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To assess the value of aortic diastolic flow measured by cardiac magnetic resonance (CMR) imaging as a marker for thoracic aorta elastic properties in Marfan syndrome (MFS) patients.
Materials and Methods
CMR imaging was performed in 146 patients with MFS to measure systolic, diastolic flow, diastolic ratio (diastolic flow divided by systolic flow), distensibility at the descending aorta at the level of the pulmonary bifurcation, and pulse wave velocity (PWV) of the total aorta at baseline and after 3 years of follow-up. Diastolic ratio was also measured in 10 non-Marfan controls.
During 3 years of follow-up, diastolic ratio decreased from 23.8 to 20.3 (p<0.001), Diastolic ratio was lower in Marfan patients than controls (15.9 vs 21.2, p=0.03), distensibility decreased from 3.6 mmHg-1 to 3.3 mmHg-1 (p=0.007), aortic diameter at the diaphragm increased from 20.5 mm to 20.9mm (p<0.001), and proximal descending aorta diameter from 23.6 mm to 24.2 mm (p<0.001). Diastolic ratio was found to have a significant negative correlation with age (r=-0.295, p<0.001), aortic diameter (r=-0.294, p<0.001), and PWV of the total aorta (r=-0.360, p<0.001), and a significant positive correlation with distensibility (r=0.318, p<0.001). While no correlation was found with diastolic or mean arterial blood pressure. Interestingly, patients developed aortic dissection (n=3) during follow-up were having a lower diastolic ratio at baseline compared to the patients without a dissection (7.9 versus 24.2, p=0.008).
Diastolic ratio measured by CMR can be regarded as a new easy method for assessment of thoracic aorta elastic properties.