Cardiovascular diagnosis and therapy · 2025
A cross-sectional comparison of invasive and noninvasive aortic pulse wave velocity measurement in patients with or at risk for heart failure with preserved ejection fraction.
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Asif Anum, Nelson Michael D, Shufelt Chrisandra, Samuel T Jake, Cook-Wiens Galen, Luu Judy, Tjoe Benita, Tamarappoo Balaji, Berman Daniel S, Bairey Merz C Noel, Wei Janet
Аннотация
BACKGROUND: Increased aortic pulse wave velocity (aPWV), a marker of arterial stiffness, is associated with poor prognosis in patients with or at risk for heart failure with preserved ejection fraction (HFpEF). Increasingly, advanced imaging using cardiac magnetic resonance imaging (MRI) is used to evaluate cardiac dysfunction, including coronary microvascular dysfunction (CMD). To facilitate investigation linking CMD with HFpEF, we compared MRI-measured aPWV with traditional invasive or noninvasive measurements of aPWV.
METHODS: We studied 118 participants (90.7% women) with or at risk for HFpEF due to suspected CMD in a cross-sectional design at Cedars-Sinai Medical Center between October 2025 and February 2022. aPWV was measured by: (I) MRI through-plane phase-contrast imaging at the ascending and distal descending aorta (MRI-aPWV) (n=78), (II) invasively via catheter pullback (cath-aPWV) (n=68), and (III) carotid-femoral applanation tonometry (cf-aPWV; SphygmoCor XCEL, Atcor Medical) (n=87). MRI-aPWV was compared to cath-aPWV and cf-aPWV using Pearson correlation and Bland-Altman plots.
RESULTS: Mean age was 58±11.8 years, and mean aPWV were 8.48±3.21 m/s (MRI-PWV), 7.51±2.79 m/s (cath-aPWV), and 8.68±1.83 m/s (cf-aPWV). MRI-aPWV strongly correlated with cf-aPWV with r=0.74 [95% confidence interval (CI): 0.61-0.83, P<0.001] with mean difference -0.18 and standard deviation (SD) 2.14. Comparison of MRI-aPWV to cath-aPWV showed a modest correlation of 0.52 (95% CI: 0.29-0.69, P<0.001) with a mean difference of -0.74 and SD 2.78.
CONCLUSIONS: MRI measurement of aPWV shows good agreement with traditional invasive and noninvasive measurements in participants with or at risk for HFpEF. Reliable measurement of arterial stiffness combined with cardiac MRI measures of ventricular remodeling, fibrosis, scar and perfusion may offer pathophysiology insights and treatment targets for HFpEF.
METHODS: We studied 118 participants (90.7% women) with or at risk for HFpEF due to suspected CMD in a cross-sectional design at Cedars-Sinai Medical Center between October 2025 and February 2022. aPWV was measured by: (I) MRI through-plane phase-contrast imaging at the ascending and distal descending aorta (MRI-aPWV) (n=78), (II) invasively via catheter pullback (cath-aPWV) (n=68), and (III) carotid-femoral applanation tonometry (cf-aPWV; SphygmoCor XCEL, Atcor Medical) (n=87). MRI-aPWV was compared to cath-aPWV and cf-aPWV using Pearson correlation and Bland-Altman plots.
RESULTS: Mean age was 58±11.8 years, and mean aPWV were 8.48±3.21 m/s (MRI-PWV), 7.51±2.79 m/s (cath-aPWV), and 8.68±1.83 m/s (cf-aPWV). MRI-aPWV strongly correlated with cf-aPWV with r=0.74 [95% confidence interval (CI): 0.61-0.83, P<0.001] with mean difference -0.18 and standard deviation (SD) 2.14. Comparison of MRI-aPWV to cath-aPWV showed a modest correlation of 0.52 (95% CI: 0.29-0.69, P<0.001) with a mean difference of -0.74 and SD 2.78.
CONCLUSIONS: MRI measurement of aPWV shows good agreement with traditional invasive and noninvasive measurements in participants with or at risk for HFpEF. Reliable measurement of arterial stiffness combined with cardiac MRI measures of ventricular remodeling, fibrosis, scar and perfusion may offer pathophysiology insights and treatment targets for HFpEF.