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Coupling between MRI-assessed regional aortic pulse wave velocity and diameters in patients with thoracic aortic aneurysm: a feasibility study.

Kröner ES, Westenberg JJ, Kroft LJ, Brouwer NJ, van den Boogaard PJ, Scholte AJ - Neth Heart J (2015)

Bottom Line: Aortic diameter was increased in 28 (14 %) segments.Specificity of regional PWV testing for the prediction of increased regional diameter was ≥ 84 % in the descending thoracic to abdominal aorta and ≥ 68 % in the ascending aorta and aortic arch.Normal regional PWV is related to absence of increased diameter, with high specificity in the descending thoracic to abdominal aorta and moderate results in the ascending aorta and aortic arch.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. e.s.j.kroner@lumc.nl.

ABSTRACT

Aims: Thoracic aortic aneurysm (TAA) is potentially life-threatening and requires close follow-up to prevent aortic dissection. Aortic stiffness and size are considered to be coupled. Regional aortic stiffness in patients with TAA is unknown. We aimed to evaluate coupling between regional pulse wave velocity (PWV), a marker of vascular stiffness, and aortic diameter in TAA patients.

Methods: In 40 TAA patients (59 ± 13 years, 28 male), regional aortic diameters and regional PWV were assessed by 1.5 T MRI. The incidence of increased diameter and PWV were determined for five aortic segments (S1, ascending aorta; S2, aortic arch; S3, thoracic descending aorta; S4, suprarenal and S5, infrarenal abdominal aorta). In addition, coupling between regional PWV testing and aortic dilatation was evaluated and specificity and sensitivity were assessed.

Results: Aortic diameter was 44 ± 5 mm for the aortic root and 39 ± 5 mm for the ascending aorta. PWV was increased in 36 (19 %) aortic segments. Aortic diameter was increased in 28 (14 %) segments. Specificity of regional PWV testing for the prediction of increased regional diameter was ≥ 84 % in the descending thoracic to abdominal aorta and ≥ 68 % in the ascending aorta and aortic arch.

Conclusion: Normal regional PWV is related to absence of increased diameter, with high specificity in the descending thoracic to abdominal aorta and moderate results in the ascending aorta and aortic arch.

No MeSH data available.


Related in: MedlinePlus

Representation of image acquisition and analysis of aortic dimensions in a TAA patient. a and b are acquired by conventional cine bright blood gradient-echo imaging. a is taken in the oblique sagittal plane and b in the oblique coronal plane. a and b show the levels of the aortic annulus (Ao annulus), sinuses of Valsalva (SV) and sino-tubular junction (STJ) were maximal luminal diameters were evaluated. c is acquired by 2D black blood spin-echo imaging and shows the levels of the ascending aorta (AA), aortic arch (Arch) and thoracic descending aorta (DA) were maximal aortic diameters were measured. d is a maximum intensity projection of a contrast-enhanced magnetic resonance angiogram, acquired by first-pass imaging with a three-dimensional, T1-weighted fast gradient-echo sequence, representing the entire aorta. For both analysis of aortic dimensions and for analysis of aortic PWV, five aortic segments were evaluated: the ascending aorta (S1), the aortic arch (S2), the thoracic descending aorta (S3), the suprarenal abdominal aorta (S4), the infrarenal abdominal aorta (S5). Ao aorta, SV sinuses of Valsalva, STJ sino-tubular junction, AA ascending aorta, DA descending aorta
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Fig1: Representation of image acquisition and analysis of aortic dimensions in a TAA patient. a and b are acquired by conventional cine bright blood gradient-echo imaging. a is taken in the oblique sagittal plane and b in the oblique coronal plane. a and b show the levels of the aortic annulus (Ao annulus), sinuses of Valsalva (SV) and sino-tubular junction (STJ) were maximal luminal diameters were evaluated. c is acquired by 2D black blood spin-echo imaging and shows the levels of the ascending aorta (AA), aortic arch (Arch) and thoracic descending aorta (DA) were maximal aortic diameters were measured. d is a maximum intensity projection of a contrast-enhanced magnetic resonance angiogram, acquired by first-pass imaging with a three-dimensional, T1-weighted fast gradient-echo sequence, representing the entire aorta. For both analysis of aortic dimensions and for analysis of aortic PWV, five aortic segments were evaluated: the ascending aorta (S1), the aortic arch (S2), the thoracic descending aorta (S3), the suprarenal abdominal aorta (S4), the infrarenal abdominal aorta (S5). Ao aorta, SV sinuses of Valsalva, STJ sino-tubular junction, AA ascending aorta, DA descending aorta

Mentions: Aortic dimensions were assessed from the acquisition of conventional (1) cine bright-blood gradient-echo imaging in coronal (Fig. 1a) and sagittal (Fig. 1b) direction and (2) two-dimensional black-blood spin-echo imaging (Fig. 1c). To visualise the entire aorta, a three-dimensional, T1-weighted fast gradient-echo sequence was used to obtain a contrast-enhanced magnetic resonance angiography (MRA) of the full aorta, as previously described (Fig. 1d) [12].Fig. 1


Coupling between MRI-assessed regional aortic pulse wave velocity and diameters in patients with thoracic aortic aneurysm: a feasibility study.

Kröner ES, Westenberg JJ, Kroft LJ, Brouwer NJ, van den Boogaard PJ, Scholte AJ - Neth Heart J (2015)

Representation of image acquisition and analysis of aortic dimensions in a TAA patient. a and b are acquired by conventional cine bright blood gradient-echo imaging. a is taken in the oblique sagittal plane and b in the oblique coronal plane. a and b show the levels of the aortic annulus (Ao annulus), sinuses of Valsalva (SV) and sino-tubular junction (STJ) were maximal luminal diameters were evaluated. c is acquired by 2D black blood spin-echo imaging and shows the levels of the ascending aorta (AA), aortic arch (Arch) and thoracic descending aorta (DA) were maximal aortic diameters were measured. d is a maximum intensity projection of a contrast-enhanced magnetic resonance angiogram, acquired by first-pass imaging with a three-dimensional, T1-weighted fast gradient-echo sequence, representing the entire aorta. For both analysis of aortic dimensions and for analysis of aortic PWV, five aortic segments were evaluated: the ascending aorta (S1), the aortic arch (S2), the thoracic descending aorta (S3), the suprarenal abdominal aorta (S4), the infrarenal abdominal aorta (S5). Ao aorta, SV sinuses of Valsalva, STJ sino-tubular junction, AA ascending aorta, DA descending aorta
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4580663&req=5

Fig1: Representation of image acquisition and analysis of aortic dimensions in a TAA patient. a and b are acquired by conventional cine bright blood gradient-echo imaging. a is taken in the oblique sagittal plane and b in the oblique coronal plane. a and b show the levels of the aortic annulus (Ao annulus), sinuses of Valsalva (SV) and sino-tubular junction (STJ) were maximal luminal diameters were evaluated. c is acquired by 2D black blood spin-echo imaging and shows the levels of the ascending aorta (AA), aortic arch (Arch) and thoracic descending aorta (DA) were maximal aortic diameters were measured. d is a maximum intensity projection of a contrast-enhanced magnetic resonance angiogram, acquired by first-pass imaging with a three-dimensional, T1-weighted fast gradient-echo sequence, representing the entire aorta. For both analysis of aortic dimensions and for analysis of aortic PWV, five aortic segments were evaluated: the ascending aorta (S1), the aortic arch (S2), the thoracic descending aorta (S3), the suprarenal abdominal aorta (S4), the infrarenal abdominal aorta (S5). Ao aorta, SV sinuses of Valsalva, STJ sino-tubular junction, AA ascending aorta, DA descending aorta
Mentions: Aortic dimensions were assessed from the acquisition of conventional (1) cine bright-blood gradient-echo imaging in coronal (Fig. 1a) and sagittal (Fig. 1b) direction and (2) two-dimensional black-blood spin-echo imaging (Fig. 1c). To visualise the entire aorta, a three-dimensional, T1-weighted fast gradient-echo sequence was used to obtain a contrast-enhanced magnetic resonance angiography (MRA) of the full aorta, as previously described (Fig. 1d) [12].Fig. 1

Bottom Line: Aortic diameter was increased in 28 (14 %) segments.Specificity of regional PWV testing for the prediction of increased regional diameter was ≥ 84 % in the descending thoracic to abdominal aorta and ≥ 68 % in the ascending aorta and aortic arch.Normal regional PWV is related to absence of increased diameter, with high specificity in the descending thoracic to abdominal aorta and moderate results in the ascending aorta and aortic arch.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. e.s.j.kroner@lumc.nl.

ABSTRACT

Aims: Thoracic aortic aneurysm (TAA) is potentially life-threatening and requires close follow-up to prevent aortic dissection. Aortic stiffness and size are considered to be coupled. Regional aortic stiffness in patients with TAA is unknown. We aimed to evaluate coupling between regional pulse wave velocity (PWV), a marker of vascular stiffness, and aortic diameter in TAA patients.

Methods: In 40 TAA patients (59 ± 13 years, 28 male), regional aortic diameters and regional PWV were assessed by 1.5 T MRI. The incidence of increased diameter and PWV were determined for five aortic segments (S1, ascending aorta; S2, aortic arch; S3, thoracic descending aorta; S4, suprarenal and S5, infrarenal abdominal aorta). In addition, coupling between regional PWV testing and aortic dilatation was evaluated and specificity and sensitivity were assessed.

Results: Aortic diameter was 44 ± 5 mm for the aortic root and 39 ± 5 mm for the ascending aorta. PWV was increased in 36 (19 %) aortic segments. Aortic diameter was increased in 28 (14 %) segments. Specificity of regional PWV testing for the prediction of increased regional diameter was ≥ 84 % in the descending thoracic to abdominal aorta and ≥ 68 % in the ascending aorta and aortic arch.

Conclusion: Normal regional PWV is related to absence of increased diameter, with high specificity in the descending thoracic to abdominal aorta and moderate results in the ascending aorta and aortic arch.

No MeSH data available.


Related in: MedlinePlus