Aortic flow is abnormal in HFpEF

Mehmood, Zia, Assadi, Hosamadin ORCID:, Li, Rui, Kasmai, Bahman, Matthews, Gareth ORCID:, Grafton-Clarke, Ciaran ORCID:, Sanz, Aureo, Zhao, Xiaodan, Zhong, Liang, Aung, Nay, Skinner, Kristian, Hadinnapola, Charaka, Swoboda, Peter P., Swift, Andrew J., Vassiliou, Vassilios S. ORCID:, Miller, Christopher, van der Geest, Rob J., Petersen, Steffen Erhard and Garg, Pankaj ORCID: (2024) Aortic flow is abnormal in HFpEF. Wellcome Open Research, 8. ISSN 2398-502X

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Aims: Turbulent aortic flow makes the cardiovascular system less effective. It remains unknown if patients with heart failure with preserved ejection fraction (HFpEF) have disturbed aortic flow. This study sought to investigate advanced markers of aortic flow disturbances in HFpEF. Methods: This case-controlled observational study used four-dimensional flow cardiovascular magnetic resonance derived, two-dimensional phase-contrast reformatted plane data at an orthogonal plane just above the sino-tubular junction. We recruited 10 young healthy controls (HCs), 10 old HCs and 23 patients with HFpEF. We analysed average systolic aortic flow displacement (FDsavg), systolic flow reversal ratio (sFRR) and pulse wave velocity (PWV). In a sub-group analysis, we compared old HCs versus age-gender-matched HFpEF (N=10). Results: Differences were significant in mean age (P<0.001) among young HCs (22.9±3.5 years), old HCs (60.5±10.2 years) and HFpEF patients (73.7±9.7 years). FDsavg, sFRR and PWV varied significantly (P<0.001) in young HCs (8±4%, 2±2%, 4±2m/s), old HCs (16±5%, 7±6%, 11±8m/s), and HFpEF patients (23±10%, 11±10%, 8±3). No significant PWV differences existed between old HCs and HFpEF.HFpEF had significantly higher FDsavg versus old HCs (23±10% vs 16±5%, P<0.001). A FDsavg > 17.7% achieved 74% sensitivity, 70% specificity for differentiating them. sFRR was notably higher in HFpEF (11±10% vs 7±6%, P<0.001). A sFRR > 7.3% yielded 78% sensitivity, 70% specificity in differentiating these groups. In sub-group analysis, FDsavg remained distinctly elevated in HFpEF (22.4±9.7% vs 16±4.9%, P=0.029). FDsavg of >16% showed 100% sensitivity and 70% specificity (P=0.01). Similarly, sFRR remained significantly higher in HFpEF (11.3±9.5% vs 6.6±6.4%, P=0.007). A sFRR of >7.2% showed 100% sensitivity and 60% specificity (P<0.001). Conclusion: Aortic flow haemodynamics namely FDsavg and sFRR are significantly affected in ageing and HFpEF patients.

Item Type: Article
Additional Information: Data availability: The datasets generated and analysed during the current study are not publicly available. Access to the raw images of patients is not permitted since specialised post-processing imaging-based solutions can identify the study patients in the future. Data are available from the corresponding author upon reasonable request.
Uncontrolled Keywords: aortic flow,cardiac output,hfpef,haemodynamics,magnetic resonance imaging,medicine (miscellaneous),biochemistry, genetics and molecular biology(all) ,/dk/atira/pure/subjectarea/asjc/2700/2701
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Science > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health
Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
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Depositing User: LivePure Connector
Date Deposited: 27 Mar 2024 09:30
Last Modified: 03 Apr 2024 09:31
DOI: 10.12688/wellcomeopenres.20192.2

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