Required temporal resolution for accurate thoracic aortic pulse wave velocity measurements by phase-contrast magnetic resonance imaging and comparison with clinical standard applanation tonometry

BACKGROUND: Pulse wave velocity (PWV) is a biomarker for arterial stiffness, clinically assessed by applanation tonometry (AT). Increased use of phase-contrast cardiac magnetic resonance (CMR) imaging allows for PWV assessment with minor routine protocol additions. The aims were to investigate the acquired temporal resolution needed for accurate and precise measurements of CMR-PWV, and develop a tool for CMR-PWV measurements. METHODS: Computer phantoms were generated for PWV = 2–20 m/s based on human CMR-PWV data. The PWV measurements were performed in 13 healthy young subjects and 13 patients at risk for cardiovascular disease. The CMR-PWV was measured by through-plane phase-contrast CMR in the ascending aorta and at the diaphragm level. Centre-line aortic distance was determined between flow planes. The AT-PWV was assessed within 2 h after CMR. Three observers (CMR experience: 15, 4, and <1 year) determined CMR-PWV. The developed tool was based on the flow-curve foot transit time for PWV quantification. RESULTS: Computer phantoms showed bias 0.27 ± 0.32 m/s for a temporal resolution of at least 30 ms. Intraobserver variability for CMR-PWV were: 0 ± 0.03 m/s (15 years), -0.04 ± 0.33 m/s (4 years), and -0.02 ± 0.30 m/s (<1 year). Interobserver variability for CMR-PWV was below 0.02 ± 0.38 m/s. The AT-PWV overestimated CMR-PWV by 1.1 ± 0.7 m/s in healthy young subjects and 1.6 ± 2.7 m/s in patients. CONCLUSIONS: An acquired temporal resolution of at least 30 ms should be used to obtain accurate and precise thoracic aortic phase-contrast CMR-PWV. A new freely available research tool was used to measure PWV in healthy young subjects and in patients, showing low intra- and interobserver variability also for less experienced CMR observers.