Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Journal of Cardiovascular Magnetic Resonance
Published in: Journal of Cardiovascular Magnetic Resonance 1/2019

Open Access 01-12-2019 | Research

Comparison of different methods for the estimation of aortic pulse wave velocity from 4D flow cardiovascular magnetic resonance

Authors: Sophia Houriez--Gombaud-Saintonge, Elie Mousseaux, Ioannis Bargiotas, Alain De Cesare, Thomas Dietenbeck, Kevin Bouaou, Alban Redheuil, Gilles Soulat, Alain Giron, Umit Gencer, Damian Craiem, Emmanuel Messas, Emilie Bollache, Yasmina Chenoune, Nadjia Kachenoura

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2019

Login to get access

Abstract

Background

Arterial pulse wave velocity (PWV) is associated with increased mortality in aging and disease. Several studies have shown the accuracy of applanation tonometry carotid-femoral PWV (Cf-PWV) and the relevance of evaluating central aorta stiffness using 2D cardiovascular magnetic resonance (CMR) to estimate PWV, and aortic distensibility-derived PWV through the theoretical Bramwell-Hill model (BH-PWV). Our aim was to compare various methods of aortic PWV (aoPWV) estimation from 4D flow CMR, in terms of associations with age, Cf-PWV, BH-PWV and left ventricular (LV) mass-to-volume ratio while evaluating inter-observer reproducibility and robustness to temporal resolution.

Methods

We studied 47 healthy subjects (49.5 ± 18 years) who underwent Cf-PWV and CMR including aortic 4D flow CMR as well as 2D cine SSFP for BH-PWV and LV mass-to-volume ratio estimation. The aorta was semi-automatically segmented from 4D flow data, and mean velocity waveforms were estimated in 25 planes perpendicular to the aortic centerline. 4D flow CMR aoPWV was calculated: using velocity curves at two locations, namely ascending aorta (AAo) and distal descending aorta (DAo) aorta (S1, 2D-like strategy), or using all velocity curves along the entire aortic centreline (3D-like strategies) with iterative transit time (TT) estimates (S2) or a plane fitting of velocity curves systolic upslope (S3). For S1 and S2, TT was calculated using three approaches: cross-correlation (TTc), wavelets (TTw) and Fourier transforms (TTf). Intra-class correlation coefficients (ICC) and Bland-Altman biases (BA) were used to evaluate inter-observer reproducibility and effect of lower temporal resolution.

Results

4D flow CMR aoPWV estimates were significantly (p < 0.05) correlated to the CMR-independent Cf-PWV, BH-PWV, age and LV mass-to-volume ratio, with the strongest correlations for the 3D-like strategy using wavelets TT (S2-TTw) (R = 0.62, 0.65, 0.77 and 0.52, respectively, all p < 0.001). S2-TTw was also highly reproducible (ICC = 0.99, BA = 0.09 m/s) and robust to lower temporal resolution (ICC = 0.97, BA = 0.15 m/s).

Conclusions

Reproducible 4D flow CMR aoPWV estimates can be obtained using full 3D aortic coverage. Such 4D flow CMR stiffness measures were significantly associated with Cf-PWV, BH-PWV, age and LV mass-to-volume ratio, with a slight superiority of the 3D strategy using wavelets transit time (S2-TTw).
Appendix
Available only for authorised users
Literature
1.
Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension. 2001;37:1236–41.PubMedCrossRef
2.
Safar ME, London GM. Therapeutic studies and arterial stiffness in hypertension: recommendations of the European Society of Hypertension. The clinical Committee of Arterial Structure and Function. Working group on vascular structure and function of the European Society of Hypertension. J Hypertens. 2000;18:1527–35.PubMedCrossRef
3.
Meaume S, Benetos A, Henry OF, Rudnichi A, Safar ME. Aortic pulse wave velocity predicts cardiovascular mortality in subjects >70 years of age. Arterioscler Thromb Vasc Biol. 2001;21:2046–50.PubMedCrossRef
4.
Ben-Shlomo Y, Spears M, Boustred C, May M, Anderson SG, Benjamin EJ, et al. Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects. J Am Coll Cardiol. 2014;63:636–46.PubMedCrossRef
5.
Sutton-Tyrrell K, Najjar SS, Boudreau RM, Venkitachalam L, Kupelian V, Simonsick EM, et al. Elevated aortic pulse wave velocity, a marker of arterial stiffness, predicts cardiovascular events in well-functioning older adults. Circulation. 2005;111:3384–90.PubMedCrossRef
6.
Willum-Hansen T, Staessen JA, Torp-Pedersen C, Rasmussen S, Thijs L, Ibsen H, et al. Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population. Circulation. 2006;113:664–70.PubMedCrossRef
7.
Collaboration TRV for AS. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: establishing normal and reference values. Eur Heart J. 2010;31:2338–50.CrossRef
8.
Alecu C, Labat C, Kearney-Schwartz A, Fay R, Salvi P, Joly L, et al. Reference values of aortic pulse wave velocity in the elderly. J Hypertens. 2008;26:2207–12.PubMedCrossRef
9.
Van Bortel LM, Balkestein EJ, van der Heijden-Spek JJ, Vanmolkot FH, Staessen JA, Kragten JA, et al. Non-invasive assessment of local arterial pulse pressure: comparison of applanation tonometry and echo-tracking. J Hypertens. 2001;19:1037–44.PubMedCrossRef
10.
Latham RD, Westerhof N, Sipkema P, Rubal BJ, Reuderink P, Murgo JP. Regional wave travel and reflections along the human aorta: a study with six simultaneous micromanometric pressures. Circulation. 1985;72:1257–69.PubMedCrossRef
11.
Grotenhuis HB, Westenberg JJM, Steendijk P, van der Geest RJ, Ottenkamp J, Bax JJ, et al. Validation and reproducibility of aortic pulse wave velocity as assessed with velocity-encoded MRI. J Magn Reson Imaging. 2009;30:521–6.PubMedCrossRef
12.
13.
Hickson SS, Butlin M, Graves M, Taviani V, Avolio AP, McEniery CM, et al. The relationship of age with regional aortic stiffness and diameter. JACC Cardiovasc Imaging. 2010;3:1247–55.PubMedCrossRef
14.
Vulliémoz S, Stergiopulos N, Meuli R. Estimation of local aortic elastic properties with MRI. Magn Reson Med. 2002;47:649–54.PubMedCrossRef
15.
Dogui A, Kachenoura N, Frouin F, Lefort M, De Cesare A, Mousseaux E, et al. Consistency of aortic distensibility and pulse wave velocity estimates with respect to the Bramwell-Hill theoretical model: a cardiovascular magnetic resonance study. J Cardiovasc Magn Reson. 2011;13:11.PubMedPubMedCentralCrossRef
16.
Westenberg JJ, van Poelgeest EP, Steendijk P, Grotenhuis HB, Jukema J, 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.PubMedPubMedCentralCrossRef
17.
Bramwell JC, Hill AV. The velocity of the pulse wave in man. Proc R Soc Lond B Biol Sci. 1922;93:298–306.CrossRef
18.
19.
Markl M, Schnell S, Barker AJ. 4D flow imaging: current status to future clinical applications. Curr Cardiol Rep. 2014;16:481.PubMedCrossRef
20.
Markl M, Wallis W, Strecker C, Gladstone BP, Vach W, Harloff A. Analysis of pulse wave velocity in the thoracic aorta by flow-sensitive four-dimensional MRI: reproducibility and correlation with characteristics in patients with aortic atherosclerosis. J Magn Reson Imaging. 2012;35:1162–8.PubMedCrossRef
21.
Guala A, Camporeale C, Ridolfi L, Mesin L. Non-invasive aortic systolic pressure and pulse wave velocity estimation in a primary care setting: an in silico study. Med Eng Phys. 2017;42:91–8.PubMedCrossRef
22.
Harloff A, Mirzaee H, Lodemann T, Hagenlocher P, Wehrum T, Stuplich J, et al. Determination of aortic stiffness using 4D flow cardiovascular magnetic resonance - a population-based study. J Cardiovasc Magn Reson. 2018;20:43.PubMedPubMedCentralCrossRef
23.
Dyverfeldt P, Bissell M, Barker AJ, Bolger AF, Carlhäll C-J, Ebbers T, et al. 4D flow cardiovascular magnetic resonance consensus statement. J Cardiovasc Magn Reson. 2015;17:72.PubMedPubMedCentralCrossRef
24.
Markl M, Wallis W, Brendecke S, Simon J, Frydrychowicz A, Harloff A. Estimation of global aortic pulse wave velocity by flow-sensitive 4D MRI. Magn Reson Med. 2010;63:1575–82.PubMedCrossRef
25.
Wentland AL, Wieben O, François CJ, Boncyk C, Rio AMD, Johnson KM, et al. Aortic pulse wave velocity measurements with Undersampled 4D flow-sensitive MRI: comparison to 2D and algorithm determination. J Magn Reson Imaging. 2013;37:853–9.PubMedCrossRef
26.
Vasanawala SS, Alley MT, Hargreaves BA, Barth RA, Pauly JM, Lustig M. Improved pediatric MR imaging with compressed sensing. Radiology. 2010;256:607–16.PubMedPubMedCentralCrossRef
27.
Lustig M, Pauly JM. SPIRiT: iterative self-consistent parallel imaging reconstruction from arbitrary k-space. Magn Reson Med. 2010;64:457–71.PubMedPubMedCentral
28.
Vasanawala S, Murphy M, Alley M, Lai P, Keutzer K, Pauly J, et al. Practical parallel imaging compressed sensing MRI: summary of two years of experience in accelerating body MRI of pediatric patients. Proc IEEE Int Symp Biomed Imaging. 2011;2011:1039–43. https://​doi.​org/​10.​1109/​ISBI.​2011.​5872579.
29.
Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006;27:2588–605.PubMedCrossRef
30.
Cheng S, Fernandes VRS, Bluemke DA, McClelland RL, Kronmal RA, Lima JAC. Age-related left ventricular remodeling and associated risk for cardiovascular outcomes: the multi-ethnic study of atherosclerosis. Circ Cardiovasc Imaging. 2009;2:191–8.PubMedPubMedCentralCrossRef
31.
Herment A, Kachenoura N, Lefort M, Bensalah M, Dogui A, Frouin F, et al. Automated segmentation of the aorta from phase contrast MR images: validation against expert tracing in healthy volunteers and in patients with a dilated aorta. J Magn Reson Imaging. 2010;31:881–8.PubMedCrossRef
32.
Markl M, Harloff A, Bley TA, Zaitsev M, Jung B, Weigang E, et al. Time-resolved 3D MR velocity mapping at 3T: improved navigator-gated assessment of vascular anatomy and blood flow. J Magn Reson Imaging. 2007;25:824–31.PubMedCrossRef
33.
Dietenbeck T, Craiem D, Rosenbaum D, Giron A, De Cesare A, Bouaou K, et al. 3D aortic morphology and stiffness in MRI using semi-automated cylindrical active surface provides optimized description of the vascular effects of aging and hypertension. Comput Biol Med. 2018;103:101–8.PubMedCrossRef
34.
Spottiswoode B, Stalder AF, Gulsun MA, Campione KF, Carr M, Wasielewski M, et al. Fast semi-automated analysis of pulse wave velocity in the thoracic aorta using high temporal resolution 4D flow MRI. J Cardiovasc Magn Reson. 2013;15:P87.PubMedCentralCrossRef
35.
Ibrahim E-SH, Johnson KR, Miller AB, Shaffer JM, White RD. Measuring aortic pulse wave velocity using high-field cardiovascular magnetic resonance: comparison of techniques. J Cardiovasc Magn Reson. 2010;12:26.PubMedCentralCrossRef
36.
Dogui A, Redheuil A, Lefort M, DeCesare A, Kachenoura N, Herment A, et al. 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;33:1321–9.PubMedCrossRef
37.
Bargiotas I, Mousseaux E, Yu W-C, Venkatesh BA, Bollache E, de Cesare A, et al. Estimation of aortic pulse wave transit time in cardiovascular magnetic resonance using complex wavelet cross-spectrum analysis. J Cardiovasc Magn Reson. 2015;17:65.PubMedPubMedCentralCrossRef
38.
Meloni A, Zymeski H, Pepe A, Lombardi M, Wood JC. Robust estimation of pulse wave transit time using group delay. J Magn Reson Imaging. 2014;39:550–8.PubMedCrossRef
39.
Ou P, Celermajer DS, Raisky O, Jolivet O, Buyens F, Herment A, et al. Angular (gothic) aortic arch leads to enhanced systolic wave reflection, central aortic stiffness, and increased left ventricular mass late after aortic coarctation repair: evaluation with magnetic resonance flow mapping. J Thorac Cardiovasc Surg. 2008;135:62–8.PubMedCrossRef
40.
Westerhof BE, Guelen I, Westerhof N, Karemaker JM, Avolio A. Quantification of wave reflection in the human aorta from pressure alone. Hypertension. 2006;48:595–601.PubMedCrossRef
41.
Bensalah MZ, Bollache E, Kachenoura N, Giron A, Cesare AD, Macron L, et al. Geometry is a major determinant of flow reversal in proximal aorta. Am J Physiol - Heart Circ Physiol. 2014;306:H1408–16.PubMedCrossRef
42.
Bland JM, Altman D. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;327:307–10.CrossRef
43.
Kawel-Boehm N, Maceira A, Valsangiacomo-Buechel ER, Vogel-Claussen J, Turkbey EB, Williams R, et al. Normal values for cardiovascular magnetic resonance in adults and children. J Cardiovasc Magn Reson. 2015;17:29.PubMedPubMedCentralCrossRef
44.
Dyverfeldt P, Ebbers T, Länne T. Pulse wave velocity with 4D flow MRI: systematic differences and age-related regional vascular stiffness. Magn Reson Imaging. 2014;32:1266–71.PubMedCrossRef
45.
Fielden SW, Fornwalt BK, Jerosch-Herold M, Eisner RL, Stillman AE, Oshinski JN. A new method for the determination of aortic pulse wave velocity using cross-correlation on 2D PCMR velocity data. J Magn Reson Imaging. 2008;27:1382–7.PubMedCrossRef
46.
Douglas PS, Katz SE, Weinberg EO, Chen MH, Bishop SP, Lorell BH. Hypertrophic remodeling: gender differences in the early response to left ventricular pressure overload. J Am Coll Cardiol. 1998;32:1118–25.PubMedCrossRef
47.
Cheng JY, Hanneman K, Zhang T, Alley MT, Lai P, Tamir JI, et al. Comprehensive motion-compensated highly accelerated 4D flow MRI with ferumoxytol enhancement for pediatric congenital heart disease. J Magn Reson Imaging. 2016;43:1355–68.PubMedCrossRef
48.
Cheng JY, Zhang T, Ruangwattanapaisarn N, Alley MT, Uecker M, Pauly JM, et al. Free-breathing pediatric MRI with nonrigid motion correction and acceleration. J Magn Reson Imaging. 2015;42:407–20.PubMedCrossRef
Metadata
Title
Comparison of different methods for the estimation of aortic pulse wave velocity from 4D flow cardiovascular magnetic resonance
Authors
Sophia Houriez--Gombaud-Saintonge
Elie Mousseaux
Ioannis Bargiotas
Alain De Cesare
Thomas Dietenbeck
Kevin Bouaou
Alban Redheuil
Gilles Soulat
Alain Giron
Umit Gencer
Damian Craiem
Emmanuel Messas
Emilie Bollache
Yasmina Chenoune
Nadjia Kachenoura
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Cardiovascular Magnetic Resonance / Issue 1/2019
Electronic ISSN: 1532-429X
DOI
https://doi.org/10.1186/s12968-019-0584-x

Other articles of this Issue 1/2019

Journal of Cardiovascular Magnetic Resonance 1/2019 Go to the issue

Research

Feasibility of real-time cine cardiac magnetic resonance imaging to predict the presence of significant retrosternal adhesions prior to redo-sternotomy

Position statement

Clinical practice of cardiovascular magnetic resonance: position statement of the Society for Cardiovascular Magnetic Resonance

Research

Long term CMR follow up of patients with right ventricular abnormality and clinically suspected arrhythmogenic right ventricular cardiomyopathy (ARVC)

Research

Kidney transplantation is associated with reduced myocardial fibrosis. A cardiovascular magnetic resonance study with native T1 mapping

Research

Microvasculature and intraplaque hemorrhage in atherosclerotic carotid lesions: a cardiovascular magnetic resonance imaging study

Technical notes

T2STIR preparation for single-shot cardiovascular magnetic resonance myocardial edema imaging