Aortic flow is associated with aging and exercise capacity
European Heart Journal Open, vol. 3, pp. oead079
Abstract
Abstract Aims Increased blood flow eccentricity in the aorta has been associated with aortic (AO) pathology, however, its association with exercise capacity has not been investigated. This study aimed to assess the relationships between flow eccentricity parameters derived from 2-dimensional (2D) phase-contrast (PC) cardiovascular magnetic resonance (CMR) imaging and aging and cardiopulmonary exercise test (CPET) in a cohort of healthy subjects. Methods and Results One hundred and sixty-nine healthy subjects (age 44 ± 13 years, M/F: 96/73) free of cardiovascular disease were recruited in a prospective study (NCT03217240) and underwent CMR, including 2D PC at an orthogonal plane just above the sinotubular junction, and CPET (cycle ergometer) within one week. The following AO flow parameters were derived: AO forward and backward flow indexed to body surface area (FFi, BFi), average flow displacement during systole (FDsavg), late systole (FDlsavg), diastole (FDdavg), systolic retrograde flow (SRF), systolic flow reversal ratio (sFRR), and pulse wave velocity (PWV). Exercise capacity was assessed by peak oxygen uptake (PVO2) from CPET. The mean values of FDsavg, FDlsavg, FDdavg, SRF, sFRR, and PWV were 17 ± 6%, 19 ± 8%, 29 ± 7%, 4.4 ± 4.2 mL, 5.9 ± 5.1%, and 4.3 ± 1.6 m/s, respectively. They all increased with age (r = 0.623, 0.628, 0.353, 0.590, 0.649, 0.598, all P < 0.0001), and decreased with PVO2 (r = −0.302, −0.270, −0.253, −0.149, −0.219, −0.161, all P < 0.05). A stepwise multivariable linear regression analysis using left ventricular ejection fraction (LVEF), FFi, and FDsavg showed an area under the curve of 0.769 in differentiating healthy subjects with high-risk exercise capacity (PVO2 ≤ 14 mL/kg/min). Conclusion AO flow haemodynamics change with aging and predict exercise capacity. Registration NCT03217240
Authors 16
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National Heart Centre Singapore
Affiliation as printed
National Heart Research Institute Singapore, National Heart Centre Singapore , 5 Hospital Drive, 169609 Singapore , Singapore
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University of East Anglia · Norfolk and Norwich University Hospital · Norfolk and Norwich University Hospitals NHS Foundation Trust
Affiliation as printed
Cardiology Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Ln, Norwich, NR4 7UY Norfolk , UK
Department of Cardiovascular and Metabolic Health, Norwich Medical School, University of East Anglia , Rosalind Franklin Rd, Norwich, NR4 7UQ Norfolk , UK
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University of East Anglia · Norfolk and Norwich University Hospital · Norfolk and Norwich University Hospitals NHS Foundation Trust
Affiliation as printed
Cardiology Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Ln, Norwich, NR4 7UY Norfolk , UK
Department of Cardiovascular and Metabolic Health, Norwich Medical School, University of East Anglia , Rosalind Franklin Rd, Norwich, NR4 7UQ Norfolk , UK
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National University of Singapore · Duke-NUS Medical School · National Heart Centre Singapore
Affiliation as printed
Duke-NUS Medical School, National University of Singapore, 8 College Road, 169857 Singapore , Singapore
National Heart Research Institute Singapore, National Heart Centre Singapore , 5 Hospital Drive, 169609 Singapore , Singapore
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National University of Singapore · National University Hospital · National University Health System
Affiliation as printed
Department of Diagnostic Imaging, National University Hospital Singapore , 5 Lower Kent Ridge Road, 119074 Singapore , Singapore
Yong Loo Lin School of Medicine, National University of Singapore , 10 Medical Drive, 117597 Singapore , Singapore
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National University of Singapore · National University Hospital · National University Health System
Affiliation as printed
Department of Diagnostic Imaging, National University Hospital Singapore , 5 Lower Kent Ridge Road, 119074 Singapore , Singapore
Yong Loo Lin School of Medicine, National University of Singapore , 10 Medical Drive, 117597 Singapore , Singapore
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University of East Anglia · Norfolk and Norwich University Hospital · Norfolk and Norwich University Hospitals NHS Foundation Trust
Affiliation as printed
Cardiology Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Ln, Norwich, NR4 7UY Norfolk , UK
Department of Cardiovascular and Metabolic Health, Norwich Medical School, University of East Anglia , Rosalind Franklin Rd, Norwich, NR4 7UQ Norfolk , UK
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University of East Anglia · Norfolk and Norwich University Hospital · Norfolk and Norwich University Hospitals NHS Foundation Trust
Affiliation as printed
Cardiology Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Ln, Norwich, NR4 7UY Norfolk , UK
Department of Cardiovascular and Metabolic Health, Norwich Medical School, University of East Anglia , Rosalind Franklin Rd, Norwich, NR4 7UQ Norfolk , UK
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National University of Singapore · Duke-NUS Medical School · National Heart Centre Singapore
Affiliation as printed
Duke-NUS Medical School, National University of Singapore, 8 College Road, 169857 Singapore , Singapore
National Heart Research Institute Singapore, National Heart Centre Singapore , 5 Hospital Drive, 169609 Singapore , Singapore
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National University of Singapore · Duke-NUS Medical School · National Heart Centre Singapore
Affiliation as printed
Duke-NUS Medical School, National University of Singapore, 8 College Road, 169857 Singapore , Singapore
National Heart Research Institute Singapore, National Heart Centre Singapore , 5 Hospital Drive, 169609 Singapore , Singapore
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National University of Singapore · National University Hospital · National University Health System
Affiliation as printed
Department of Diagnostic Imaging, National University Hospital Singapore , 5 Lower Kent Ridge Road, 119074 Singapore , Singapore
Yong Loo Lin School of Medicine, National University of Singapore , 10 Medical Drive, 117597 Singapore , Singapore
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National University of Singapore · National University Hospital · National University Health System
Affiliation as printed
Department of Diagnostic Imaging, National University Hospital Singapore , 5 Lower Kent Ridge Road, 119074 Singapore , Singapore
Yong Loo Lin School of Medicine, National University of Singapore , 10 Medical Drive, 117597 Singapore , Singapore
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National University of Singapore · National University Hospital · National University Health System
Affiliation as printed
Department of Diagnostic Imaging, National University Hospital Singapore , 5 Lower Kent Ridge Road, 119074 Singapore , Singapore
Yong Loo Lin School of Medicine, National University of Singapore , 10 Medical Drive, 117597 Singapore , Singapore
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National University of Singapore · Duke-NUS Medical School · National Heart Centre Singapore
Affiliation as printed
Duke-NUS Medical School, National University of Singapore, 8 College Road, 169857 Singapore , Singapore
National Heart Research Institute Singapore, National Heart Centre Singapore , 5 Hospital Drive, 169609 Singapore , Singapore
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Leiden University Medical Center
Affiliation as printed
Department of Radiology, Leiden University Medical Center , Albinusdreef 2, 2333 ZA Leiden, The Netherlands
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National University of Singapore · Duke-NUS Medical School · National Heart Centre Singapore
Affiliation as printed
Duke-NUS Medical School, National University of Singapore, 8 College Road, 169857 Singapore , Singapore
National Heart Research Institute Singapore, National Heart Centre Singapore , 5 Hospital Drive, 169609 Singapore , Singapore
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