the diaphragm level. Centre-line aortic distance was determined between flow planes. The AT-PWV was assessed within 2 h after CMR. Three observers (CMR experience: 15, 4, and <1 year) determined CMR-PWV. The developed tool was based on the flow-curve foot transit time for PWV quantification.ResultsComputer phantoms showed bias 0.27 ± 0.32 m/s for a temporal resolution of at least 30 ms. Intraobserver variability for CMR-PWV were: 0 ± 0.03 m/s (15 years), -0.04 ± 0.33 m/s (4 years), and -0.02 ± 0.30 m/s (<1 year). Interobserver variability for CMR-PWV was below 0.02 ± 0.38 m/s. The AT-PWV overestimated CMR-PWV by 1.1 ± 0.7 m/s in healthy young subjects and 1.6 ± 2.7 m/s in patients.ConclusionsAn acquired temporal resolution of at least 30 ms should be used to obtain accurate and precise thoracic aortic phase-contrast CMR-PWV. A new freely available research tool was used to measure PWV in healthy young subjects and in patients, showing low intra- and interobserver variability also for less experienced CMR observers.

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Section: Discussioncontrasting

confidence: 46%

Required temporal resolution for accurate thoracic aortic pulse wave velocity measurements by phase-contrast magnetic resonance imaging and comparison with clinical standard applanation tonometry

Dorniak

Heiberg

Hellmann

et al. 2016

BMC Cardiovasc Disord

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“…Some of the limitations in determining variations in regional vessel wall motion can be addressed through the use of cine phase contrast magnetic resonance imaging (PCMR) to assess PWV at multiple axial locations along the length of the aorta . Previously, axial cine PCMR has been used to evaluate variability in distensibility and compliance with respect to axial location . However, these methods are unable to measure heterogeneities in aortic distension circumferentially (ie, around the vessel) or radially (ie, through the aortic wall).…”

mentioning

confidence: 99%

“…10 Previously, axial cine PCMR has been used to evaluate variability in distensibility and compliance with respect to axial location. 11,12 However, these methods are unable to measure heterogeneities in aortic distension circumferentially (ie, around the vessel) or radially (ie, through the aortic wall). Circumferential and radial mechanical heterogeneity may be critical in risk stratification and therapeutic planning for certain aortic pathologies (eg, rupture risk in abdominal aortic aneurysms [AAA]), which likely depend on local, patient-specific biomechanics.…”

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confidence: 99%

Demonstration of circumferential heterogeneity in displacement and strain in the abdominal aortic wall by spiral cine DENSE MRI

Iffrig

Wilson

Zhong

et al. 2018

Magnetic Resonance Imaging

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Background Knowledge of tissue properties of the abdominal aorta can improve understanding of vascular disease and guide interventional approaches. Existing MRI methods to quantify aortic wall displacement and strain are unable to discern circumferential heterogeneity. Purpose To assess regional variation in abdominal aortic wall displacement and strain as a function of circumferential position using spiral cine displacement encoding with stimulated echoes (DENSE). Study Type Prospective. Population Cardiovascular disease‐free men (n = 8) and women (n = 9) ages 30–42. Sequences Prospective electrocardiogram (ECG)‐gated and navigator echo‐gated spiral, cine 2D DENSE and retrospective ECG‐gated phase contrast MR (PCMR) sequences at 3T. Assessment In‐plane displacement values of the aortic wall acquired with DENSE were used to determine radial and circumferential aortic wall motion. A quadrilateral‐based 2D strain calculation method was implemented to determine strain from the displacement field. Peak displacement and its radial and circumferential contributions as well as peak circumferential strain were compared among eight circumferential wall segments. Distensibility was calculated using PCMR and compared with homogenized circumferential strain. Statistical Tests To account for repeated measurements in volunteers, linear mixed models for mean sector values were created for displacement magnitude, circumferential displacement, radial displacement, and circumferential strain. Comparisons were made between sectors. Calculated distensibility and homogenized circumferential strain were compared using Bland–Altman analysis. Statistical significance was defined as P < 0.05. Results Displacement was highest in the anterior wall (1.5 ± 0.7 mm) and was primarily in the radial as compared with circumferential direction (1.04 ± 0.05 mm vs. 0.81 ± 0.42 mm). Circumferential strain was highest in the lateral walls (left 0.16 ± 0.05 and right 0.21 ± 0.12) with homogenized circumferential strain of 0.14 ± 0.05. Data Conclusion DENSE imaging in the abdominal aortic wall demonstrated that the anterior aortic wall exhibits the greatest displacement, while the lateral wall experiences the largest circumferential strain. Level of Evidence: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:731–743.

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“…Grotenhuis et al [ 9 ] evaluated the reproducibility by repeating acquisitions on the same day and reported a coefficient of variation of 9% for PWV assessment in the total aorta by CMR. In a study by Suever et al [ 27 ], reproducibility of CMR-assessed PWV was compared to applanation tonometry by performing repeated studies on volunteers on the same day. However, no data has been published for repeated acquisitions on separate days, therefore information on the physiological variation of this marker is missing, although CMR-assessed PWV is widely used in clinical research.…”

Section: Discussionmentioning

confidence: 99%

Site-specific association between distal aortic pulse wave velocity and peripheral arterial stenosis severity: a prospective cardiovascular magnetic resonance study

Bosch

Westenberg

Setz-Pels

et al. 2015

Journal of Cardiovascular Magnetic Resonance

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BackgroundVascular disease expression in one location may not be representative for disease severity in other vascular territories, however, strong correlation between disease expression and severity within the same vascular segment may be expected. Therefore, we hypothesized that aortic stiffening is more strongly associated with disease expression in a vascular territory directly linked to that aortic segment rather than in a more remote segment. We prospectively compared the association between aortic wall stiffness, expressed by pulse wave velocity (PWV), sampled in the distal aorta, with the severity of peripheral arterial occlusive disease (PAOD) as compared to atherosclerotic markers sampled in remote vascular territories such as PWV in the proximal aorta and the normalized wall index (NWI), representing the vessel wall thickness, of the left common carotid artery.MethodsForty-two patients (23 men; mean age 64±10 years) underwent velocity-encoded cardiovascular magnetic resonance (CMR) in the proximal and distal aorta, whole-body contrast-enhanced MR angiography (CE-MRA) and carotid vessel wall imaging with black-blood CMR in the work-up for PAOD. Strength of associations between aortic stiffness, carotid NWI and peripheral vascular stenosis grade were assessed and evaluated with multiple linear regression.ResultsStenosis severity correlated well with PWV in the distal aorta (Pearson rP=0.64, p<0.001, Spearman rS=0.65, p<0.001) but to a lesser extent with PWV in the proximal aorta (rP=0.48, p=0.002, rS=0.22, p=0.18). Carotid NWI was not associated with peripheral stenosis severity (rP=0.17, p=0.28, rS=0.14, p=0.37) nor with PWV in the proximal aorta (rP=0.22, p=0.17) nor in the distal aorta (rP=0.21, p=0.18). Correlation between stenosis severity and distal aortic PWV remained statistically significant after correction for age and gender.ConclusionsDistal aortic wall stiffness is more directly related to peripheral arterial stenosis severity than markers from more remote vascular territories such as proximal aortic wall stiffness or carotid arterial wall thickness. Site-specific evaluation of vascular disease may be required for full vascular risk estimation.

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Reproducibility of pulse wave velocity measurements with phase contrast magnetic resonance and applanation tonometry

Cited by 18 publications

References 23 publications

Required temporal resolution for accurate thoracic aortic pulse wave velocity measurements by phase-contrast magnetic resonance imaging and comparison with clinical standard applanation tonometry

Required temporal resolution for accurate thoracic aortic pulse wave velocity measurements by phase-contrast magnetic resonance imaging and comparison with clinical standard applanation tonometry

Demonstration of circumferential heterogeneity in displacement and strain in the abdominal aortic wall by spiral cine DENSE MRI

Site-specific association between distal aortic pulse wave velocity and peripheral arterial stenosis severity: a prospective cardiovascular magnetic resonance study

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