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Journal of Cardiovascular Magnetic Resonance

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Open Access 01-12-2015 | Research

Real-time aortic pulse wave velocity measurement during exercise stress testing

Authors: Paul A. Roberts, Brett R. Cowan, Yingmin Liu, Aaron C. W. Lin, Poul M. F. Nielsen, Andrew J. Taberner, Ralph A. H. Stewart, Hoi Ieng Lam, Alistair A. Young

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2015

Abstract

Background

Pulse wave velocity (PWV), a measure of arterial stiffness, has been demonstrated to be an independent predictor of adverse cardiovascular outcomes. This can be derived non-invasively using cardiovascular magnetic resonance (CMR). Changes in PWV during exercise may reveal further information on vascular pathology. However, most known CMR methods for quantifying PWV are currently unsuitable for exercise stress testing.

Methods

A velocity-sensitive real-time acquisition and evaluation (RACE) pulse sequence was adapted to provide interleaved acquisition of two locations in the descending aorta (at the level of the pulmonary artery bifurcation and above the renal arteries) at 7.8 ms temporal resolution. An automated method was used to calculate the foot-to-foot transit time of the velocity pulse wave. The RACE method was validated against a standard gated phase contrast (STD) method in flexible tube phantoms using a pulsatile flow pump. The method was applied in 50 healthy volunteers (28 males) aged 22–75 years using a MR-compatible cycle ergometer to achieve moderate work rate (38 ± 22 W, with a 31 ± 12 bpm increase in heart rate) in the supine position. Central pulse pressures were estimated using a MR-compatible brachial device. Scan-rescan reproducibility was evaluated in nine volunteers.

Results

Phantom PWV was 22 m/s (STD) vs. 26 ± 5 m/s (RACE) for a butyl rubber tube, and 5.5 vs. 6.1 ± 0.3 m/s for a latex rubber tube. In healthy volunteers PWV increased with age at both rest (R² = 0.31 p < 0.001) and exercise (R² = 0.40, p < 0.001). PWV was significantly increased at exercise relative to rest (0.71 ± 2.2 m/s, p = 0.04). Scan-rescan reproducibility at rest was −0.21 ± 0.68 m/s (n = 9).

Conclusions

This study demonstrates the validity of CMR in the evaluation of PWV during exercise in healthy subjects. The results support the feasibility of using this method in evaluating of patients with systemic aortic disease.

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Title: Real-time aortic pulse wave velocity measurement during exercise stress testing
Authors: Paul A. Roberts
Brett R. Cowan
Yingmin Liu
Aaron C. W. Lin
Poul M. F. Nielsen
Andrew J. Taberner
Ralph A. H. Stewart
Hoi Ieng Lam
Alistair A. Young
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: Journal of Cardiovascular Magnetic Resonance / Issue 1/2015
Electronic ISSN: 1532-429X
DOI: https://doi.org/10.1186/s12968-015-0191-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Real-time aortic pulse wave velocity measurement during exercise stress testing

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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