Cardiovascular outcome associations among cardiovascular magnetic resonance measures of arterial stiffness: the Dallas heart study

Journal of Cardiovascular Magnetic Resonance

Kevin S King¹  Suhny Abbara¹  Ronald M Peshock³  Akshay Goel¹  Colby Ayers²  Amit Khera³  Christopher D Maroules¹ 

[1] Departments of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8896, USA;Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA;Division of Cardiology, Internal Medicine, and Clinical Sciences, Dallas, TX, USA

关键词: Cardiovascular magnetic resonance;    Total arterial compliance;    Aortic distensibility;    Pulse wave velocity;    Arterial stiffness;   

Others  :  801270
DOI  :  10.1186/1532-429X-16-33

 received in 2014-01-06, accepted in 2014-05-02,  发布年份 2014

【 摘 要 】

Background

Cardiovascular magnetic resonance (CMR) has been validated for the noninvasive assessment of total arterial compliance and aortic stiffness, but their associations with cardiovascular outcomes is unknown. The purpose of this study was to evaluate associations of CMR measures of total arterial compliance and two CMR measures of aortic stiffness with respect to future cardiovascular events.

Methods

The study consisted of 2122 Dallas Heart Study participants without cardiovascular disease who underwent CMR at 1.5 Tesla. Aortic stiffness was measured by CMR-derived ascending aortic distensibility and aortic arch pulse wave velocity. Total arterial compliance was calculated by dividing left ventricular stroke volume by pulse pressure. Participants were monitored for cardiovascular death, non-fatal cardiac events, and non-fatal extra-cardiac vascular events over 7.8 ± 1.5 years. Cox proportional hazards regression was used to assess for associations between CMR measures and cardiovascular events.

Results

Age, systolic blood pressure, and resting heart rate were independently associated with changes in ascending aortic distensibility, arch pulse wave velocity, and total arterial compliance (all p < .0001). A total of 153 participants (6.9%) experienced a cardiovascular event. After adjusting for traditional risk factors, total arterial compliance was modestly associated with increased risk for composite events (HR 1.07 per 1SD, p = 0.03) while the association between ascending aortic distensibility and composite events trended towards significance (HR 1.18 per 1SD, p = 0.08). Total arterial compliance and aortic distensibility were independently associated with nonfatal cardiac events (HR 1.11 per 1SD, p = 0.001 and HR 1.45 per 1SD, p = 0.0005, respectively), but not with cardiovascular death or nonfatal extra-cardiac vascular events. Arch pulse wave velocity was independently associated with nonfatal extra-cardiac vascular events (HR 1.18 per 1SD, p = 0.04) but not with cardiovascular death or nonfatal cardiac events.

Conclusions

In a multiethnic population free of cardiovascular disease, CMR measures of arterial stiffness are associated with future cardiovascular events. Total arterial compliance and aortic distensibility may be stronger predictors of nonfatal cardiac events, while pulse wave velocity may be a stronger predictor of nonfatal extra-cardiac vascular events.

【 授权许可】

   
2014 Maroules et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Cavalcante JL, Lima JA, Redheuil A, Al-Mallah MH: Aortic stiffness: current understanding and future directions. J Am Coll Cardiol 2011, 57:1511-1522.
• [2]Vlachopoulos C, Aznaouridis K, Stefanadis C: Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol 2010, 55:1318-1327.
• [3]Chemla D, Hebert JL, Coirault C, Zamani K, Suard I, Colin P, Lecarpentier Y: Total arterial compliance estimated by stroke volume-to-aortic pulse pressure ratio in humans. Am J Physiol 1998, 274:H500-H505.
• [4]Rerkpattanapipat P, D’Agostino RB Jr, Link KM, Shahar E, Lima JA, Bluemke DA, Sinha S, Herrington DM, Hundley WG: Location of arterial stiffening differs in those with impaired fasting glucose versus diabetes: implications for left ventricular hypertrophy from the Multi-Ethnic Study of Atherosclerosis. Diabetes 2009, 58:946-953.
• [5]Nelson AJ, Worthley SG, Cameron JD, Willoughby SR, Piantadosi C, Carbone A, Dundon BK, Leung MC, Hope SA, Meredith IT, Worthley MI: Cardiovascular magnetic resonance-derived aortic distensibility: validation and observed regional differences in the elderly. J Hypertens 2009, 27:535-542.
• [6]Lehmann ED, Parker JR, Hopkins KD, Taylor MG, Gosling RG: Validation and reproducibility of pressure-corrected aortic distensibility measurements using pulse-wave-velocity Doppler ultrasound. J Biomed Eng 1993, 15:221-228.
• [7]Dogui A, Redheuil A, Lefort M, DeCesare A, Kachenoura N, Herment A, Mousseaux E: Measurement of aortic arch pulse wave velocity in cardiovascular MR: comparison of transit time estimators and description of a new approach. J Magn Reson Imaging 2011, 33:1321-1329.
• [8]Grotenhuis HB, Westenberg JJ, Steendijk P, van der Geest RJ, Ottenkamp J, Bax JJ, Jukema JW, de Roos A: Validation and reproducibility of aortic pulse wave velocity as assessed with velocity-encoded MRI. J Magn Reson Imaging 2009, 30:521-526.
• [9]Westenberg JJ, van Poelgeest EP, Steendijk P, Grotenhuis HB, Jukema JW, de Roos A: Bramwell-Hill modeling for local aortic pulse wave velocity estimation: a validation study with velocity-encoded cardiovascular magnetic resonance and invasive pressure assessment. J Cardiovasc Magn Reson 2012, 14:2. BioMed Central Full Text
• [10]Isselbacher EM: Thoracic and abdominal aortic aneurysms. Circulation 2005, 111:816-828.
• [11]Rogers WJ, Hu YL, Coast D, Vido DA, Kramer CM, Pyeritz RE, Reichek N: Age-associated changes in regional aortic pulse wave velocity. J Am Coll Cardiol 2001, 38:1123-1129.
• [12]Kinlay S, Creager MA, Fukumoto M, Hikita H, Fang JC, Selwyn AP, Ganz P: Endothelium-derived nitric oxide regulates arterial elasticity in human arteries in vivo. Hypertension 2001, 38:1049-1053.
• [13]Schram MT, Henry RM, van Dijk RA, Kostense PJ, Dekker JM, Nijpels G, Heine RJ, Bouter LM, Westerhof N, Stehouwer CD: Increased central artery stiffness in impaired glucose metabolism and type 2 diabetes: the Hoorn Study. Hypertension 2004, 43:176-181.
• [14]Laurent S, Mousseaux E, Boutouyrie P: Arterial stiffness as an imaging biomarker: are all pathways equal? Hypertension 2013, 62:10-12.
• [15]Victor RG, Haley RW, Willett DL, Peshock RM, Vaeth PC, Leonard D, Basit M, Cooper RS, Iannacchione VG, Visscher WA, Staab JM, Hobbs HH: The Dallas Heart Study: a population-based probability sample for the multidisciplinary study of ethnic differences in cardiovascular health. Am J Cardiol 2004, 93:1473-1480.
• [16]King KS, Chen KX, Hulsey KM, McColl RW, Weiner MF, Nakonezny PA, Peshock RM: White matter hyperintensities: use of aortic arch pulse wave velocity to predict volume independent of other cardiovascular risk factors. Radiology 2013, 267:709-717.
• [17]van der Meer RW, Diamant M, Westenberg JJ, Doornbos J, Bax JJ, de Roos A, Lamb HJ: Magnetic resonance assessment of aortic pulse wave velocity, aortic distensibility, and cardiac function in uncomplicated type 2 diabetes mellitus. J Cardiovasc Magn Reson 2007, 9:645-651.
• [18]Bolster BD Jr, Atalar E, Hardy CJ, McVeigh ER: Accuracy of arterial pulse-wave velocity measurement using MR. J Magn Reson Imaging 1998, 8:878-888.
• [19]Jain T, Peshock R, McGuire DK, Willett D, Yu Z, Vega GL, Guerra R, Hobbs HH, Grundy SM: African Americans and Caucasians have a similar prevalence of coronary calcium in the Dallas Heart Study. J Am Coll Cardiol 2004, 44:1011-1017.
• [20]Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Makuc DM, Marcus GM, Marelli A, Matchar DB, Moy CS, Mozaffarian D, Mussolino ME, Nichol G, Paynter NP, Soliman EZ, et al.: Heart disease and stroke statistics–2012 update: a report from the American Heart Association. Circulation 2012, 125:e2-e220.
• [21]Dallas Fort Worth Hospital Council 2012. http://www.dfwhcfoundation.org webcite
• [22]Maroules CD, Rosero E, Ayers C, Peshock RM, Khera A: Abdominal aortic atherosclerosis at mr imaging is associated with cardiovascular events: The Dallas heart study. Radiology 2013, 269:84-91.
• [23]Budoff MJ, Nasir K, Katz R, Takasu J, Carr JJ, Wong ND, Allison M, Lima JA, Detrano R, Blumenthal RS, Kronmal R: Thoracic aortic calcification and coronary heart disease events: the multi-ethnic study of atherosclerosis (MESA). Atherosclerosis 2011, 215:196-202.
• [24]Cohn JN: Arterial stiffness, vascular disease, and risk of cardiovascular events. Circulation 2006, 113:601-603.
• [25]Mattace-Raso FU, van der Cammen TJ, Hofman A, van Popele NM, Bos ML, Schalekamp MA, Asmar R, Reneman RS, Hoeks AP, Breteler MM, Witteman JC: Arterial stiffness and risk of coronary heart disease and stroke: the Rotterdam Study. Circulation 2006, 113:657-663.
• [26]Mitchell GF, Hwang SJ, Vasan RS, Larson MG, Pencina MJ, Hamburg NM, Vita JA, Levy D, Benjamin EJ: Arterial stiffness and cardiovascular events: the Framingham Heart Study. Circulation 2010, 121:505-511.
• [27]Sutton-Tyrrell K, Najjar SS, Boudreau RM, Venkitachalam L, Kupelian V, Simonsick EM, Havlik R, Lakatta EG, Spurgeon H, Kritchevsky S, Pahor M, Bauer D, Newman A: Elevated aortic pulse wave velocity, a marker of arterial stiffness, predicts cardiovascular events in well-functioning older adults. Circulation 2005, 111:3384-3390.
• [28]Pannier B, Guerin AP, Marchais SJ, Safar ME, London GM: Stiffness of capacitive and conduit arteries: prognostic significance for end-stage renal disease patients. Hypertension 2005, 45:592-596.
• [29]Terai M, Ohishi M, Ito N, Takagi T, Tatara Y, Kaibe M, Komai N, Rakugi H, Ogihara T: Comparison of arterial functional evaluations as a predictor of cardiovascular events in hypertensive patients: the Non-Invasive Atherosclerotic Evaluation in Hypertension (NOAH) study. Hypertens Res 2008, 31:1135-1145.
• [30]Oliver JJ, Webb DJ: Noninvasive assessment of arterial stiffness and risk of atherosclerotic events. Arterioscler Thromb Vasc Biol 2003, 23:554-566.
• [31]Kawaguchi M, Hay I, Fetics B, Kass DA: Combined ventricular systolic and arterial stiffening in patients with heart failure and preserved ejection fraction: implications for systolic and diastolic reserve limitations. Circulation 2003, 107:714-720.
• [32]Redheuil A, Yu WC, Wu CO, Mousseaux E, de Cesare A, Yan R, Kachenoura N, Bluemke D, Lima JA: Reduced ascending aortic strain and distensibility: earliest manifestations of vascular aging in humans. Hypertension 2010, 55:319-326.
• [33]Resnick LM, Militianu D, Cunnings AJ, Pipe JG, Evelhoch JL, Soulen RL: Direct magnetic resonance determination of aortic distensibility in essential hypertension: relation to age, abdominal visceral fat, and in situ intracellular free magnesium. Hypertension 1997, 30:654-659.
• [34]Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M, Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Manolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes PA, Sleight P, Viigimaa M, Waeber B, Zannad F, Burnier M, Ambrosioni E, Caufield M, Coca A, Olsen MH, et al.: ESH/ESC Guidelines for the management of arterial hypertension. Eur Heart J 2013, 34:2159-2219.
• [35]Malayeri AA, Natori S, Bahrami H, Bertoni AG, Kronmal R, Lima JA, Bluemke DA: Relation of aortic wall thickness and distensibility to cardiovascular risk factors (from the Multi-Ethnic Study of Atherosclerosis [MESA]). Am J Cardiol 2008, 102:491-496.
• [36]Rose JL, Lalande A, Bouchot O, Bourennane El B, Walker PM, Ugolini P, Revol-Muller C, Cartier R, Brunotte F: Influence of age and sex on aortic distensibility assessed by MRI in healthy subjects. Magn Reson Imaging 2010, 28:255-263.
• [37]Stacey RB, Bertoni AG, Eng J, Bluemke DA, Hundley WG, Herrington D: Modification of the effect of glycemic status on aortic distensibility by age in the multi-ethnic study of atherosclerosis. Hypertension 2010, 55:26-32.
• [38]Fagard RH, Pardaens K, Staessen JA, Thijs L: The pulse pressure-to-stroke index ratio predicts cardiovascular events and death in uncomplicated hypertension. J Am Coll Cardiol 2001, 38:227-231.
• [39]Rerkpattanapipat P, Hundley WG, Link KM, Brubaker PH, Hamilton CA, Darty SN, Morgan TM, Kitzman DW: Relation of aortic distensibility determined by magnetic resonance imaging in patients > or =60 years of age to systolic heart failure and exercise capacity. Am J Cardiol 2002, 90:1221-1225.
• [40]Mandry D, Eschalier R, Kearney-Schwartz A, Rossignol P, Joly L, Djaballah W, Bohme P, Escanye JM, Vuissoz PA, Fay R, Zannad F, Marie PY: Comprehensive MRI analysis of early cardiac and vascular remodeling in middle-aged patients with abdominal obesity. J Hypertens 2012, 30:567-573.
• [41]Grotenhuis HB, Westenberg JJ, Doornbos J, Kroft LJ, Schoof PH, Hazekamp MG, Vliegen HW, Ottenkamp J, De Roos A: Aortic root dysfunctioning and its effect on left ventricular function in Ross procedure patients assessed with magnetic resonance imaging. Am Heart J 2006, 152(975):e971-e978.
• [42]Wentland AL, Wieben O, Francois CJ, Boncyk C, Munoz Del Rio A, Johnson KM, Grist TM, Frydrychowicz A: Aortic pulse wave velocity measurements with undersampled 4D flow-sensitive MRI: comparison with 2D and algorithm determination. J Magn Reson Imaging 2013, 37:853-859.