Journal
JOURNAL OF MAGNETIC RESONANCE IMAGING
Volume 47, Issue 2, Pages 487-498Publisher
WILEY
DOI: 10.1002/jmri.25773
Keywords
aorta; aging; heart valve disease; 4D flow MRI
Funding
- National Institutes of Health National Heart, Lung, and Blood Institute [R01HL115828, K25HL119608]
- Netherlands Heart Foundation [2014T087]
- American Heart Association [14POST18350019]
- Mitacs Canada [IT07679]
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Purpose: To apply flow distribution analysis in the entire aorta across a wide age range from pediatric to adult subjects. Material and Methods: In all, 98 healthy subjects (age 9-78 years, 41 women) underwent 4D flow MRI at 1.5T and 3T for the assessment of 3D blood flow in the thoracic aorta. Subjects were categorized into age groups: group 1 (n = 9, 5 women): 9-15 years; group 2 (n = 13, 8 women): 16-20 years; group 3 (n = 27, 14 women): 21-39 years; group 4 (n = 40, 11 women): 40-59 years; group 5 (n = 9, 3 women): >60 years. Data analysis included the 3D segmentation of the aorta, aortic valve peak velocity, mid-ascending aortic diameter, and calculation of flow velocity distribution descriptors (mean, median, standard deviation, incidence of velocities >1 m/s, skewness, and kurtosis of aortic velocity magnitude). Ascending aortic diameter was normalized by body surface area. Results: Age was significantly associated with normalized aortic diameter (R = 0.73, P < 0.001), skewness (R = 0.76, P < 0.001), and kurtosis (R = 0.74, P < 0.001), all adjusted by heart rate. Aortic peak velocity and velocity distribution descriptors, adjusted by heart rate, were significantly different between age groups (P < 0.001, analysis of covariance). Skewness and kurtosis significantly increased (P < 0.001) during adulthood (>40 years) as compared with childhood (<21 years). Men and women revealed significant differences (P <= 0.05) for peak velocity, incidence, mean, median, standard deviation, and skewness, all adjusted by heart rate. Conclusion: Aortic hemodynamics significantly change with age and gender, indicating the importance of age- and gender-matched control cohorts for the assessment of the impact of cardiovascular disease on aortic blood flow.
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