Clinical relevance of aortic conduit and reservoir function

Area of Science:

• Cardiovascular Imaging
• Biomedical Engineering
• Gerontology

Background:

• Four-dimensional flow (4D flow) cardiovascular magnetic resonance (CMR) can measure aortic conduit and reservoir functions.
• Aortic function assessment is crucial for understanding cardiovascular health, particularly in aging populations and conditions like HFpEF.

Purpose of the Study:

• To investigate the relationship between aging, heart failure with preserved ejection fraction (HFpEF), and aortic conduit and reservoir functions.
• To determine the association of aortic function with renal function decline.

Main Methods:

• Recruited 20 healthy controls (young and old) and 20 HFpEF patients for 4D flow CMR.
• Quantified flow at ascending and descending aorta, systolic flow displacement (FDs), and systolic flow reversal ratio (sFRR).
• Defined aortic conduit function (∆Fs) and reservoir function (descending aortic diastolic stroke volume, DAo SVd).

Main Results:

• Aortic conduit (∆Fs) and reservoir (DAo SVd) functions significantly declined with age.
• HFpEF patients exhibited significantly increased ∆Fs compared to age-matched controls.
• Both ∆Fs and DAo SVd were independent predictors of estimated glomerular filtration rate, indicating association with renal function.

Conclusions:

• Aortic conduit and reservoir functions decline with age and are independently associated with renal functional decline.
• Ascending aortic turbulent flow signatures correlate with diminished aortic conduit and reservoir functions.
• HFpEF is characterized by a progressive decline in aortic conduit and reservoir functions.