Abstract
Aim: to evaluate different parameters of thoracic aortic stiffness derived from cardiovascular magnetic resonance (CMR) imaging in patients with myocardial infarction (MI) and evaluate their values in prediction of MI size. Methods: 60 subjects were prospectively included, and classified into 2 groups: subjects without CAD (N-CAD, n = 27), subjects with MI (MI, n = 33). The regional pulse wave velocity (rPWV) in the aortic arch was measured using velocity encoded cardiovascular magnetic resonance. ART-FUN software was used for automated spatial segmentation of aorta, combining the estimation of the transit time and the length of the aortic arch. The temporal evolution of the aortic area during one cardiac cycle provides the estimation of other local rigidity indices: distensibility of the ascending aorta (D-AA) and distensibility of descending aorta (D-DA), strain of ascending (S-AA) and descending aorta (S-DA), local PWV in ascending (PWV-AA). The size of myocardial infarction (surface) was evaluated by left ventricular late enhancement of gadolinium (LELV) using phase sensitive inversion recovery MRI sequences. Results: Age of the population was 56.7 ± 14.5 years. The proportion of males and smoker in MI was higher than N-CMD group (p = 0.001, p = 0.013 respectively). There was no significant difference of all aortic stiffness parameters between the two groups (p = NS). In MI group, PWV-AA was inversely correlated with S-AA and D-AA (r = 0.6, p = 0.001; r = 0.8,p = 0.0001). The rPWV is correlated with age (r = 0.5, p = 0.0001). S-AA and D-AA were inversely correlated with smoking (r = -0.6, p = 0.001; r = -0.4, p = 0.02). Multivariate analysis showed that age, aortic stiffness (increased rPWV and decreased D-AD) were independent risk factors of higher MI size (p = 0.01, p = 0.02, p = 0.03 respectively). Conclusion: CMR imaging is a non-invasive technique useful for the evaluation of local and regional aortic stiffness. Aortic stiffness and age are independent predictors of the myocardial infraction size.
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