Validation of simple measures of aortic distensibility based on standard 4-chamber cine CMR: a new approach for clinical studies

Stoiber, Lukas; Ghorbani, Niky; Kelm, Marcus; Küehne, Titus; Rank, Nina; Lapinskas, Tomas; Stehning, Christian; Pieske, Burkert; Falk, Volkmar; Gebker, Rolf; Kelle, Sebastian

doi:10.1007/s00392-019-01525-8

Cited by 4 publications

(1 citation statement)

References 28 publications

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“…To ensure comparability and consistency of aortic compliance and distensibility measurements, the interobserver variability has been assessed. 34 To reduce the risk of overestimating vessel diameters, angulation errors were reduced using minimal cross-sectional diameters of the vessel. Furthermore, central blood pressure estimations are required for distensibility calculation and were not directly assessed by invasive heart catheterisation.…”

Section: Discussionmentioning

confidence: 99%

Impact of valve morphology, hypertension and age on aortic wall properties in patients with coarctation: a two-centre cross-sectional study

Ghorbani

Muthurangu²,

Khushnood³

et al. 2020

BMJ Open

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ObjectiveWe aimed to investigate the combined effects of arterial hypertension, bicuspid aortic valve disease (BAVD) and age on the distensibility of the ascending and descending aortas in patients with aortic coarctation.DesignCross-sectional study.SettingThe study was conducted at two university medical centres, located in Berlin and London.ParticipantsA total of 121 patients with aortic coarctation (ages 1–71 years) underwent cardiac MRI, echocardiography and blood pressure measurements.Outcome measuresCross-sectional diameters of the ascending and descending aortas were assessed to compute aortic area distensibility. Findings were compared with age-specific reference values. The study complied with the Strengthening the Reporting of Observational Studies in Epidemiology statement and reporting guidelines.ResultsImpaired distensibility (below fifth percentile) was seen in 37% of all patients with coarctation in the ascending aorta and in 43% in the descending aorta. BAVD (43%) and arterial hypertension (72%) were present across all ages. In patients >10 years distensibility impairment of the ascending aorta was predominantly associated with BAVD (OR 3.1, 95% CI 1.33 to 7.22, p=0.009). Distensibility impairment of the descending aorta was predominantly associated with arterial hypertension (OR 2.8, 95% CI 1.08 to 7.2, p=0.033) and was most pronounced in patients with uncontrolled hypertension despite antihypertensive treatment.ConclusionFrom early adolescence on, both arterial hypertension and BAVD have a major impact on aortic distensibility. Their specific effects differ in strength and localisation (descending vs ascending aorta). Moreover, adequate blood pressure control is associated with improved distensibility. These findings could contribute to the understanding of cardiovascular complications and the management of patients with aortic coarctation.

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Section: Discussionmentioning

confidence: 99%

Impact of valve morphology, hypertension and age on aortic wall properties in patients with coarctation: a two-centre cross-sectional study

Ghorbani

Muthurangu²,

Khushnood³

et al. 2020

BMJ Open

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Development of a novel CT-derived measure of cardiovascular health: the CT aortic stiffness index (CTASI)

et al. 2021

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Vascular Remodeling During Late-Gestation Pregnancy: An In-Vitro Assessment of the Murine Ascending Thoracic Aorta

Vargas,

Tarraf,

Jennings

et al. 2024

Journal of Biomechanical Engineering

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Maternal mortality due to cardiovascular disease is a rising concern in the U.S. Pregnancy triggers changes in the circulatory system, potentially influencing the structure of the central vasculature. Evidence suggests a link between a woman's pregnancy history and future cardiovascular health, but our understanding remains limited. To fill this gap, we examined the passive mechanics of the murine ascending thoracic aorta during late gestation. By performing biaxial mechanical testing on the ascending aorta, we were able to characterize the mechanical properties of both control and late-gestation tissues. By examining mechanical, structural, and geometric properties, we confirmed that a remodeling of the aortic wall occurred. Morphological and mechanical properties of the tissue indicated an outward expansion of the tissue, as reflected in changes in wall thickness (~ 12% increase) and luminal diameter (~ 6% increase) at its physiologically loaded state in the pregnant group. With these geometric adaptations and despite increased hemodynamic loads, pregnancy did not induce significant changes in the tensile wall stress at the similar physiological pressure levels of the pregnant and control tissues. The geometric alterations also included reduced intrinsic stiffness in the circumferential direction (~ 18 %) and reduced structural stiffness (~ 26 %) in the pregnant group. The observed vascular remodeling maintained the elastic stored energy of the aortic wall under systolic loads, indicating preservation of vascular function. Data from our study of pregnancy-related vascular remodeling will provide valuable insights for future investigations of maternal cardiovascular health.

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Validation of simple measures of aortic distensibility based on standard 4-chamber cine CMR: a new approach for clinical studies

Cited by 4 publications

References 28 publications

Impact of valve morphology, hypertension and age on aortic wall properties in patients with coarctation: a two-centre cross-sectional study

Impact of valve morphology, hypertension and age on aortic wall properties in patients with coarctation: a two-centre cross-sectional study

Development of a novel CT-derived measure of cardiovascular health: the CT aortic stiffness index (CTASI)

Vascular Remodeling During Late-Gestation Pregnancy: An In-Vitro Assessment of the Murine Ascending Thoracic Aorta

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