Aortic biomechanics by magnetic resonance: Early markers of aortic disease in Marfan syndrome regardless of aortic dilatation?

Gisela Teixido-Tura, Alban Redheuil, Jose Rodríguez-Palomares, Laura Gutiérrez, Violeta Sánchez, Alberto Forteza, Joao A.C. Lima, David García-Dorado, Artur Evangelista

Research output: Contribution to journalArticlepeer-review

Abstract

Background Previous studies demonstrated the usefulness of MRI in the evaluation of aortic biomechanics in Marfan patients with aortic dilatation. However, these parameters have not been well studied in earlier stages of aortic disease. The present work aimed to study aortic biomechanics: aortic distensibility (AD) and pulse wave velocity (PWV), by MRI in Marfan patients without advanced aortic disease. Methods Eighty consecutive Marfan patients were compared with 36 age- and sex-matched controls. MRI images at the level of ascending, descending and abdominal aorta were used to determine AD and PWV. Results Marfan patients (27 men; age: 32.0 ± 10.5 years; mean aortic root diameter: 37.2 ± 4.6 mm) had lower AD at all levels (ascending 2.6 ± 2.1 vs. 6.2 ± 3.7 mm Hg- 1 · 10- 3, p < 0.001; descending 3.1 ± 2.0 vs. 8.3 ± 4.2, p < 0.001; and abdominal 4.5 ± 2.2 vs. 14.0 ± 5.2, p < 0.001), higher aortic arch PWV (8.1 ± 6.5 vs. 4.3 ± 1.8 m/s, p < 0.01) and ascending-to-abdominal PWV (6.1 ± 3.0 vs. 4.7 ± 1.5 m/s, p < 0.01) compared with controls. Thirty-five Marfan patients had a non-dilated aortic root (mean aortic root diameter: 34.5 ± 3.8 mm). In multivariable analyses, after adjustment for age, pulse pressure and aortic dimensions, AD remained lower and PWV higher in Marfan patients; even Marfan patients with non-dilated aortic root showed impaired aortic biomechanics compared with controls. Z-score for ascending AD < - 3.5 distinguished Marfan patients from controls with 82.5% sensitivity and 86.1% specificity. Conclusions Aortic biomechanics by MRI were abnormal in the entire aorta in Marfan patients. Moreover, Marfan patients without dilated aortic root showed clear impairment of aortic biomechanics, which suggests that they may be used as early markers of aortic involvement in these patients.

Original languageEnglish (US)
Pages (from-to)56-61
Number of pages6
JournalInternational Journal of Cardiology
Volume171
Issue number1
DOIs
StatePublished - Jan 15 2014

Keywords

  • Aortic distensibility
  • Magnetic resonance imaging
  • Marfan syndrome
  • Pulse wave velocity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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