May 5, 2025Experimental PhysiologyOpen Access

Circumferential strain and strain rates of the descending aorta as novel measures of aortic stiffness and wall mechanics from standard cardiac MRI

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Why the study?

It was unknown whether descending aortic strain assessed from standard CMR horizontal long-axis cine images is sensitive to age- and HFpEF-related arteriosclerosis.

Does descending aortic strain measured from standard cardiac MRI detect age- and disease-related arteriosclerosis in patients with HFpEF compared to healthy young and older individuals?

Structured PICO

Does descending aortic strain measured from standard cardiac MRI detect age- and disease-related arteriosclerosis in patients with HFpEF compared to healthy young and older individuals?

Population

83 participants divided into three groups: 34 young individuals (age 22 ± 3 years), 19 older individuals (age 69 ± 5 years), and 26 patients with HFpEF (age 69 ± 6 years).

Intervention

Measurement of descending aortic cross-sectional area and circumferential strain from standard cardiac MRI (horizontal long-axis cine image)

Comparator

Comparison between young, older, and HFpEF groups

Outcome

Peak descending aortic strain and absolute distensionsurrogate

Descending aortic strain measured from standard cardiac MRI is a sensitive marker for age- and disease-related arterial stiffness.

Implication

May support CMR-derived descending aortic strain as an arteriosclerosis marker in HFpEF; hypothesis-generating and should not yet change practice.

Abstract

During standard cardiovascular magnetic resonance (CMR) the horizontal long‐axis cine image (i.e., 4‐chamber) is captured which includes a cross‐section of the descending aorta. The aortic cross‐section can be used to assess aortic stiffness (distensibility; ∆area/pressure) or circumferential strain (percentage vascular deformation). We examined whether descending aortic strain from traditional CMR is sensitive to age‐ and disease‐related (heart failure with preserved ejection fraction; HFpEF) arteriosclerosis. We recruited 83 participants into three groups: (1) 34 young individuals (age: 22 ± 3 years; body mass index (BMI): 24.3 ± 2.8 kg/m 2 ); (2) 19 older individuals (age: 69 ± 5 years; BMI: 26.9 ± 4.7 kg/m 2 ) and (3) 26 patients with HFpEF (age: 69 ± 6 years; BMI: 35.8 ± 6.1 kg/m 2 ). All participants were studied in the same 3 T scanner (Phillips, Achieva). Descending aortic cross‐sectional area and circumferential strain were measured using cvi 42 software. Blood pressure was measured via a brachial oscillometric cuff. Data were compared via ANOVA. All data are reported as means ± standard deviation. Compared to the young group (71 ± 5 mmHg), mean arterial pressure was higher in the older (83 ± 9 mmHg, P < 0.001) and HFpEF groups (86 ± 10 mmHg, P < 0.001). Minimum and maximum aortic areas were greater in the older and HFpEF groups (both, P < 0.01). Peak descending aortic strain (young: 11.4% ± 2.2%; older: 4.8% ± 1.6%; HFpEF 3.8% ± 1.6%) and absolute distension were lower (all, P < 0.02) in the older and HFpEF groups compared to the young. Peak descending aortic strain and strain rates are sensitive to age and may provide a novel assessment of arterial stiffness for longitudinal studies that utilize or have utilized CMR.