Ten-year longitudinal change in aortic stiffness assessed by cardiac MRI in the second half of the human lifespan: the multi-ethnic study of atherosclerosis

Ohyama, Yoshiaki; Teixidó-Turà, Gisela; Ambale-Venkatesh, Bharath; Noda, Chiharu; Chugh, Atul R.; Liu, Chia Ying; Redheuil, Alban; Stacey, Richard; Dietz, Harry C.; Gomes, Antoinette S.; Prince, Martin R.; Evangelista, Arturo; Wu, Colin O.; Hundley, W. Gregory; Bluemke, David A.; Lima, João A.C.

doi:10.1093/ehjci/jev332

Cited by 55 publications

(49 citation statements)

References 30 publications

(28 reference statements)

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“…5Evolution in median aortic distensibility (AD) from baseline to 6-month follow-up (left) in comparison with norm values reported in the MESA trial (right) [7] …”

Section: Discussionmentioning

confidence: 99%

Renal sympathetic denervation restores aortic distensibility in patients with resistant hypertension: data from a multi-center trial

et al. 2018

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Renal sympathetic denervation (RDN) is under investigation as a treatment option in patients with resistant hypertension (RH). Determinants of arterial compliance may, however, help to predict the BP response to therapy. Aortic distensibility (AD) is a well-established parameter of aortic stiffness and can reliably be obtained by CMR. This analysis sought to investigate the effects of RDN on AD and to assess the predictive value of pre-treatment AD for BP changes. We analyzed data of 65 patients with RH included in a multicenter trial. RDN was performed in all participants. A standardized CMR protocol was utilized at baseline and at 6-month follow-up. AD was determined as the change in cross-sectional aortic area per unit change in BP. Office BP decreased significantly from 173/92 ± 24/16 mmHg at baseline to 151/85 ± 24/17 mmHg (p < 0.001) 6 months after RDN. Maximum aortic areas increased from 604.7 ± 157.7 to 621.1 ± 157.3 mm2 (p = 0.011). AD improved significantly by 33% from 1.52 ± 0.82 to 2.02 ± 0.93 × 10−3 mmHg−1 (p < 0.001). Increase of AD at follow-up was significantly more pronounced in younger patients (p = 0.005) and responders to RDN (p = 0.002). Patients with high-baseline AD were significantly younger (61.4 ± 10.1 vs. 67.1 ± 8.4 years, p = 0.022). However, there was no significant correlation of baseline AD to response to RDN. AD is improved after RDN across all age groups. Importantly, these improvements appear to be unrelated to observed BP changes, suggesting that RDN may have direct effects on the central vasculature.Electronic supplementary materialThe online version of this article (10.1007/s00392-018-1229-z) contains supplementary material, which is available to authorized users.

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“…5Evolution in median aortic distensibility (AD) from baseline to 6-month follow-up (left) in comparison with norm values reported in the MESA trial (right) [7] …”

Section: Discussionmentioning

confidence: 99%

Renal sympathetic denervation restores aortic distensibility in patients with resistant hypertension: data from a multi-center trial

et al. 2018

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“…These findings imply that proximal aortic stiffness would occur earlier compared to distal and arch PWV assessed by MRI would be more helpful to stratify the risk for incident CVD among middle-aged population compared to other arterial stiffness markers. Moreover, measurement for arch PWV by MRI has high inter-study reproducibility 31, 32 , so arch PWV would be used as an surrogate measure for CVD in the evaluation of pharmacological treatment.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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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.

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“…Cardiac MRI was performed using 1.5-T whole-body MRI scanners as described elsewhere [15]. Phase-contrast cine gradient echo sequence with electrocardiography gating was used to evaluate the proximal aortic size and stiffness.…”

Section: Methodsmentioning

confidence: 99%

Obstructive Sleep Apnea and Structural/Functional Properties of the Thoracic Ascending Aorta: The Multi-Ethnic Study of Atherosclerosis (MESA)

et al. 2019

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Background: Structural and functional properties of the proximal thoracic aorta have important implications in clinical and subclinical cardiovascular disease (CVD). We examined whether obstructive sleep apnea (OSA) is associated with proximal aortic size and aortic stiffness in a multi-ethnic community-based cohort. Methods: The sample included the Multi-Ethnic Study of Atherosclerosis (MESA) Sleep Ancillary study participants without known CVD who underwent cardiac magnetic resonance imaging. The main exposure variable was OSA severity based on the polysomnography-derived apnea hypopnea index (AHI; normal, AHI <5/h; mild, 5≤ AHI <15/h; moderate to severe, AHI ≥15/h). The study outcomes were ascending aortic diameter (AoD, cm), aortic pulse wave velocity (AoPWV, m/s), and ascending aortic distensibility (AAD, %/mm Hg). Analyses were performed in the overall sample and in sex-specific strata, adjusted for multiple potential confounders. Results: The 708 participants were 55.9% female and on average 68 years old (54–93 years). There was a significant trend (p < 0.0001) of greater mean (SD) AoD across the three OSA groups: normal (n = 87), 3.13 cm (0.35); mild (n = 215), 3.25 (0.34); moderate to severe (n = 406), 3.37 (0.36). In adjusted analysis, participants with moderate to severe OSA had a greater mean AoD compared with the normal group: adjusted mean difference (95% CI), 0.12 cm (0.05, 0.20), p = 0.002. This AoD gradient was observed in women but not in men (p for interaction = 0.02). No differences were found in AoPWV or AAD among the OSA groups. Conclusion: In a diverse community-based cohort, moderate to severe OSA (vs. no OSA) was associated with a larger ascending AoD in women.

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Ten-year longitudinal change in aortic stiffness assessed by cardiac MRI in the second half of the human lifespan: the multi-ethnic study of atherosclerosis

Abstract: In our longitudinal, community-based cohort study of adult individuals aged 45 years or greater, greater mean blood pressure and a history of smoking history were associated with increased aortic stiffening over 10 years as assessed by MRI.

Cited by 55 publications

References 30 publications

Renal sympathetic denervation restores aortic distensibility in patients with resistant hypertension: data from a multi-center trial

Renal sympathetic denervation restores aortic distensibility in patients with resistant hypertension: data from a multi-center trial

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

Obstructive Sleep Apnea and Structural/Functional Properties of the Thoracic Ascending Aorta: The Multi-Ethnic Study of Atherosclerosis (MESA)

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