Association of Brachial-Ankle Pulse Wave Velocity and Cardiomegaly With Aortic Arch Calcification in Patients on Hemodialysis

Abstract Background Guidelines recommend increased aortic stiffness as a negative prognostic factor to be considered in primary and secondary prevention. Pulse wave velocity (PWV) is a frequently employed surrogate marker of aortic stiffness. Carotid-femoral PWV is the most common index in research and clinical practice, but recently several velocity-encoded magnetic resonance imaging (MRI) techniques have been used for the evaluation of regional aortic arch PWV, where the stiffness seems to be particularly relevant from a prognostic point of view. Purposes. We developed a new ultrasound method for the assessment of aortic arch PWV, using a single-beat dual-gate simultaneous pulsed wave Doppler tracing. The aim of the study is to evaluate the feasibility of this new technique in a group of healthy volunteers. Methods We examined 126 healthy volunteers (81 females, 45 males, mean age 42 + 15 years, range 13-83 years) using a commercially available machine equipped with simultaneous dual-gate pulsed Doppler. Using the suprasternal approach, the first sample volume was placed in ascending aorta and the second one in descending aorta. The distance between the two sites was directly measured with a curvilinear tracing in the middle of the vessel, following the shape of the aortic arch. PWV was calculated as the ratio of distance (in millimiters) and the transit time (in milliseconds) measured using the "foot-to-foot" method. The results are then easily transformed, simplifying in the commonly unit of meters/second. Results Feasibility was 99%; in one case it was not possible to measure accurately the aortic arch PWV due to unfavorable suprasternal acustic window. The procedure time was very fast, requiring 2 + 1 minutes. Intraobserver and interobserver variability were 7% and 9% respectively. Aortic arch PWV, as expected, showed a strong correlation with age in males as well as in females (r= 0.71 and r = 0.60 respectively, p < 0.001 for both); there was also a significant correlation with body mass index (r = 0.31; p < 0.001). Aortic arch PWV values ranged from 3.1 to 8.5 m/s, showing a substantial overlap with normal values reported in MRI studies. Conclusions The direct measurement of aortic arch PWV is feasible and reproducible with ultrasound, using the novel single-beat dual-gate simultaneous pulsed wave Doppler tracing. This technique could be implemented in a standard echo examination, that is much more available than MRI studies. Further studies are needed to evaluate if Doppler-derived aortic arch PWV could provide additional prognostic information. Abstract P1830 Figure. Aortic Arch PWV

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Abstract P182: Aortic Arch Pulse Wave Velocity Assessed by MRI as a Predictor of All-Cause Mortality and Incident Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis (MESA)

Circulation ◽

10.1161/circ.131.suppl_1.p182 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Yoshiaki Ohyama ◽

Bharath Ambale-Venkatesh ◽

Chikara Noda ◽

Jang Young Kim ◽

Atul Chugh ◽

...

Keyword(s):

Risk Factors ◽

Pulse Wave Velocity ◽

Aortic Arch ◽

Wave Velocity ◽

Pulse Wave ◽

Ethnic Study ◽

Risk Of Death ◽

Increased Risk ◽

Sagittal Image ◽

All Cause Mortality

Background: The carotid-femoral pulse wave velocity (PWV) assessed by tonometry is predictive of future cardiovascular disease (CVD) events. However, the predictive value of aortic arch PWV assessed by MRI for mortality and CVD events has not been established in the general population. The aim of this study was to evaluate the association of arch PWV with all-cause mortality and incident CVD events over 10 years in the Multi-Ethnic Study of Atherosclerosis (MESA). Method: Aortic arch PWV was measured using phase contrast (PC) cine MRI at the level of the pulmonary artery bifurcation for transit time and black blood sagittal image for transit length at baseline in 3537 MESA participants free of overt CVD. Cox regression was used to evaluate the risk of death and incident CVD in relation to arch PWV adjusted for age, gender, race, and CV risk factors. Results: At baseline, participants were aged 62 ± 10 years; 53% women; 36% White, 15% Chinese, 29% African American, 20% Hispanic; 45% hypertension. The mean value of arch PWV was 9.0 ± 6.3 m/s. There were 418 deaths and 236 CVD events over 10-year follow-up. There was significant interaction between arch PWV and mean age for both outcomes, so we stratified by age; below 60 years (n=1503) and above 60 years (n=2034). Increased PWV had a trend with increased risk of all-cause mortality with a hazard ratio for the 4th vs 1st quartile of PWV of 2.1 (95%CI: 1.0-4.6, p=0.05) independent of risk factors in age below 60 years group. There was no significant association of PWV with incident CVD in age below 60 years after adjustment for risk factors. In age above 60 years group, increased PWV was not associated with either all-cause mortality or incident CVD events in univariate or multivariate analysis (Table). Conclusion: Arch PWV assessed by MRI is not a significant predictor of all-cause mortality and incident CVD events among individuals without overt CVD.

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Measurement of aortic arch pulse wave velocity in cardiovascular MR: Comparison of transit time estimators and description of a new approach

Journal of Magnetic Resonance Imaging ◽

10.1002/jmri.22570 ◽

2011 ◽

Vol 33 (6) ◽

pp. 1321-1329 ◽

Cited By ~ 49

Author(s):

Anas Dogui ◽

Alban Redheuil ◽

Muriel Lefort ◽

Alain DeCesare ◽

Nadjia Kachenoura ◽

...

Keyword(s):

Pulse Wave Velocity ◽

Aortic Arch ◽

Wave Velocity ◽

Transit Time ◽

Pulse Wave ◽

New Approach ◽

Cardiovascular Mr

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

Hypertension ◽

10.1161/hypertensionaha.116.08749 ◽

2017 ◽

Vol 70 (3) ◽

pp. 524-530 ◽

Cited By ~ 26

Author(s):

Yoshiaki Ohyama ◽

Bharath Ambale-Venkatesh ◽

Chikara Noda ◽

Jang-Young Kim ◽

Yutaka Tanami ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Pulse Wave Velocity ◽

Aortic Arch ◽

Wave Velocity ◽

Cardiovascular Events ◽

Pulse Wave ◽

Resonance Imaging

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Pulse wave velocity and flow in the carotid artery versus the aortic arch: Effects of aging

Journal of Magnetic Resonance Imaging ◽

10.1002/jmri.24470 ◽

2013 ◽

Vol 40 (2) ◽

pp. 287-293 ◽

Cited By ~ 16

Author(s):

Eleanore S.J. Kröner ◽

Hildo J. Lamb ◽

Hans-Marc J. Siebelink ◽

Suzanne C. Cannegieter ◽

Pieter J. van den Boogaard ◽

...

Keyword(s):

Carotid Artery ◽

Pulse Wave Velocity ◽

Aortic Arch ◽

Wave Velocity ◽

Pulse Wave ◽

Effects Of Aging

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Abnormal Aortic Wall Properties in Women with Turner Syndrome

Aorta ◽

10.1055/s-0040-1714384 ◽

2020 ◽

Vol 08 (05) ◽

pp. 121-131

Author(s):

Lidia R. Bons ◽

Allard T. Van Den Hoven ◽

Maira Malik ◽

Annemien E. Van Den Bosch ◽

Jacky S. McGhie ◽

...

Keyword(s):

Pulse Wave Velocity ◽

Aortic Arch ◽

Turner Syndrome ◽

Wave Velocity ◽

Aortic Wall ◽

Pulse Wave ◽

Control Group ◽

Aortic Tissue ◽

Aortic Dilatation ◽

Significant Difference

Abstract Background Turner syndrome (TS) is associated with aortic dilatation and dissection, but the underlying process is unclear. The aim of this study was to investigate the elastic properties and composition of the aortic wall in women with TS. Methods In this cross-sectional study, 52 women with TS aged 35 ± 13 years (50% monosomy, 12 with bicuspid aortic valve [BAV] and 4 with coarctation) were investigated using carotid-femoral pulse wave velocity (CF-PWV) by echocardiography and ascending aortic distensibility (AAD) and aortic arch pulse wave velocity (AA-PWV) by magnetic resonance imaging (MRI). As control group, 13 women with BAV without TS and 48 healthy patients were included. Results Women with TS showed a higher AA-PWV (β = 1.08, confidence interval [CI]: 0.54–1.62) after correcting for age and comorbidities compared with controls. We found no significant difference in AAD and CF-PWV. In women with TS, the presence of BAV, coarctation of the aorta, or monosomy (45, X) was not associated with aortic stiffness. In addition, aortic tissue samples were investigated with routine and immunohistochemical stains in five additional women with TS who were operated. The tissue showed more compact smooth muscle cell layers with abnormal deposition and structure of elastin and diminished or absent expression of contractile proteins desmin, actin, and caldesmon, as well as the progesterone receptor. Conclusion Both aortic arch stiffness measurements on MRI and histomorphological changes point toward an inherent abnormal thoracic aortic wall in women with TS.

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