What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Healthy controls (n=100). Intervention: Age and sex (Observational). Primary outcome: Systolic velocity and 3D wall shear stress (3D-WSS).

March 11, 2020Open Access

Impact of age, sex, and global function on normal aortic hemodynamics

Key Result

In 100 healthy controls, advancing age was associated with significant decreases in aortic systolic velocity and 3D wall shear stress, with 3D-WSS decreasing over up to 62% of the aorta surface area in the oldest cohort.

Study Design

Type

Cross-Sectional (n=100)

Multicenter

Structured PICO

Population

100 healthy controls (50 female, 50 male) with no history of cardiovascular disease, stratified into age groups (18-30, 31-40, 41-50, 51-60, and 61-80 years, 10 volunteers per group)

Outcome

Velocity, helicity, and 3D wall shear stress (3D-WSS) in the aorta measured by 4D-flow MRIsurrogate

Healthy aortic hemodynamics measured by 4D-flow MRI are dependent on age and correlate with vessel diameter and cardiac function.

Limitations

Time-consuming manual 3D segmentation of the aorta
Segmentations are weighted to represent the aorta geometry at systole
3D-WSS tends to be underestimated due to limited spatial resolution

Abstract

PURPOSE: To examine the effects of age, sex, and left ventricular global function on velocity, helicity, and 3D wall shear stress (3D-WSS) in the aorta of N = 100 healthy controls. METHODS: Fifty female and 50 male volunteers with no history of cardiovascular disease, with 10 volunteers per age group (18-30, 31-40, 41-50, 51-60, and 61-80 years) underwent aortic 4D-flow MRI. Quantification of systolic aortic peak velocity, helicity, and 3D-WSS distribution and the calculation of age group-averaged peak systolic velocity and 3D-WSS maps ("atlases") were computed. Age-related and sex-related changes in peak velocity, helicity, and 3D-WSS were computed and correlated with standard metrics of left ventricular function derived from short-axis cine MRI. RESULTS: No significant differences were found in peak systolic velocity or 3D-WSS based on sex except for the 18- to 30-year-old group (males 8% higher velocity volume and 3D-WSS surface area). Between successively older groups, systolic velocity decreased (13%, 0.35, P < .001). Arch and descending aorta systolic mean velocity, mean 3D-WSS, and median helicity increased with normalized left ventricular volumes: end diastolic volume (r = 0.31-0.37, P < .01), end systolic volume (r = 0.27-0.35, P < .01), and stroke volume (r = 0.28-0.35, P < .01). CONCLUSION: Healthy aortic hemodynamics are dependent on subject age, and correlate with vessel diameter and cardiac function.

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