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. 2022 Aug 30:18:653-665.
doi: 10.2147/VHRM.S359632. eCollection 2022.

Descending Aortic Distensibility and Cardiovascular Outcomes: A Cardiac Magnetic Resonance Imaging Study

Michael R Sood  1   2 , Sahar S Abdelmoneim  1 , Nripen Dontineni  1 , Alexander Ivanov  1 , Ernest Lee  1 , Michael Rubin  1 , Michael Vittoria  1 , Marcella Meykler  1 , Vidhya Ramachandran  1 , Terrence Sacchi  1 , Sorin Brener  1 , Igor Klem  3 , John F Heitner  1   4
Affiliations

Descending Aortic Distensibility and Cardiovascular Outcomes: A Cardiac Magnetic Resonance Imaging Study

Michael R Sood et al. Vasc Health Risk Manag. .

Abstract

Background: Aortic distensibility (AD) is an important determinant of cardiovascular (CV) morbidity and mortality. There is scant data on the association between AD measured within the descending thoracic aorta and CV outcomes.

Objective: We evaluated the association of AD at the descending thoracic aorta (AD desc) with the primary outcome of all-cause mortality, myocardial infarction (MI), stroke or coronary revascularization in patients referred for a cardiovascular magnetic resonance (CMR) study.

Methods: 928 consecutive patients [(mean age 60 ± 17; 33% with prior cardiovascular disease (CVD))] were evaluated. AD desc was measured at the cross-section of the descending thoracic aorta in the 4-chamber view (via steady-state free precession [SSFP] cine sequences) and was grouped into quintiles (with the 1st quintile corresponding to the least AD, i.e., the stiffest aorta). Cox proportional-hazards regression analysis were performed for the primary outcome.

Results: A total of 315 patients (34%) experienced the primary outcome during a median (25% IQR, 75% IQR) follow-up of 5.0 (0.56, 9.3) years. A decreased AD was significantly associated with hypertension, diabetes, renal disease, and dyslipidemia (p <0.0001). A primary outcome occurred in 43% of patients with AD desc ≤ median compared to 25% with AD desc > median, p <0.0001, and in 44% of patients with AD desc in the 1st quintile compared to 31% with AD desc in the other quintiles (p = 0.0004). Event free survival was incrementally reduced amongst quintiles (p <0.0001). However, AD desc ≤ median was not an independent predictor of the primary endpoint after multivariable adjustment in the overall population [adjusted HR 1.09 (95% CI:0.82-1.45), p = 0.518] or in the subgroup analysis of patients with or without prior CVD.

Conclusion: In this real-world cohort of 928 patients referred for CMR, AD desc is not an independent predictor of CV outcomes.

Keywords: AD; CMR; aortic distensibility; cardiovascular magnetic resonance; descending aorta.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
CMR showing a true FISP cine sequence (4-chamber view) showing the descending thoracic aorta cross sectional area highlighted in red (for illustrative purpose) during diastole (A) and systole (B). Arrows pointing to the descending aorta.
Figure 2
Figure 2
Mean AD across different age strata (p <0.0001). Data presented as mean and standard deviation (error bars).
Figure 3
Figure 3
Kaplan-Meier Survival Curves illustrates the survival rate among study population showing significant difference between the groups as categorized by: (A) AD desc ≤median cutoff, (B) different AD desc quintiles, (C) AD desc ≤ 1st quintile cutoff. (A) KM curves categorized by ADdesc ≤median cutoff. (B) KM curves categorized by AD desc quintiles. 1st quintiles correspond to least aortic distensibility and 5th quintile corresponds to the lowest aortic distensibility. (C) KM curves categorized by AD desc ≤ 1st quintile cutoff.
See this image and copyright information in PMC

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