Key result
Adults aged ≥40 years had lower main pulmonary artery flow volume (61.69 vs 69.39 ml/cycle, p=0.04) and left pulmonary artery wall shear stress (0.12 vs 0.15 Pa, p=0.03) than those <40 years.
Why the study?
This study aimed to assess age- and sex-related changes in pulmonary arterial flow distribution and wall shear stress using 4D flow CMR in healthy adults.
Does 4D flow cardiovascular magnetic resonance detect age- and sex-related differences in pulmonary arterial flow distribution and wall shear stress in healthy adults?
Cross-Sectional (n=57)
Single-blind (observers blinded to age, sex, and clinical information)
No
Does 4D flow cardiovascular magnetic resonance detect age- and sex-related differences in pulmonary arterial flow distribution and wall shear stress in healthy adults?
This 4D flow CMR study provides preliminary reference data on normal pulmonary arterial hemodynamics, demonstrating that adults aged ≥40 years have lower main pulmonary artery flow volume, a higher RPA/LPA flow ratio, and lower left pulmonary artery wall shear stress magnitude than younger adults.
Answers are grounded in this paper and cite their sources.
Should not yet change clinical practice; leaves open the prognostic utility of 4D flow CMR parameters in aging adults.
To assess age- and sex-related changes in pulmonary arterial flow distribution and wall shear stress (WSS) using 4D flow CMR in healthy adults. This prospective study included 57 healthy adults who underwent 4D flow CMR between February and November 2025. The participants were initially divided into two age groups (group 1: <40 years, group 2: ≥40 years). Then, each age group was subdivided by sex (male: A, female: B), resulting in four subgroups (groups 1 A, 1B, 2 A, and 2B). Cardiac cine imaging sequences of the heart (short-axis and two-, three-, and four-chamber views) and 4D flow sequences were obtained. On the obtained 4D flow images, the flow volume and WSS parameters were calculated for each artery in a cardiac cycle. Using these data, the distribution ratio for both pulmonary arteries was calculated. Measurements were performed by two radiologists. In the 4D flow sequence evaluation, main pulmonary artery flow volume was lower in group 2 than that in group 1 (61.69 ± 11.98 vs. 69.39 ± 15.80 ml/cycle, p = 0.04). Furthermore, group 1 exhibited significantly higher WSS magnitude values than group 2 in the left pulmonary artery (0.15 ± 0.04 Pa vs. 0.12 ± 0.02 Pa, p = 0.03, after false discovery rate [FDR] correction). No significant difference was observed between sexes (all p > 0.05, after FDR correction). 4D flow CMR enables noninvasive quantification of pulmonary arterial hemodynamics in healthy adults. This study provides preliminary reference data on pulmonary arterial flow distribution and WSS assessed using 4D flow CMR, highlighting the potential age-related differences in pulmonary arterial hemodynamics. Not applicable.
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Zhang et al. (2026) conducted a cross-sectional in Healthy adults (pulmonary arterial hemodynamics) (n=57). Age ≥40 years vs. Age <40 years was evaluated on Main pulmonary artery (MPA) flow volume (ml/cycle) (p=0.04). Adults aged ≥40 years had lower main pulmonary artery flow volume (61.69 vs 69.39 ml/cycle, p=0.04) and left pulmonary artery wall shear stress (0.12 vs 0.15 Pa, p=0.03) than those <40 years.
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