Associations of CMR-based pulse wave velocity and aortic distensibility with infrarenal ultrasound-based aortic parameters in the Hamburg City Health Study

Abstract Background Although pulse wave velocity (PWV) and aortic distensibility (AD) can be readily obtained from cardiac magnetic resonance imaging (CMR), there is a paucity of data on their use for screening for abdominal aortic aneurysm (AAA) and cardiovascular risk stratification. Methods Data from the Hamburg City Health Study (HCHS) were used: PWV, AD of the ascending (AD AoAsc) and descending aorta (AD AoDesc) were quantified using 2D-phase-contrast-velocity-encoding-CMR-sequences. The maximum diameter and peak flow velocity of the infrarenal aorta were quantified by ultrasound-measurements. Diameter thresholds for infrarenal ectasia (25-29 mm) and aneurysm (≥ 30 mm) were defined in accordance with current guidelines. Results The cohort consisted of 2,093 participants (median age 66 years, 42% women). Median infrarenal aortic diameter was 18.1 mm [IQR 16.4, 19.9] and peak flow velocity 98.6 cm/s [IQR 83.6,115.9]. After adjustment for age and sex, there were significant associations of diameter with AD AoDesc (Coefficient -0.572 p = 0.009) and of peak flow velocity with PWV (Coefficient -0.399, p = 0.029). Participants with infrarenal ectasia or aneurysm ( n = 55) had significantly higher median PWV, whereas AD AoAsc, AD AoDesc and peak flow velocity were significantly lower ( p = 0.004, p = 0.042, p = 0.039, p < 0.001) compared with normal aortic diameter cohort. After adjustment for covariates, PWV and AD showed a significant predictive value neither for prevalent infrarenal ectasia or nor for aneurysm. Conclusion CMR-based aortic stiffness parameters such as PWV and AD were associated with infrarenal aortic parameters. Their diagnostic, screening, and prognostic value remains to be investigated.