Validation of simple measures of aortic distensibility based on standard 4-chamber cine CMR: a new approach for clinical studies

Clin Res Cardiol. 2020 Apr;109(4):454-464. doi: 10.1007/s00392-019-01525-8. Epub 2019 Jul 13.

Abstract

Objective: Aortic distensibility (AD) represents a well-established parameter of aortic stiffness. It remains unclear, however, whether AD can be obtained with high reproducibility in standard 4-chamber cine CMR images of the descending aorta. This study investigated the intra- and inter-observer agreement of AD based on different angles of the aorta and provided a sample size calculation of AD for future trials.

Methods: Thirty-one patients underwent CMR. Angulation of the descending aorta was performed to obtain strictly transversal and orthogonal cross-sectional aortic areas. AD was obtained both area and diameter based.

Results: For area-based values, inter-observer agreement was highest for 4-chamber AD (ICC 0.97; 95% CI 0.93-99), followed by orthogonal AD (ICC 0.96; 95% CI 0.91-98) and transversal AD (ICC 0.93; 95% CI 0.80-97). For diameter-based values, agreement was also highest for 4-chamber AD (ICC 0.97; 95% CI 0.94-99), followed by orthogonal AD (ICC 0.96; 95% CI 0.92-98) and transversal AD (ICC 0.91; 95% CI 0.77-96). Bland-Altman plots confirmed a small variation among observers. Sample size calculation showed a sample size of 12 patients to detect a change in 4-chamber AD of 1 × 10-3 mmHg-1 with either the area or diameter approach.

Conclusion: AD measurements are highly reproducible and allow an accurate and rapid assessment of arterial compliance from standard 4-chamber cine CMR.

Keywords: Aortic distensibility; Cardiac magnetic resonance imaging; Cine MRI; Compliance; Reproducibility.

Publication types

  • Validation Study

MeSH terms

  • Aorta / diagnostic imaging*
  • Aorta / physiopathology
  • Female
  • Humans
  • Magnetic Resonance Imaging, Cine*
  • Male
  • Middle Aged
  • Observer Variation
  • Predictive Value of Tests
  • Reproducibility of Results
  • Retrospective Studies
  • Vascular Stiffness*