Age- and sex-specific reference values of biventricular flow components and kinetic energy by 4D flow cardiovascular magnetic resonance in healthy subjects
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Key result
Healthy women show ~11% lower LV residual volume than men on 4D flow CMR.
- P<0.001
- n=163
Why the study?
To investigate age and sex differences and effects on 4D flow CMR-derived LV and RV relative flow components and kinetic energy parameters in healthy subjects.
Population
163 healthy participants free of cardiovascular diseases
Comparison
Age and sex differences
Design
Prospective registry study
Authors
Discussion
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Implication
Supports age- and sex-specific 4D flow CMR norms; leaves open prospective validation in patients.
Study Design
Type
Observational (n=163)
Multicenter
Yes
Structured PICO
P
Population
163 healthy participants (42% female; mean age 43 ± 13 years) from a prospective multicenter registry. Key exclusion criteria: history of non-cardiac illness with life expectancy <2 years, previous transplantation, major medical problems, cardiovascular disease or risk factors (hypertension, diabetes, dyslipidemia), taking cardiovascular medications, and smoking.
I
Intervention
Four-dimensional flow cardiovascular magnetic resonance (4D flow CMR) imaging
O
Outcome
Age and sex differences in 4D flow CMR-derived left ventricular (LV) and right ventricular (RV) relative flow components (direct flow, retained inflow, delayed ejection flow, residual volume) and kinetic energy (KE) parameters indexed to end-diastolic volume (KEiEDV)surrogate
Main Result
Absolute Event Rate: 31% vs 35%
p-value: p=<0.001
Biventricular flow components and kinetic energy parameters measured by 4D flow CMR vary significantly by age and sex, indicating that demographic-specific reference values should be used in clinical interpretation.
Limitations
- Small sample size and gender imbalance in the 60-70 years age group.
- Use of two different scanners (Philips and Siemens) with different ECG triggering methods.
- Normalization of kinetic energy to end-diastolic volume rather than other parameters like stroke volume.
- Potential inclusion of subjects with white coat hypertension due to lack of ambulatory blood pressure monitoring.
Cite This Study
Zhao et al. (2023) conducted an observational in Healthy (n=163). 4D flow cardiovascular magnetic resonance (CMR) vs. Men (for sex differences) / Younger age groups (for age differences) was evaluated on Left ventricular (LV) residual volume (%) (p=<0.001). In healthy subjects, 4D flow CMR revealed that women had lower left ventricular residual volume than men (31% vs 35%), while advancing age correlated with decreased early diastolic kinetic energy.
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