Aortic Distensibility Measured by Automated Analysis of Magnetic Resonance Imaging Predicts Adverse Cardiovascular Events in UK Biobank
Background Automated analysis of cardiovascular magnetic resonance images provides the potential to assess aortic distensibility in large populations. The aim of this study was to compare the prediction of cardiovascular events by automated cardiovascular magnetic resonance with those of other simpl...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-12-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.026361 |
| _version_ | 1811170060118523904 |
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| author | Marina Cecelja Bram Ruijsink Esther Puyol‐Antón Ye Li Harriet Godwin Andrew P. King Reza Razavi Phil Chowienczyk |
| author_facet | Marina Cecelja Bram Ruijsink Esther Puyol‐Antón Ye Li Harriet Godwin Andrew P. King Reza Razavi Phil Chowienczyk |
| author_sort | Marina Cecelja |
| collection | DOAJ |
| description | Background Automated analysis of cardiovascular magnetic resonance images provides the potential to assess aortic distensibility in large populations. The aim of this study was to compare the prediction of cardiovascular events by automated cardiovascular magnetic resonance with those of other simple measures of aortic stiffness suitable for population screening. Methods and Results Aortic distensibility was measured from automated segmentation of aortic cine cardiovascular magnetic resonance using artificial intelligence in 8435 participants. The associations of distensibility, brachial pulse pressure, and stiffness index (obtained by finger photoplethysmography) with conventional risk factors was examined by multivariable regression and incident cardiovascular events by Cox proportional‐hazards regression. Mean (±SD) distensibility values for men and women were 1.77±1.15 and 2.10±1.45 (P<0.0001) 10−3 mm Hg−1, respectively. There was a good correlation between automatically and manually obtained systolic and diastolic aortic areas (r=0.980 and r=0.985, respectively). In regression analysis, distensibility associated with age, mean arterial pressure, heart rate, weight, and plasma glucose but not male sex, cholesterol or current smoking. During an average follow‐up of 2.8±1.3 years, 86 participants experienced cardiovascular events 6 of whom died. Higher distensibility was associated with reduced risk of cardiovascular events (adjusted hazard ratio [HR], 0.61 per log unit of distensibility; P=0.016). There was no evidence of an association between pulse pressure (adjusted HR 1.00; P=0.715) or stiffness index (adjusted HR, 1.02; P=0.535) and risk of cardiovascular events. Conclusions Automated cardiovascular magnetic resonance‐derived aortic distensibility may be incorporated into routine clinical imaging. It shows a similar association to cardiovascular risk factors as other measures of arterial stiffness and predicts new‐onset cardiovascular events, making it a useful tool for the measurement of vascular aging and associated cardiovascular risk. |
| first_indexed | 2024-04-10T16:51:16Z |
| format | Article |
| id | doaj.art-be242cfee424420ca49f4563ac2e9db7 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T16:51:16Z |
| publishDate | 2022-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-be242cfee424420ca49f4563ac2e9db72023-02-07T16:03:22ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-12-01112310.1161/JAHA.122.026361Aortic Distensibility Measured by Automated Analysis of Magnetic Resonance Imaging Predicts Adverse Cardiovascular Events in UK BiobankMarina Cecelja0Bram Ruijsink1Esther Puyol‐Antón2Ye Li3Harriet Godwin4Andrew P. King5Reza Razavi6Phil Chowienczyk7King’s College London British Heart Foundation Centre, Department of Clinical Pharmacology St Thomas’ Hospital London United KingdomSchool of Bioengineering and Imaging Sciences King’s College London London United KingdomSchool of Bioengineering and Imaging Sciences King’s College London London United KingdomKing’s College London British Heart Foundation Centre, Department of Clinical Pharmacology St Thomas’ Hospital London United KingdomKing’s College London British Heart Foundation Centre School of Cardiovascular Medicine & Sciences, Department of Cardiology London United KingdomSchool of Bioengineering and Imaging Sciences King’s College London London United KingdomSchool of Bioengineering and Imaging Sciences King’s College London London United KingdomKing’s College London British Heart Foundation Centre, Department of Clinical Pharmacology St Thomas’ Hospital London United KingdomBackground Automated analysis of cardiovascular magnetic resonance images provides the potential to assess aortic distensibility in large populations. The aim of this study was to compare the prediction of cardiovascular events by automated cardiovascular magnetic resonance with those of other simple measures of aortic stiffness suitable for population screening. Methods and Results Aortic distensibility was measured from automated segmentation of aortic cine cardiovascular magnetic resonance using artificial intelligence in 8435 participants. The associations of distensibility, brachial pulse pressure, and stiffness index (obtained by finger photoplethysmography) with conventional risk factors was examined by multivariable regression and incident cardiovascular events by Cox proportional‐hazards regression. Mean (±SD) distensibility values for men and women were 1.77±1.15 and 2.10±1.45 (P<0.0001) 10−3 mm Hg−1, respectively. There was a good correlation between automatically and manually obtained systolic and diastolic aortic areas (r=0.980 and r=0.985, respectively). In regression analysis, distensibility associated with age, mean arterial pressure, heart rate, weight, and plasma glucose but not male sex, cholesterol or current smoking. During an average follow‐up of 2.8±1.3 years, 86 participants experienced cardiovascular events 6 of whom died. Higher distensibility was associated with reduced risk of cardiovascular events (adjusted hazard ratio [HR], 0.61 per log unit of distensibility; P=0.016). There was no evidence of an association between pulse pressure (adjusted HR 1.00; P=0.715) or stiffness index (adjusted HR, 1.02; P=0.535) and risk of cardiovascular events. Conclusions Automated cardiovascular magnetic resonance‐derived aortic distensibility may be incorporated into routine clinical imaging. It shows a similar association to cardiovascular risk factors as other measures of arterial stiffness and predicts new‐onset cardiovascular events, making it a useful tool for the measurement of vascular aging and associated cardiovascular risk.https://www.ahajournals.org/doi/10.1161/JAHA.122.026361aortic stiffnessdistensibilityoutcome |
| spellingShingle | Marina Cecelja Bram Ruijsink Esther Puyol‐Antón Ye Li Harriet Godwin Andrew P. King Reza Razavi Phil Chowienczyk Aortic Distensibility Measured by Automated Analysis of Magnetic Resonance Imaging Predicts Adverse Cardiovascular Events in UK Biobank Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease aortic stiffness distensibility outcome |
| title | Aortic Distensibility Measured by Automated Analysis of Magnetic Resonance Imaging Predicts Adverse Cardiovascular Events in UK Biobank |
| title_full | Aortic Distensibility Measured by Automated Analysis of Magnetic Resonance Imaging Predicts Adverse Cardiovascular Events in UK Biobank |
| title_fullStr | Aortic Distensibility Measured by Automated Analysis of Magnetic Resonance Imaging Predicts Adverse Cardiovascular Events in UK Biobank |
| title_full_unstemmed | Aortic Distensibility Measured by Automated Analysis of Magnetic Resonance Imaging Predicts Adverse Cardiovascular Events in UK Biobank |
| title_short | Aortic Distensibility Measured by Automated Analysis of Magnetic Resonance Imaging Predicts Adverse Cardiovascular Events in UK Biobank |
| title_sort | aortic distensibility measured by automated analysis of magnetic resonance imaging predicts adverse cardiovascular events in uk biobank |
| topic | aortic stiffness distensibility outcome |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.026361 |
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