Clinical relevance of aortic conduit and reservoir function

Assadi, Hosamadin ORCID: https://orcid.org/0000-0002-6143-8095, Sawh, Chris, Spohr, Hilmar, Nelthorpe, Faye, Nair, Sunil, Hughes, Marina, Ashman, David, Ryding, Alisdair, Matthews, Gareth ORCID: https://orcid.org/0000-0001-8353-4806, Li, Rui, Grafton-Clarke, Ciaran ORCID: https://orcid.org/0000-0002-8537-0806, Mehmood, Zia, Al-Mohammad, Abdallah, Kasmai, Bahman, Vassiliou, Vassilios S. ORCID: https://orcid.org/0000-0002-4005-7752 and Garg, Pankaj ORCID: https://orcid.org/0000-0002-5483-169X (2024) Clinical relevance of aortic conduit and reservoir function. Open Heart, 11. ISSN 2053-3624

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Abstract

Background Aortic conduit and reservoir functions can be directly measured by four-dimensional flow (4D flow) cardiovascular magnetic resonance (CMR). Methods Twenty healthy controls (10 young and 10 age-gender-matched old controls) and 20 patients with heart failure with preserved ejection fraction (HFpEF) were recruited. All had 4D flow CMR. Flow was quantified at the ascending and descending aorta levels. In addition, at the ascending aorta level, we quantified systolic flow displacement (FDs) and systolic flow reversal ratio (sFRR). The aortic conduit function was defined as the relative drop in systolic flow from the ascending to the descending aorta (∆Fs). Aortic reservoir function was defined as descending aortic diastolic stroke volume (DAo SVd). Results Both ∆Fs (R=0.51, p=0.001) and DAo SVd (R=−0.68, p=0.001) were significantly associated with ageing. Native T1 (R=0.51, p=0.001) and extracellular volume (R=0.51, p=0.001) showed maximum association with ∆Fs. ∆Fs significantly increased in HFpEF versus age-gender-matched controls (41±8% vs 52±12%, p=0.02). In multiple regression, only ∆Fs and DAo SVd were independent predictors of the estimated glomerular filtration rate (model R=0.77, p=0.0001). FDs was significantly associated with ∆Fs (R=0.4, p=0.01) and DAo SVd (R=−0.48, p=0.002), whereas sFRR was mainly associated with DAo SVd (R=−0.46, p=0.003). Conclusion Both aortic conduit and reservoir function decline with age and this decline in aortic function is also independently associated with renal functional decline. Ascending aortic turbulent flow signatures are associated with loss of aortic conduit and reservoir functions. Finally, in HFpEF, aortic conduit and reservoir function demonstrate progressive decline.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
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
Depositing User: LivePure Connector
Date Deposited: 20 Aug 2024 11:30
Last Modified: 25 Sep 2024 18:02
URI: https://ueaeprints.uea.ac.uk/id/eprint/96274
DOI: 10.1136/openhrt-2024-002713

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