Related Experiment Video
Updated: Feb 9, 2026
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Age-related changes of right atrial morphology and inflow pattern assessed using 4D flow cardiovascular magnetic
Thomas Wehrum1, Thomas Lodemann2, Paul Hagenlocher2
1Department of Neurology and Neuroscience, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 64, 79106, Freiburg, Germany. thomas.wehrum@uniklinik-freiburg.de.
Insights
Aging significantly alters blood flow and geometry in the caval veins and right atrium. Blood flow becomes less helical and more turbulent with age, impacting cardiac assessment.
Area of Science:
- Cardiovascular Imaging
- Hemodynamics
- Geriatric Cardiology
Background:
- Assessing age-related changes in cardiovascular structures is crucial for understanding cardiac health in older populations.
- The caval veins and right atrium (RA) play a vital role in cardiac function and can be affected by aging.
Purpose of the Study:
- To evaluate age-related modifications in blood flow and geometry of the caval veins and right atrium (RA).
- To establish reference values for 4D flow cardiovascular magnetic resonance (CMR) in different age groups.
Main Methods:
- Utilized 4D flow CMR data from an age-stratified population sample (n=126) aged 20-80 years.
- Analyzed blood flow patterns and RA morphology, comparing three age groups (20-39, 40-59, 60-80).
- Assessed inflow patterns in the superior and inferior caval veins and the RA.
Main Results:
- Younger subjects exhibited a clockwise helical blood flow in the RA, which was less common and more turbulent in older subjects.
- An age-related shift in caval vein axis orientation was observed, with lateralization in older individuals.
- Mean and peak systolic blood flow in the caval veins decreased significantly with advancing age.
Conclusions:
- Aging significantly impacts the hemodynamics of the RA inflow tract, altering blood flow patterns and geometry.
- Reference values for 4D CMR blood flow across different age groups were established.
- These age-related effects must be considered when evaluating cardiac conditions in clinical practice.
Background:
To assess age-related changes of blood flow and geometry of the caval veins and right atrium (RA) using 4D flow cardiovascular magnetic resonance (CMR) data obtained in a population-based study.
Methods:
An age-stratified sample (n = 126) of the population of the city of Freiburg, Germany, underwent transthoracic echocardiography and electrocardiogram-triggered and navigator-gated 4D flow CMR at 3 Tesla covering the caval veins and right heart. Study participants were divided into three age groups (1:20-39; 2:40-59; and 3:60-80 years of age). Analysis planes were placed in the superior and inferior caval vein. Subsequently, RA morphology and three-dimensional blood inflow pattern was assessed.
Results:
Blood flow of the RA showed a clockwise rotating helix without signs of turbulence in younger subjects. By contrast, such rotation was absent in 12 subjects of group 3 and turbulences were significantly more frequent (p < 0.001). We observed an age-related shift of the caval vein axis. While the outlets of the superior and inferior caval veins were facing each other in group 1, lateralization occurred in older subjects (p < 0.001). A convergence of axes was observed from lateral view with facing axes in older subjects (p = 0.004). Finally, mean and peak systolic blood flow in the caval veins decreased with age (group 3 < 2 < 1).
Conclusions:
We have provided reference values of 4D CMR blood flow for different age groups and demonstrated the significant impact of age on hemodynamics of the RA inflow tract. This effect of aging should be taken into account when assessing pathologic conditions of the heart in the future.
More Related Videos
11:16In vitro Assessment of Aortic Regurgitation Using Four-Dimensional Flow Magnetic Resonance Imaging
Published on: February 25, 2022
09:36A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
Published on: August 12, 2025
Related Concept Videos
01:27Imaging Studies IV: Magnetic Resonance Imaging
01:24Magnetic Resonance Imaging
01:29Assessment of the Cardiovascular System II: Inspection
Head and Neck
01:25Assessment of the Cardiovascular System IV: Auscultation
Normal Heart Sounds
S1 (First Heart Sound)-
S1 is made by the closure of the mitral and tricuspid valves (atrioventricular valves), marking the beginning of systole.
S2 (Second Heart Sound)-
S2 is made by the closure of the aortic and pulmonic valves (semilunar valves), marking the end of the systole.
01:05Atomic Nuclei: Magnetic Resonance
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...