Impact of aortic stiffness by velocity-encoded magnetic resonance imaging on late gadolinium enhancement to predict cardiovascular events
Background: Increased aortic stiffness has been established as a marker in various cardiovascular diseases. Previous reports revealed a significant correlation between aortic stiffness and myocardial scarring using the late gadolinium enhancement cardiovascular magnetic resonance (LGE-CMR). However,...
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Format: | Article |
Language: | English |
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Elsevier
2020-10-01
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Series: | International Journal of Cardiology: Heart & Vasculature |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S235290672030333X |
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author | Yodying Kaolawanich Thananya Boonyasirinant |
author_facet | Yodying Kaolawanich Thananya Boonyasirinant |
author_sort | Yodying Kaolawanich |
collection | DOAJ |
description | Background: Increased aortic stiffness has been established as a marker in various cardiovascular diseases. Previous reports revealed a significant correlation between aortic stiffness and myocardial scarring using the late gadolinium enhancement cardiovascular magnetic resonance (LGE-CMR). However, prognostic data concerning aortic stiffness combining myocardial scarring remains limited. Method: A total of 402 patients who had undergone clinical CMR for the evaluation of cardiac function, LGE, and aortic pulse wave velocity (PWV) using velocity encoded-CMR (VE-CMR) were included. Patients were classified into 4 groups using mean PWV and the presence of LGE as elevated or non-elevated PWV and positive or negative LGE. Patients received follow-up for major adverse cardiovascular events (MACE) comprising cardiovascular death, non-fatal myocardial infarction, hospitalization for heart failure, coronary revascularization, and ischemic stroke. Predictors of MACE and hard cardiac events (cardiovascular death or non-fatal myocardial infarction) were evaluated. Results: During the average follow-up period of 47.7 months, 58 MACE occurred. Patients who had elevated PWV and positive LGE experienced the highest rate of MACE compared to the group with non-elevated PWV and negative LGE (HR 11.90, p < 0.001). Among patients who had LGE, those who had elevated PWV experienced a 2.4-times higher rate of MACE compared to those who had non-elevated PWV. Multivariate analysis showed that PWV and LGE were independent predictors of MACE and hard cardiac events. PWV had excellent intra- and inter-observer reproducibility (intra-: ICC = 0.98, p < 0.001, inter-: ICC = 0.97, p < 0.001). Conclusion: Aortic stiffness using VE-CMR had prognostic value to predict cardiovascular events, with the added benefits of LGE. |
first_indexed | 2024-04-13T16:50:11Z |
format | Article |
id | doaj.art-8dcb0355b23640d0908bdb62053262e4 |
institution | Directory Open Access Journal |
issn | 2352-9067 |
language | English |
last_indexed | 2024-04-13T16:50:11Z |
publishDate | 2020-10-01 |
publisher | Elsevier |
record_format | Article |
series | International Journal of Cardiology: Heart & Vasculature |
spelling | doaj.art-8dcb0355b23640d0908bdb62053262e42022-12-22T02:38:57ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672020-10-0130100635Impact of aortic stiffness by velocity-encoded magnetic resonance imaging on late gadolinium enhancement to predict cardiovascular eventsYodying Kaolawanich0Thananya Boonyasirinant1Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandCorresponding author at: Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok 10700, Thailand.; Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandBackground: Increased aortic stiffness has been established as a marker in various cardiovascular diseases. Previous reports revealed a significant correlation between aortic stiffness and myocardial scarring using the late gadolinium enhancement cardiovascular magnetic resonance (LGE-CMR). However, prognostic data concerning aortic stiffness combining myocardial scarring remains limited. Method: A total of 402 patients who had undergone clinical CMR for the evaluation of cardiac function, LGE, and aortic pulse wave velocity (PWV) using velocity encoded-CMR (VE-CMR) were included. Patients were classified into 4 groups using mean PWV and the presence of LGE as elevated or non-elevated PWV and positive or negative LGE. Patients received follow-up for major adverse cardiovascular events (MACE) comprising cardiovascular death, non-fatal myocardial infarction, hospitalization for heart failure, coronary revascularization, and ischemic stroke. Predictors of MACE and hard cardiac events (cardiovascular death or non-fatal myocardial infarction) were evaluated. Results: During the average follow-up period of 47.7 months, 58 MACE occurred. Patients who had elevated PWV and positive LGE experienced the highest rate of MACE compared to the group with non-elevated PWV and negative LGE (HR 11.90, p < 0.001). Among patients who had LGE, those who had elevated PWV experienced a 2.4-times higher rate of MACE compared to those who had non-elevated PWV. Multivariate analysis showed that PWV and LGE were independent predictors of MACE and hard cardiac events. PWV had excellent intra- and inter-observer reproducibility (intra-: ICC = 0.98, p < 0.001, inter-: ICC = 0.97, p < 0.001). Conclusion: Aortic stiffness using VE-CMR had prognostic value to predict cardiovascular events, with the added benefits of LGE.http://www.sciencedirect.com/science/article/pii/S235290672030333XAortic stiffnessCardiovascular magnetic resonance imagingLate gadolinium enhancementPrognosis |
spellingShingle | Yodying Kaolawanich Thananya Boonyasirinant Impact of aortic stiffness by velocity-encoded magnetic resonance imaging on late gadolinium enhancement to predict cardiovascular events International Journal of Cardiology: Heart & Vasculature Aortic stiffness Cardiovascular magnetic resonance imaging Late gadolinium enhancement Prognosis |
title | Impact of aortic stiffness by velocity-encoded magnetic resonance imaging on late gadolinium enhancement to predict cardiovascular events |
title_full | Impact of aortic stiffness by velocity-encoded magnetic resonance imaging on late gadolinium enhancement to predict cardiovascular events |
title_fullStr | Impact of aortic stiffness by velocity-encoded magnetic resonance imaging on late gadolinium enhancement to predict cardiovascular events |
title_full_unstemmed | Impact of aortic stiffness by velocity-encoded magnetic resonance imaging on late gadolinium enhancement to predict cardiovascular events |
title_short | Impact of aortic stiffness by velocity-encoded magnetic resonance imaging on late gadolinium enhancement to predict cardiovascular events |
title_sort | impact of aortic stiffness by velocity encoded magnetic resonance imaging on late gadolinium enhancement to predict cardiovascular events |
topic | Aortic stiffness Cardiovascular magnetic resonance imaging Late gadolinium enhancement Prognosis |
url | http://www.sciencedirect.com/science/article/pii/S235290672030333X |
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