Cardiovascular magnetic resonance imaging markers of ageing: A multi-centre, cross-sectional cohort study

Assadi, Hosamadin S., Zhao, Xiaodan, Matthews, Gareth, Li, Rui, Broncano Cabrero, Jordi, Kasmai, Bahman, Alabed, Samer, Royuela Del Val, Javier, Spohr, Hilmar, Gurung-Koney, Yashoda, Aung, Nay, Nair, Sunil, Swift, Andrew J., Vassiliou, Vassilios S., Zhong, Liang, Al-Mohammad, Abdallah, van der Geest, Rob J., Swoboda, Peter P., Plein, Sven and Garg, Pankaj (2025) Cardiovascular magnetic resonance imaging markers of ageing: A multi-centre, cross-sectional cohort study. European Heart Journal Open, 5 (3). ISSN 2752-4191

[thumbnail of Assadi_etal_2025_EHJOpen]
Preview
PDF (Assadi_etal_2025_EHJOpen) - Published Version
Available under License Creative Commons Attribution.

Download (1MB) | Preview

Abstract

Aims Cardiac ageing involves a series of anatomical and physiological changes contributing to a decline in overall performance. Cardiac magnetic resonance (CMR) provides comprehensive structural and functional assessment for detecting age-related cardiovascular remodelling. We aimed to develop a fully automated CMR model to predict functional heart age. Methods and results This international, multi-centre, retrospective observational study enrolled 191 healthy individuals with normal body mass index (BMI), free of metabolic, cardiovascular, and respiratory disease as the derivation cohort. Left atrial (LA) end-systolic volume and LA ejection fraction were selected for the final model. The model was validated on 366 patients with BMI >25 kg/m2 and one or more comorbidities [hypertension, diabetes mellitus (DM), atrial fibrillation (AF), and obesity]. In healthy individuals [median age: 34 years, 105 (55%) female], CMR-derived functional heart age was similar to the chronological age [bias: 0.05%, 95% confidence interval (CI): 9.56–9.67%, P = 0.993]. In the validation cohort [median age: 53 years, 157 (43%) female], CMR-derived functional heart age was 4.6 years higher than chronological age (95% CI: 1.6–7.6 years, P = 0.003). Cardiac magnetic resonance-derived functional heart age was significantly higher in patients with hypertension (P < 0.001), DM (P < 0.001), and AF (P < 0.001) than age-matched healthy controls. Moreover, CMR-derived functional heart age was higher than the chronological age in obesity Class I (P = 0.07), obesity Class II (P = 0.11), and obesity Class III (P < 0.001). Conclusion This study highlights the time course of structural and physiological changes in the heart during healthy and unhealthy ageing. We propose simple equations that should help communicate subtle changes in heart assessment with ageing.

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 specialized post-processing imaging-based solutions can identify the study patients in the future. Data are available from the corresponding author upon reasonable request. Funding: P.G. is funded by the Wellcome Trust (220703/Z/20/Z). The funders had no role in study design, data collection, analysis, publishing decisions, or manuscript preparation. For the purpose of Open Access, the authors have applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission.
Uncontrolled Keywords: ageing,diabetes mellitus,hypertension,magnetic resonance imaging (cine),obesity,cardiology and cardiovascular medicine,surgery,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2705
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
Related URLs:
Depositing User: LivePure Connector
Date Deposited: 02 Jul 2025 08:30
Last Modified: 14 Jul 2025 12:33
URI: https://ueaeprints.uea.ac.uk/id/eprint/99799
DOI: 10.1093/ehjopen/oeaf032

Downloads

Downloads per month over past year

Actions (login required)

View Item View Item