Abstract P182: Aortic Arch Pulse Wave Velocity Assessed by MRI as a Predictor of All-Cause Mortality and Incident Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis (MESA)

Abstract

Background: The carotid-femoral pulse wave velocity (PWV) assessed by tonometry is predictive of future cardiovascular disease (CVD) events. However, the predictive value of aortic arch PWV assessed by MRI for mortality and CVD events has not been established in the general population. The aim of this study was to evaluate the association of arch PWV with all-cause mortality and incident CVD events over 10 years in the Multi-Ethnic Study of Atherosclerosis (MESA). Method: Aortic arch PWV was measured using phase contrast (PC) cine MRI at the level of the pulmonary artery bifurcation for transit time and black blood sagittal image for transit length at baseline in 3537 MESA participants free of overt CVD. Cox regression was used to evaluate the risk of death and incident CVD in relation to arch PWV adjusted for age, gender, race, and CV risk factors. Results: At baseline, participants were aged 62 ± 10 years; 53% women; 36% White, 15% Chinese, 29% African American, 20% Hispanic; 45% hypertension. The mean value of arch PWV was 9.0 ± 6.3 m/s. There were 418 deaths and 236 CVD events over 10-year follow-up. There was significant interaction between arch PWV and mean age for both outcomes, so we stratified by age; below 60 years (n=1503) and above 60 years (n=2034). Increased PWV had a trend with increased risk of all-cause mortality with a hazard ratio for the 4th vs 1st quartile of PWV of 2.1 (95%CI: 1.0-4.6, p=0.05) independent of risk factors in age below 60 years group. There was no significant association of PWV with incident CVD in age below 60 years after adjustment for risk factors. In age above 60 years group, increased PWV was not associated with either all-cause mortality or incident CVD events in univariate or multivariate analysis (Table). Conclusion: Arch PWV assessed by MRI is not a significant predictor of all-cause mortality and incident CVD events among individuals without overt CVD.