Key result
Noninvasive wave reflection timing indices strongly correlate with age and augmentation index.
Why the study?
To evaluate associations of newly proposed noninvasive central arterial wave reflection timing indices with age and reference indices of reflection magnitude using combined MRI aortic flow and tonometry pressure waveforms.
Cross-Sectional (n=113)
Effect estimate: r = 0.61 to 0.78
p-value: p=<0.0001
Combining MRI flow and tonometry pressure waveforms reliably captures central wave reflection timing indices, which correlate strongly with age and gold standard measures of reflection magnitude.
Central wave reflection timing may mark vascular aging noninvasively; leaves open added prognostic value beyond augmentation index.
Objective: To study associations of newly proposed noninvasive central arterial wave reflection timing indices with age and reference indices of reflection magnitude, using superimposed MRI aortic flow and applanation tonometry carotid pressure waveforms. Methods: Consecutively acquired MRI flow and tonometry pressure waveforms were superimposed in 113 volunteers [56 women, age: 43 ± 16 (19–81) years] free from overt cardiovascular disease except for hypertension, after registration and interpolation to averaged cardiac cycle duration using a custom interface to derive time to peak flow ( T Qmax ) and pressure ( T Pmax ). Conventional time to return of reflected pressure wave ( T i ), augmentation index (AIx) and reflection magnitude (RM) were further measured and used as reference. Results: T Qmax occurred slightly earlier, whereas T Pmax appeared later in the cardiac cycle with age, resulting in significant, independent age-related decrease in T Qmax to T i ( r = −0.63, P < 0.0001) and increase in T Qmax to T Pmax ( r = 0.61, P < 0.0001) delays. Such delays were further significantly and independently related to reference AIx ( T i − T Qmax : r = −0.66, P < 0.0001; T Pmax − T Qmax : r = 0.78, P < 0.0001) and RM ( T i − T Qmax : r = −0.55, P < 0.0001; T Pmax − T Qmax : r = 0.76, P < 0.0001). Correlations obtained with T Pmax − T Qmax were overall higher than those obtained with conventional T i timing (age: r = −0.52, P < 0.0001; AIx: r = −0.77, P < 0.0001; RM: r = −0.42, P < 0.0001). Conclusion: Combination of noninvasive flow and pressure time domain waveforms was able to reliably capture central wave reflection timing indices as demonstrated by strong and independent associations with age and gold standard measures of reflection magnitude. Such timing, which was based on straightforward peaks detection, could be used to explore and better understand left ventricular–aortic coupling in cardiovascular conditions presenting increased reflections.
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Bollache et al. (2025) conducted a cross-sectional in Healthy volunteers (free from overt cardiovascular disease except hypertension) (n=113). Superimposed MRI aortic flow and applanation tonometry carotid pressure waveforms vs. Conventional timing indices (Ti, AIx, RM) was evaluated on Associations of wave reflection timing indices (TQmax to Ti and TQmax to TPmax) with age and reference indices (r = 0.61 to 0.78, p=<0.0001). Noninvasive central arterial wave reflection timing indices derived from combined MRI and tonometry waveforms were significantly associated with age (r=0.61) and augmentation index (r=0.78, P<0.0001).
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