Prognostic Value of Aortic Stiffness using Cardiovascular Magnetic Resonance in The Elderly with Known or Suspected Coronary Artery Disease
3
Issued Date
2022-01-01
Resource Type
ISSN
0066782X
eISSN
16784170
Scopus ID
2-s2.0-85130698300
Pubmed ID
35613197
Journal Title
Arquivos Brasileiros de Cardiologia
Volume
118
Issue
5
Start Page
961
End Page
971
Rights Holder(s)
SCOPUS
Bibliographic Citation
Arquivos Brasileiros de Cardiologia Vol.118 No.5 (2022) , 961-971
Suggested Citation
Kaolawanich Y. Prognostic Value of Aortic Stiffness using Cardiovascular Magnetic Resonance in The Elderly with Known or Suspected Coronary Artery Disease. Arquivos Brasileiros de Cardiologia Vol.118 No.5 (2022) , 961-971. 971. doi:10.36660/abc.20210452 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/86536
Title
Prognostic Value of Aortic Stiffness using Cardiovascular Magnetic Resonance in The Elderly with Known or Suspected Coronary Artery Disease
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Background: Aortic stiffness is established as a marker of cardiovascular disease. Cardiovascular magnetic resonance (CMR) provides a comprehensive assessment of aortic stiffness and myocardial ischemia in a single examination. However, prognostic data concerning aortic stiffness in elderly patients remain limited. Objective: To determine the prognostic value of aortic stiffness using CMR-based pulse wave velocity (PWV) in elderly patients with known or suspected coronary artery disease (CAD). Methods: This study enrolled consecutive patients aged >70 referred for adenosine stress perfusion CMR including PWV between 2010 and 2014. Patients were followed up for occurrence of major adverse cardiovascular events (MACE), including cardiac mortality, nonfatal myocardial infarction, hospitalization for heart failure, late revascularization (>180 days after CMR), and ischemic stroke. Univariable and multivariable analyses were performed to determine the predictors of MACE. A p-value of <0.05 is considered statistically significant. Results: Mean PWV was 13.98±9.00 m/s. After a median follow-up period of 59.6 months in 263 patients (55% female, 77±5 years), 61 MACE occurred. Patients with elevated PWV (>13.98 m/s) had significantly higher rates of MACE (HR 1.75; 95% CI 1.05-2.94; p=0.03) than those with non-elevated PWV (<13.98 m/s). Multivariate analysis demonstrated diastolic blood pressure, left ventricular ejection fraction (LVEF), myocardial ischemia, and elevated PWV as independent predictors for MACE (p<0.05 for all). PWV provided an incremental prognostic value over clinical data, LVEF, and ischemia (increased global chi-square=7.25, p=0.01). Conclusion: Aortic stiffness using CMR is a strong and independent predictor of cardiovascular events in elderly patients with known or suspected CAD.