Abstract
ObjectiveAortic distensibility (AD) represents a well-established parameter of aortic stiffness. It remains unclear, however, whether AD can be obtained with high reproducibility in standard 4-chamber cine CMR images of the descending aorta. This study investigated the intra- and inter-observer agreement of AD based on different angles of the aorta and provided a sample size calculation of AD for future trials.MethodsThirty-one patients underwent CMR. Angulation of the descending aorta was performed to obtain strictly transversal and orthogonal cross-sectional aortic areas. AD was obtained both area and diameter based.ResultsFor area-based values, inter-observer agreement was highest for 4-chamber AD (ICC 0.97; 95% CI 0.93–99), followed by orthogonal AD (ICC 0.96; 95% CI 0.91–98) and transversal AD (ICC 0.93; 95% CI 0.80–97). For diameter-based values, agreement was also highest for 4-chamber AD (ICC 0.97; 95% CI 0.94–99), followed by orthogonal AD (ICC 0.96; 95% CI 0.92–98) and transversal AD (ICC 0.91; 95% CI 0.77–96). Bland–Altman plots confirmed a small variation among observers. Sample size calculation showed a sample size of 12 patients to detect a change in 4-chamber AD of 1 × 10−3 mmHg−1 with either the area or diameter approach.ConclusionAD measurements are highly reproducible and allow an accurate and rapid assessment of arterial compliance from standard 4-chamber cine CMR.Graphic abstract
Highlights
The tendency of blood vessels to stretch in response to the pulsatile blood flow, has significant physiological effects on blood pressure (BP) [1,2,3]
Inter-observer agreement was excellent in both approaches used: for area-based Aortic distensibility (AD), agreement was highest for 4-chamber AD (ICC 0.97; 95% CI 0.93–99), followed by orthogonal AD (ICC 0.96; 95% CI 0.91–98) and transversal AD (ICC 0.93; 95% CI 0.80–97)
The present work was designed to investigate the reproducibility of AD calculation in standard 4-chamber cine cardiac magnetic resonance tomography (CMR) imaging
Summary
The tendency of blood vessels to stretch in response to the pulsatile blood flow, has significant physiological effects on blood pressure (BP) [1,2,3]. The cushioning function of the aorta may be impaired due to structural degeneration of the aortic wall, increasing stiffness and the afterload for the left ventricle [3]. Aortic distensibility (AD) provides an estimation of these elastic properties and normalizes arterial compliance with the size of the vessel, allowing for a better comparison between individuals [4]. Several authors have made significant contributions to assess aortic compliance with various imaging methods [5,6,7,8]. We recently showed AD to be a potential biomarker to act as a noninvasive control in interventional hypertension trials [4]
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