Comparison of different methods for the estimation of aortic pulse wave velocity from 4D flow cardiovascular magnetic resonance
Posted on 2019-12-12 - 12:11
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).
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Houriez--Gombaud-Saintonge, Sophia; Mousseaux, Elie; Bargiotas, Ioannis; Cesare, Alain; Dietenbeck, Thomas; Bouaou, Kevin; et al. (2019). Comparison of different methods for the estimation of aortic pulse wave velocity from 4D flow cardiovascular magnetic resonance. figshare. Collection. https://doi.org/10.6084/m9.figshare.c.4778873
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AUTHORS (15)
SH
Sophia Houriez--Gombaud-Saintonge
EM
Elie Mousseaux
IB
Ioannis Bargiotas
AC
Alain Cesare
TD
Thomas Dietenbeck
KB
Kevin Bouaou
AR
Alban Redheuil
GS
Gilles Soulat
AG
Alain Giron
UG
Umit Gencer
DC
Damian Craiem
EM
Emmanuel Messas
EB
Emilie Bollache
YC
Yasmina Chenoune
NK
Nadjia Kachenoura