Vascular Health and Risk Management (Aug 2022)

Descending Aortic Distensibility and Cardiovascular Outcomes: A Cardiac Magnetic Resonance Imaging Study

  • Sood MR,
  • Abdelmoneim SS,
  • Dontineni N,
  • Ivanov A,
  • Lee E,
  • Rubin M,
  • Vittoria M,
  • Meykler M,
  • Ramachandran V,
  • Sacchi T,
  • Brener S,
  • Klem I,
  • Heitner JF

Journal volume & issue
Vol. Volume 18
pp. 653 – 665


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Michael R Sood,1,2 Sahar S Abdelmoneim,1 Nripen Dontineni,1 Alexander Ivanov,1 Ernest Lee,1 Michael Rubin,1 Michael Vittoria,1 Marcella Meykler,1 Vidhya Ramachandran,1 Terrence Sacchi,1 Sorin Brener,1 Igor Klem,3 John F Heitner1,4 1Division of Cardiology, New York-Presbyterian Hospital, Brooklyn, NY, USA; 2Division of Cardiology, Mount Sinai South Nassau, Oceanside, NY, USA; 3Duke University, Raleigh Durham, NC, USA; 4Division of Cardiology, New York University-Langone Health, Brooklyn, NY, USACorrespondence: Michael R Sood, Division of Cardiology, Mount Sinai South Nassau, Oceanside, NY, USA, Email [email protected]: Aortic distensibility (AD) is an important determinant of cardiovascular (CV) morbidity and mortality. There is scant data on the association between AD measured within the descending thoracic aorta and CV outcomes.Objective: We evaluated the association of AD at the descending thoracic aorta (AD desc) with the primary outcome of all-cause mortality, myocardial infarction (MI), stroke or coronary revascularization in patients referred for a cardiovascular magnetic resonance (CMR) study.Methods: 928 consecutive patients [(mean age 60 ± 17; 33% with prior cardiovascular disease (CVD))] were evaluated. AD desc was measured at the cross-section of the descending thoracic aorta in the 4-chamber view (via steady-state free precession [SSFP] cine sequences) and was grouped into quintiles (with the 1st quintile corresponding to the least AD, i.e., the stiffest aorta). Cox proportional-hazards regression analysis were performed for the primary outcome.Results: A total of 315 patients (34%) experienced the primary outcome during a median (25% IQR, 75% IQR) follow-up of 5.0 (0.56, 9.3) years. A decreased AD was significantly associated with hypertension, diabetes, renal disease, and dyslipidemia (p median, p < 0.0001, and in 44% of patients with AD desc in the 1st quintile compared to 31% with AD desc in the other quintiles (p = 0.0004). Event free survival was incrementally reduced amongst quintiles (p < 0.0001). However, AD desc ≤ median was not an independent predictor of the primary endpoint after multivariable adjustment in the overall population [adjusted HR 1.09 (95% CI:0.82– 1.45), p = 0.518] or in the subgroup analysis of patients with or without prior CVD.Conclusion: In this real-world cohort of 928 patients referred for CMR, AD desc is not an independent predictor of CV outcomes.Keywords: cardiovascular magnetic resonance, aortic distensibility, descending aorta, AD, CMR