CMR-assessed aortic arch stiffness is associated with brain tissue integrity assessed by diffusion tensor imaging in patients with hypertension

Michiel Sala,Albert De Roos,Jeroen Van Der Grond,Annette Van Den Berg - Huysmans,Anne Brandts,Jos J Westenberg

doi:10.1186/1532-429x-17-s1-p401

Michiel Sala, Albert De Roos + Show 4 more

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https://doi.org/10.1186/1532-429x-17-s1-p401

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Abstract

Background Increased aortic stiffness may lead to insufficient flow wave dampening and subsequent transmission of excessive pulsatile energy towards end-organs such as the brain. It has been shown that CMR-assessed aortic stiffness may augment cerebral small vessel disease in patients with hypertension, as assessed by conventional structural magnetic resonance imaging (MRI). However, in addition to these overt brain abnormalities, currently it is unknown whether aortic stiffening relates to subtle changes in brain tissue integrity, which may be a precursor to overt brain abnormalities. Diffusion tensor imaging (DTI) in the brain has been used to evaluate such subtle changes in tissue integrity. The aim of this study was to assess the association between aortic arch pulse wave velocity (PWV) as a marker of arterial stiffness and brain changes assessed by conventional structural MRI as well as DTI in patients with hypertension.

Highlights

Increased aortic stiffness may lead to insufficient flow wave dampening and subsequent transmission of excessive pulsatile energy towards end-organs such as the brain
The aim of this study was to assess the association between aortic arch pulse wave velocity (PWV) as a marker of arterial stiffness and brain changes assessed by conventional structural magnetic resonance imaging (MRI) as well as Diffusion tensor imaging (DTI) in patients with hypertension
Aortic arch PWV was associated with changes in white matter (FA: b = -0.30, p = 0.011; MD: b = 0.31; p = 0.005; AxD: b = 0.24, p = 0.040; RD: b = 0.33; p = 0.002) and grey matter integrity (MD: b = 0.28, p = 0.006; AxD: b = 0.27, p = 0.012; RD: b = 0.29, p = 0.006) (Table 1)

Summary

Introduction

Increased aortic stiffness may lead to insufficient flow wave dampening and subsequent transmission of excessive pulsatile energy towards end-organs such as the brain. It has been shown that CMR-assessed aortic stiffness may augment cerebral small vessel disease in patients with hypertension, as assessed by conventional structural magnetic resonance imaging (MRI). In addition to these overt brain abnormalities, currently it is unknown whether aortic stiffening relates to subtle changes in brain tissue integrity, which may be a precursor to overt brain abnormalities. Diffusion tensor imaging (DTI) in the brain has been used to evaluate such subtle changes in tissue integrity. The aim of this study was to assess the association between aortic arch pulse wave velocity (PWV) as a marker of arterial stiffness and brain changes assessed by conventional structural MRI as well as DTI in patients with hypertension

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Conclusion