Comprehensive monitoring of cardiac remodeling with aortic stroke volume values provided by a phase-contrast MRI sequence. Issue 5 (May 2016)

• Record Type: Journal Article
• Authors: Marie, Pierre Y.; Mandry, Damien; Huttin, Olivier; Micard, Emilien; Bonnemains, Laurent; Girerd, Nicolas; Beaumont, Marine; Fay, Renaud; Joly, Laure; Rossignol, Patrick; Benetos, Athanase; Felblinger, Jacques; Zannad, Faïez
• Is Part Of: Journal of hypertension. Volume 34:Issue 5(2016:May)
• Page Start: 967
• Page End: 973
• Publication Date: 2016-05
• Subjects: cardiac stroke volume -- hypertension -- left ventricular hypertrophy -- left ventricular remodeling -- MRI -- phase-contrast sequence; Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/HJH.0000000000000889
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objectives: Blood pressure (BP) and its changes with antihypertensive therapy are key parameters when monitoring left ventricular (LV) remodeling. This dual cross-sectional and longitudinal MRI study aimed to determine whether this monitoring is enhanced by aortic stroke volume (SV) values provided by a phase-contrast sequence. Methods: The study involved 334 MRI examinations from 247 study participants who had no significant cardiac disease (18–85 years old, 40% with hypertension) and among whom 48 had a 2–4-year MRI follow-up. Left ventricular hypertrophy and concentric geometry were: respectively assessed according to LV mass indexed to body surface area (g/m 2 ) and mass/end-diastolic volume ratio (concentric remodeling index); and correlated with vascular parameters involving BP and the indexed SV (ml/m 2 ) determined in the ascending aorta with a phase-contrast sequence. Results: Stroke volume was highly variable, ranging from 22 to 74 ml/m 2 . The best cross-sectional correlates were: mean BP × SV product, reflecting cardiac work, for LV mass ( r 2 = 0.21); and mean BP/SV ratio, reflecting arterial load, for concentric geometry ( r 2 = 0.29). These two SV-derived parameters led to more than two-fold enhancements in cross-sectional predictions compared with BP parameters alone, whereas their longitudinal changes over time paralleled those of concentric geometry ( P = 0.003 for mean BP/SV) and LV mass ( P = 0.006 for mean BP × SV), suggesting direct links with cardiac remodeling. Conclusion: The determination of aortic SV with a phase-contrast sequence leads to a significant enhancement in the characterization and monitoring of cardiac remodeling.