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Jian-hong Zhang

Yun-ping Zhu

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Kun-xian Shu

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Eleanore Kroner

Hildo J Lamb

Pieter J van den Boogaard

Hans-Marc J Siebelink

Ernst E van der Wall

Albert de Roos

Jos J Westenberg

POSTER PRESENTATION Open Access
Leveling of arterial wall stiffness between aortic
arch and left carotid artery due to aging is
associated with reduced volume flow towards the
brain: pulse wave velocity evaluation with high-
field velocity-encoded MRI
Eleanore Kroner1*, Hildo J Lamb2, Pieter J van den Boogaard2, Hans-Marc J Siebelink1, Ernst E van der Wall1,
Albert de Roos2, Jos J Westenberg2
From 16th Annual SCMR Scientific Sessions
San Francisco, CA, USA. 31 January - 3 February 2013
Background
A discrete transition of wall stiffness at the interface of a
compliant aorta and stiffer carotid arteries creates a
reflection site for the aortic pulse wave and conse-
quently limits excessive pulsatile energy transmission
towards the brain. Arterial wall stiffness can be
expressed by the pulse wave velocity (PWV) and dual-
slice one-directional through-plane velocity-encoded
(VE) MRI is well-validated for accurate PWV-assess-
ment. The hypothesis is that with aging, leveling of
PWV across the aortic arch and carotid artery will
occur with negative effect on the flow towards the brain.
The purpose of this study was to evaluate PWV and
volume flow in aorta and carotid artery in younger and
older volunteers using 3T VE MRI.
Methods
Sixteen younger volunteers with age<30 years (mean 25
±3years) and sixteen older volunteers with age>45 years
(mean 56±6years) underwent 3T MRI (Philips) to assess
PWV in the aortic arch and the left carotid artery based on
the transit-time method. PWV in the aortic arch was
acquired from a single VE MRI acquisition (Figure 1A) and
from wave propagation analysis on the velocity-time curves
(Figure 1B). Path length (required for PWV calculation)
was measured manually on a sagittal view of the aorta.
Also cardiac output (stroke volume per heart beat) was
determined from the flow curves. Carotid PWV was
assessed by 2 VE MRI acquisitions, perpendicular to the
left carotid artery (Figure 1C), one proximal at the origin of
the common carotid artery and one distal in the internal
carotid artery, just below the petrous portion. Path length
(required for PWV calculation) was measured manually on
maximal intensity projection a 3D time-of-flight MR angio-
gram. Stroke volume per heart beat was determined from
the flow curves at both levels in the carotid artery.
Results
All measurements are presented in Table 1. Older
volunteers had significant longer aortic arch trajectory.
PWV both in aortic arch as well as carotid artery was
higher in older volunteers. Interestingly, the ratio
between carotid and aortic PWV was significantly
reduced to 1.0 for older volunteers PWV, representing
leveling of wall stiffness. Furthermore, the stroke volume
in the internal carotid artery was significantly lower for
older volunteers, whereas the stroke volume in the
ascending aorta and common carotid artery was not sig-
nificantly different.
Conclusions
PWV leveling between the aortic arch and the left carotid
artery at older age represents increased stiffening of the
aortic arch and is associated with a reduction in volume
flow towards the brain. High-field velocity-encoded MRI
1LUMC, Den Haag, Netherlands
Full list of author information is available at the end of the article
Kroner et al. Journal of Cardiovascular Magnetic
Resonance 2013, 15(Suppl 1):P248
http://www.jcmr-online.com/content/15/S1/P248
© 2013 Kroner et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.
Figure 1 On a longitudional scout image of the aortic arch (1A), a single one-directional through-plane velocity-encoded MRI acquisition was
planned perpendicular to the ascending and proximal descending aorta. Figure 1B represents the resulting flow velocity wave forms assessed at
the two respective sites, illustrating the pulse wave propagation between sites. Figure 1C shows a coronal maximum intensity projection of 3D
time-of-flight data of the carotid arteries, from the origin at the aortic arch to the circle of Willis. Two one-directional velocity-encoded MRI
acquisitions were planned (yellow lines: one proximally at the left common carotid artery just above the aortic arch and one distally just below
the petrous portion of the left internal carotid artery). Figure 1D represents the resulting velocity wave forms assessed at the two respective sites,
illustrating the pulse wave propagation.
Table 1 Properties of pulse wave dynamics of the carotid artery and aortic arch.
Young Old p
Trajectory aortic arch (mm) 99 ± 17 132 ± 17 <0.001
Trajectory left carotid artery (mm) 175 ± 11 173 ± 12 0.65
PWVaorta (m/s) 4.9 ± 0.7 7.4 ± 1.4 <0.001
PWVcarotid artery (m/s) 5.7 ± 1.0 6.9 ± 1.5 0.002
Ratio (PWVcarotid artery/PWVaorta) 1.2 ± 0.2 1.0 ± 0.2 0.006
Cardiac output (ml/beat) 94 ± 22 87 ± 12 0.30
Carotid stroke volume
Common carotid artry (ml/beat) 7.7 ± 1.9 7.7 ± 2.0 0.99
Internal carotid artery (ml/beat) 5.6 ± 1.4 4.7 ± 1.3 0.06
Relative reduction (%) 26 ± 12 39 ± 8 0.002
Kroner et al. Journal of Cardiovascular Magnetic
Resonance 2013, 15(Suppl 1):P248
http://www.jcmr-online.com/content/15/S1/P248
Page 2 of 3
is well-suited for PWV evaluation across vascular
trajectories.
Funding
This study is supported by an unconditional grant pro-
vided by Dr. Rainer Bluemm (Essen, Germany).
Author details
1LUMC, Den Haag, Netherlands. 2Radiology, LUMC, Leiden, Netherlands.
Published: 30 January 2013
doi:10.1186/1532-429X-15-S1-P248
Cite this article as: Kroner et al.: Leveling of arterial wall stiffness
between aortic arch and left carotid artery due to aging is associated
with reduced volume flow towards the brain: pulse wave velocity
evaluation with high-field velocity-encoded MRI. Journal of
Cardiovascular Magnetic Resonance 2013 15(Suppl 1):P248.
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Kroner et al. Journal of Cardiovascular Magnetic
Resonance 2013, 15(Suppl 1):P248
http://www.jcmr-online.com/content/15/S1/P248
Page 3 of 3


Leveling of arterial wall stiffness between aortic arch and left carotid artery due to aging is associated with reduced volume flow towards the brain: pulse wave velocity evaluation with high-field velocity-encoded MRI

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