Abstract
BackgroundPulse wave velocity (PWV) is a biomarker for arterial stiffness, clinically assessed by applanation tonometry (AT). Increased use of phase-contrast cardiac magnetic resonance (CMR) imaging allows for PWV assessment with minor routine protocol additions. The aims were to investigate the acquired temporal resolution needed for accurate and precise measurements of CMR-PWV, and develop a tool for CMR-PWV measurements.MethodsComputer phantoms were generated for PWV = 2–20 m/s based on human CMR-PWV data. The PWV measurements were performed in 13 healthy young subjects and 13 patients at risk for cardiovascular disease. The CMR-PWV was measured by through-plane phase-contrast CMR in the ascending aorta and at the diaphragm level. Centre-line aortic distance was determined between flow planes. The AT-PWV was assessed within 2 h after CMR. Three observers (CMR experience: 15, 4, and <1 year) determined CMR-PWV. The developed tool was based on the flow-curve foot transit time for PWV quantification.ResultsComputer phantoms showed bias 0.27 ± 0.32 m/s for a temporal resolution of at least 30 ms. Intraobserver variability for CMR-PWV were: 0 ± 0.03 m/s (15 years), -0.04 ± 0.33 m/s (4 years), and -0.02 ± 0.30 m/s (<1 year). Interobserver variability for CMR-PWV was below 0.02 ± 0.38 m/s. The AT-PWV overestimated CMR-PWV by 1.1 ± 0.7 m/s in healthy young subjects and 1.6 ± 2.7 m/s in patients.ConclusionsAn acquired temporal resolution of at least 30 ms should be used to obtain accurate and precise thoracic aortic phase-contrast CMR-PWV. A new freely available research tool was used to measure PWV in healthy young subjects and in patients, showing low intra- and interobserver variability also for less experienced CMR observers.
Highlights
Pulse wave velocity (PWV) is a biomarker for arterial stiffness, clinically assessed by applanation tonometry (AT)
The aims of this study were to 1) investigate the acquired temporal resolution needed for accurate measurements of cardiac magnetic resonance (CMR)-PWV; and 2) to provide a tool for CMR-PWV measurements and use this to compare CMR-PWV with the clinical standard AT-PWV, by experienced and less experienced CMR observers
The temporal resolution of at least 30 ms yielded a bias of 0.27 ± 0.32 m/s between calculated and true PWV in the computer phantoms
Summary
Pulse wave velocity (PWV) is a biomarker for arterial stiffness, clinically assessed by applanation tonometry (AT). Increased use of phase-contrast cardiac magnetic resonance (CMR) imaging allows for PWV assessment with minor routine protocol additions. Pulse wave velocity (PWV) can be used as a biomarker for aortic stiffness, and can predict CVD outcome beyond traditional risk factors [4]. The PWV is defined as the distance between two measurement planes divided by the difference in time between pulse waves at these measurement planes. Cardiac magnetic resonance (CMR) imaging is increasingly used for cardiovascular assessment, and minor adjustments to a routine CMR protocol yields data for PWV. The CMR-PWV has been previously validated [6, 7] and is an attractive option for assessment of aortic stiffness, giving prognostic information at low extra cost
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