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Differential impact of local and regional aortic stiffness on left ventricular remodeling: a cardiovascular magnetic resonance study

Quinaglia, Thiagoa,b; Bensalah, Mourad, Z.b; Bollache, Emiliec; Kachenoura, Nadjiac; Soulat, Gillesa,b; Boutouyrie, Pierrea,b; Laurent, Stéphanea,b; Mousseaux, Eliea,b

doi: 10.1097/HJH.0000000000001597
ORIGINAL PAPERS: Blood vessels

Background: Left ventricular (LV) remodeling and aortic stiffness have independent predictive value for all causes and cardiovascular mortality. Because elastic properties of the arterial wall vary along the aortic pathway, we hypothesized that local and regional aortic stiffness could differently impact on LV remodeling.

Methods and results: Regional aortic stiffness was determined from carotid–femoral pulse wave velocity (cfPWV) measured by aplanation tonometry. Aortic arch pulse wave velocity was measured by phase contrast cardiovascular magnetic resonance (CMR). Local stiffness was calculated in the ascending aorta pulse wave velocity (aaPWV) and descending aorta pulse wave velocity using central pulse pressure measurement, cine CMR acquisition, and surface change estimation. CMR LV remodeling was expressed as LV mass to end-diastolic volume ratio.

We evaluated 146 study participants (41 ± 15 years) free of overt cardiovascular disease. In stepwise multivariate regression analysis, cfPWV and aaPWV were significantly and independently correlated to mass to end-diastolic volume ratio (partial R 2 = 0.07 and R 2 = 0.10, respectively, all P < 0.005) after adjustment for age, sex, BMI, brachial mean blood pressure, and central pulse pressure. Descending aorta pulse wave velocity was correlated with mass to end-diastolic volume ratio to a lower extent (R 2 = 0.04, P = 0.0115) and aortic arch pulse wave velocity was not independently associated with mass to end-diastolic volume ratio. CfPWV and aaPWV were both independently associated with mass to end-diastolic volume ratio, explaining 5 and 8% of mass to end-diastolic volume ratio variance, respectively.

Conclusion: In study participants free of overt cardiovascular disease, stiffness of the ascending aorta representing the local proximal aortic function face to the LV and of the downstream aortic pathway assessed by cfPWV reflecting more advanced alterations of material properties involving the entire aorta, are independent determinants of LV remodeling after adjustment to age, BMI, mean blood pressure, and sex.

aINSERM U970, Paris Centre de Recherche Cardiovasculaire, Paris Descartes University

bEuropean Hospital Georges Pompidou, Assistance Publique Hôpitaux de Paris

cINSERM 1146, CNRS 7371, Laboratoire d’Imagerie Biomédicale, University Pierre Marie Curie-Sorbonne Universités, Paris, France

Correspondence to Professor Elie Mousseaux, MD, PhD, Department of Medical Imaging, European Hospital Georges Pompidou, Assistance Publique Hôpitaux de Paris, 20 Rue Leblanc, 75908, Paris Cedex 15, France. Tel: + 33 1 56 09 37 09; fax: + 33 1 56 09 29 40; e-mail: elie.mousseaux@aphp.fr

Abbreviations: aaPWV, ascending aorta pulse wave velocity; archPWV, aortic arch pulse wave velocity; BP, blood pressure; cfPWV, carotid–femoral pulse wave velocity; CMR, cardiac magnetic resonance; daPWV, descending aorta pulse wave velocity; LV, left ventricular; MBP, mean blood pressure; PP, pulse pressure; SSFP, steady-state free precession

Received 3 May, 2017

Revised 4 August, 2017

Accepted 20 September, 2017

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