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Non-invasive assessment of ventriculo-arterial coupling using aortic wave intensity analysis combining central blood pressure and phase-contrast cardiovascular magnetic resonance.

Bhuva, AN; D'Silva, A; Torlasco, C; Nadarajan, N; Jones, S; Boubertakh, R; Van Zalen, J; Scully, P; Knott, K; Benedetti, G; et al. Bhuva, AN; D'Silva, A; Torlasco, C; Nadarajan, N; Jones, S; Boubertakh, R; Van Zalen, J; Scully, P; Knott, K; Benedetti, G; Augusto, JB; Bastiaenen, R; Lloyd, G; Sharma, S; Moon, JC; Parker, KH; Manisty, CH; Hughes, AD (2020) Non-invasive assessment of ventriculo-arterial coupling using aortic wave intensity analysis combining central blood pressure and phase-contrast cardiovascular magnetic resonance. Eur Heart J Cardiovasc Imaging, 21 (7). pp. 805-813. ISSN 2047-2412 https://doi.org/10.1093/ehjci/jez227
SGUL Authors: Bastiaenen, Rachel Marie Sharma, Sanjay

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Abstract

BACKGROUND: Wave intensity analysis (WIA) in the aorta offers important clinical and mechanistic insight into ventriculo-arterial coupling, but is difficult to measure non-invasively. We performed WIA by combining standard cardiovascular magnetic resonance (CMR) flow-velocity and non-invasive central blood pressure (cBP) waveforms. METHODS AND RESULTS: Two hundred and six healthy volunteers (age range 21-73 years, 47% male) underwent sequential phase contrast CMR (Siemens Aera 1.5 T, 1.97 × 1.77 mm2, 9.2 ms temporal resolution) and supra-systolic oscillometric cBP measurement (200 Hz). Velocity (U) and central pressure (P) waveforms were aligned using the waveform foot, and local wave speed was calculated both from the PU-loop (c) and the sum of squares method (cSS). These were compared with CMR transit time derived aortic arch pulse wave velocity (PWVtt). Associations were examined using multivariable regression. The peak intensity of the initial compression wave, backward compression wave, and forward decompression wave were 69.5 ± 28, -6.6 ± 4.2, and 6.2 ± 2.5 × 104 W/m2/cycle2, respectively; reflection index was 0.10 ± 0.06. PWVtt correlated with c or cSS (r = 0.60 and 0.68, respectively, P < 0.01 for both). Increasing age decade and female sex were independently associated with decreased forward compression wave (-8.6 and -20.7 W/m2/cycle2, respectively, P < 0.01) and greater wave reflection index (0.02 and 0.03, respectively, P < 0.001). CONCLUSION: This novel non-invasive technique permits straightforward measurement of wave intensity at scale. Local wave speed showed good agreement with PWVtt, and correlation was stronger using the cSS than the PU-loop. Ageing and female sex were associated with poorer ventriculo-arterial coupling in healthy individuals.

Item Type: Article
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in European Heart Journal - Cardiovascular Imaging following peer review. The version of record Anish N Bhuva, A D’Silva, C Torlasco, N Nadarajan, S Jones, R Boubertakh, J Van Zalen, P Scully, K Knott, G Benedetti, J B Augusto, Rachel Bastiaenen, G Lloyd, S Sharma, J C Moon, K H Parker, C H Manisty, Alun D Hughes, Non-invasive assessment of ventriculo-arterial coupling using aortic wave intensity analysis combining central blood pressure and phase-contrast cardiovascular magnetic resonance, European Heart Journal - Cardiovascular Imaging, Volume 21, Issue 7, July 2020, Pages 805–813 is available online at: https://doi.org/10.1093/ehjci/jez227
Keywords: CMR, aorta, haemodynamics, reflection index, ventriculo-arterial coupling, wave intensity analysis, CMR, aorta, haemodynamics, reflection index, ventriculo-arterial coupling, wave intensity analysis
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Eur Heart J Cardiovasc Imaging
ISSN: 2047-2412
Language: eng
Dates:
DateEvent
July 2020Published
9 September 2019Published Online
20 August 2019Accepted
Publisher License: Publisher's own licence
Projects:
Project IDFunderFunder ID
FS/15/27/31465British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
FS/16/46/32187British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
PG/13/6/29934British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
MC_UU_12019/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
FS/15/27/31465British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
FS/16/31/32185British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
PubMed ID: 31501858
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/111208
Publisher's version: https://doi.org/10.1093/ehjci/jez227

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