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Article Dans Une Revue Journal of Hypertension Année : 2016

Comprehensive monitoring of cardiac remodeling with aortic stroke volume values provided by a phase-contrast MRI sequence

Olivier Huttin
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Laurent Bonnemains
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Patrick Rossignol
Faiez Zannad

Résumé

OBJECTIVES: Blood pressure (BP) and its changes with antihypertensive therapy are key parameters when monitoring left ventricular (LV) remodeling. This dual cross-sectional and longitudinal MRI study aimed to determine whether this monitoring is enhanced by aortic stroke volume (SV) values provided by a phase-contrast sequence. METHODS: The study involved 334 MRI examinations from 247 study participants who had no significant cardiac disease (18-85 years old, 40% with hypertension) and among whom 48 had a 2-4-year MRI follow-up. Left ventricular hypertrophy and concentric geometry were: respectively assessed according to LV mass indexed to body surface area (g/m) and mass/end-diastolic volume ratio (concentric remodeling index); and correlated with vascular parameters involving BP and the indexed SV (ml/m) determined in the ascending aorta with a phase-contrast sequence. RESULTS: Stroke volume was highly variable, ranging from 22 to 74 ml/m. The best cross-sectional correlates were: mean BP × SV product, reflecting cardiac work, for LV mass (r = 0.21); and mean BP/SV ratio, reflecting arterial load, for concentric geometry (r = 0.29). These two SV-derived parameters led to more than two-fold enhancements in cross-sectional predictions compared with BP parameters alone, whereas their longitudinal changes over time paralleled those of concentric geometry (P = 0.003 for mean BP/SV) and LV mass (P = 0.006 for mean BP × SV), suggesting direct links with cardiac remodeling. CONCLUSION: The determination of aortic SV with a phase-contrast sequence leads to a significant enhancement in the characterization and monitoring of cardiac remodeling.
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Dates et versions

hal-01733041 , version 1 (14-03-2018)

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Pierre-Yves Marie, Damien Mandry, Olivier Huttin, Emilien Micard, Laurent Bonnemains, et al.. Comprehensive monitoring of cardiac remodeling with aortic stroke volume values provided by a phase-contrast MRI sequence. Journal of Hypertension, 2016, 34 (5), pp.967 - 973. ⟨10.1097/HJH.0000000000000889⟩. ⟨hal-01733041⟩
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