Whole body cardiovascular MRI for the comparison of atherosclerotic burden and cardiac remodelling in healthy South Asian and European adults

Jonathan Weir-McCall, Deirdre B. Cassidy, Jill J. F. Belch, Stephen J. Gandy, J. Graeme Houston (Lead / Corresponding author), Matthew A. Lambert, Roberta C. Littleford, Janice Rowland, Allan D. Struthers, Faisel Khan

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Abstract

OBJECTIVES: To determine the feasibility of using whole body cardiovascular MRI (WB-CVMR) to compare South Asians (SA) - a population known to have a higher risk of cardiovascular disease (CVD) but paradoxically lower prevalence of peripheral arterial disease (PAD) - and Western Europeans (WE).

METHODS: 19 SA and 38 age, gender and BMI matched WE were recruited. All were ≥40 years, free from CVD and with a 10-year risk of CVD <20% as assessed by the ATPIII risk score. WB-CVMR was performed, comprising a whole body angiogram (WBA) and cardiac MR (CMR), on a 3T MRI scanner following dual phase injection of gadolinium based contrast agent. A standardized atherosclerotic score (SAS) was calculated from the WBA, while indexed left ventricular mass and volumes were calculated from the CMR.

RESULTS: SAs exhibited a significantly lower iliofemoral atheroma burden (regional SAS 0.0±0.0 vs 1.9±6.9, p=0.048) and a trend towards lower overall atheroma burden (WB SAS 0.7±0.8 vs 1.8±2.3, p=0.1). They had significantly lower indexed left ventricular mass (46.9±11.8 vs 56.9±13.4ml/m(2), p=0.008), end diastolic volume (63.9±10.4 vs 75.2±11.4ml/m(2), p=0.001), end systolic volume (20.5±6.1 vs 24.6±6.8ml/m(2), p=0.03) and stroke volume (43.4±6.6 vs 50.6±7.9ml/m(2), p=0.001), but with no significant difference in ejection fraction, mass-volume ratio or global functioning index. These differences persisted after accounting for CVD risk factors.

CONCLUSIONS: Whole body cardiovascular MRI (WB-CVMR) can quantify cardiac and atheroma burden, and can detect differences in these metrics between ethnic groups that, if validated, may suggest that the paradoxical high risk of CVD compared with PVD risk may be due to an adverse cardiac haemodynamic status incurred by the smaller heart rather than atherosclerosis.

ADVANCES IN KNOWLEDGE: WB-CVMR can be used to stratify and compare disease between ethnicities.

Original languageEnglish
Article number20150887
Pages (from-to)1-8
Number of pages8
JournalBritish Journal of Radiology
Volume89
Issue number1065
Early online date15 Jul 2016
DOIs
Publication statusPublished - 2016

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Cardiovascular Diseases
Atherosclerotic Plaques
Angiography
Peripheral Arterial Disease
Gadolinium
Ethnic Groups
Stroke Volume
Contrast Media
Atherosclerosis
Hemodynamics
Injections
Population

Cite this

@article{06a665f8dd704770bab9818f6412f333,
title = "Whole body cardiovascular MRI for the comparison of atherosclerotic burden and cardiac remodelling in healthy South Asian and European adults",
abstract = "OBJECTIVES: To determine the feasibility of using whole body cardiovascular MRI (WB-CVMR) to compare South Asians (SA) - a population known to have a higher risk of cardiovascular disease (CVD) but paradoxically lower prevalence of peripheral arterial disease (PAD) - and Western Europeans (WE).METHODS: 19 SA and 38 age, gender and BMI matched WE were recruited. All were ≥40 years, free from CVD and with a 10-year risk of CVD <20{\%} as assessed by the ATPIII risk score. WB-CVMR was performed, comprising a whole body angiogram (WBA) and cardiac MR (CMR), on a 3T MRI scanner following dual phase injection of gadolinium based contrast agent. A standardized atherosclerotic score (SAS) was calculated from the WBA, while indexed left ventricular mass and volumes were calculated from the CMR.RESULTS: SAs exhibited a significantly lower iliofemoral atheroma burden (regional SAS 0.0±0.0 vs 1.9±6.9, p=0.048) and a trend towards lower overall atheroma burden (WB SAS 0.7±0.8 vs 1.8±2.3, p=0.1). They had significantly lower indexed left ventricular mass (46.9±11.8 vs 56.9±13.4ml/m(2), p=0.008), end diastolic volume (63.9±10.4 vs 75.2±11.4ml/m(2), p=0.001), end systolic volume (20.5±6.1 vs 24.6±6.8ml/m(2), p=0.03) and stroke volume (43.4±6.6 vs 50.6±7.9ml/m(2), p=0.001), but with no significant difference in ejection fraction, mass-volume ratio or global functioning index. These differences persisted after accounting for CVD risk factors.CONCLUSIONS: Whole body cardiovascular MRI (WB-CVMR) can quantify cardiac and atheroma burden, and can detect differences in these metrics between ethnic groups that, if validated, may suggest that the paradoxical high risk of CVD compared with PVD risk may be due to an adverse cardiac haemodynamic status incurred by the smaller heart rather than atherosclerosis.ADVANCES IN KNOWLEDGE: WB-CVMR can be used to stratify and compare disease between ethnicities.",
author = "Jonathan Weir-McCall and Cassidy, {Deirdre B.} and Belch, {Jill J. F.} and Gandy, {Stephen J.} and Houston, {J. Graeme} and Lambert, {Matthew A.} and Littleford, {Roberta C.} and Janice Rowland and Struthers, {Allan D.} and Faisel Khan",
note = "The present study was funded by the Souter Charitable Foundation and the Chest, Heart and Stroke Scotland Charity. JRWM is supported by the Wellcome Trust through the Scottish Translational Medicine and Therapeutics Initiative (grant no. WT 085664) in the form of a clinical research fellowship. Neither group had any role in study design, the collection, analysis and interpretation of data; in the writing of the article; nor in the decision to submit the article for publication.",
year = "2016",
doi = "10.1259/bjr.20160342",
language = "English",
volume = "89",
pages = "1--8",
journal = "British Journal of Radiology",
issn = "0007-1285",
publisher = "British Institute of Radiology",
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}

Whole body cardiovascular MRI for the comparison of atherosclerotic burden and cardiac remodelling in healthy South Asian and European adults. / Weir-McCall, Jonathan; Cassidy, Deirdre B.; Belch, Jill J. F.; Gandy, Stephen J.; Houston, J. Graeme (Lead / Corresponding author); Lambert, Matthew A.; Littleford, Roberta C.; Rowland, Janice; Struthers, Allan D.; Khan, Faisel.

In: British Journal of Radiology, Vol. 89, No. 1065, 20150887, 2016, p. 1-8.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Whole body cardiovascular MRI for the comparison of atherosclerotic burden and cardiac remodelling in healthy South Asian and European adults

AU - Weir-McCall, Jonathan

AU - Cassidy, Deirdre B.

AU - Belch, Jill J. F.

AU - Gandy, Stephen J.

AU - Houston, J. Graeme

AU - Lambert, Matthew A.

AU - Littleford, Roberta C.

AU - Rowland, Janice

AU - Struthers, Allan D.

AU - Khan, Faisel

N1 - The present study was funded by the Souter Charitable Foundation and the Chest, Heart and Stroke Scotland Charity. JRWM is supported by the Wellcome Trust through the Scottish Translational Medicine and Therapeutics Initiative (grant no. WT 085664) in the form of a clinical research fellowship. Neither group had any role in study design, the collection, analysis and interpretation of data; in the writing of the article; nor in the decision to submit the article for publication.

PY - 2016

Y1 - 2016

N2 - OBJECTIVES: To determine the feasibility of using whole body cardiovascular MRI (WB-CVMR) to compare South Asians (SA) - a population known to have a higher risk of cardiovascular disease (CVD) but paradoxically lower prevalence of peripheral arterial disease (PAD) - and Western Europeans (WE).METHODS: 19 SA and 38 age, gender and BMI matched WE were recruited. All were ≥40 years, free from CVD and with a 10-year risk of CVD <20% as assessed by the ATPIII risk score. WB-CVMR was performed, comprising a whole body angiogram (WBA) and cardiac MR (CMR), on a 3T MRI scanner following dual phase injection of gadolinium based contrast agent. A standardized atherosclerotic score (SAS) was calculated from the WBA, while indexed left ventricular mass and volumes were calculated from the CMR.RESULTS: SAs exhibited a significantly lower iliofemoral atheroma burden (regional SAS 0.0±0.0 vs 1.9±6.9, p=0.048) and a trend towards lower overall atheroma burden (WB SAS 0.7±0.8 vs 1.8±2.3, p=0.1). They had significantly lower indexed left ventricular mass (46.9±11.8 vs 56.9±13.4ml/m(2), p=0.008), end diastolic volume (63.9±10.4 vs 75.2±11.4ml/m(2), p=0.001), end systolic volume (20.5±6.1 vs 24.6±6.8ml/m(2), p=0.03) and stroke volume (43.4±6.6 vs 50.6±7.9ml/m(2), p=0.001), but with no significant difference in ejection fraction, mass-volume ratio or global functioning index. These differences persisted after accounting for CVD risk factors.CONCLUSIONS: Whole body cardiovascular MRI (WB-CVMR) can quantify cardiac and atheroma burden, and can detect differences in these metrics between ethnic groups that, if validated, may suggest that the paradoxical high risk of CVD compared with PVD risk may be due to an adverse cardiac haemodynamic status incurred by the smaller heart rather than atherosclerosis.ADVANCES IN KNOWLEDGE: WB-CVMR can be used to stratify and compare disease between ethnicities.

AB - OBJECTIVES: To determine the feasibility of using whole body cardiovascular MRI (WB-CVMR) to compare South Asians (SA) - a population known to have a higher risk of cardiovascular disease (CVD) but paradoxically lower prevalence of peripheral arterial disease (PAD) - and Western Europeans (WE).METHODS: 19 SA and 38 age, gender and BMI matched WE were recruited. All were ≥40 years, free from CVD and with a 10-year risk of CVD <20% as assessed by the ATPIII risk score. WB-CVMR was performed, comprising a whole body angiogram (WBA) and cardiac MR (CMR), on a 3T MRI scanner following dual phase injection of gadolinium based contrast agent. A standardized atherosclerotic score (SAS) was calculated from the WBA, while indexed left ventricular mass and volumes were calculated from the CMR.RESULTS: SAs exhibited a significantly lower iliofemoral atheroma burden (regional SAS 0.0±0.0 vs 1.9±6.9, p=0.048) and a trend towards lower overall atheroma burden (WB SAS 0.7±0.8 vs 1.8±2.3, p=0.1). They had significantly lower indexed left ventricular mass (46.9±11.8 vs 56.9±13.4ml/m(2), p=0.008), end diastolic volume (63.9±10.4 vs 75.2±11.4ml/m(2), p=0.001), end systolic volume (20.5±6.1 vs 24.6±6.8ml/m(2), p=0.03) and stroke volume (43.4±6.6 vs 50.6±7.9ml/m(2), p=0.001), but with no significant difference in ejection fraction, mass-volume ratio or global functioning index. These differences persisted after accounting for CVD risk factors.CONCLUSIONS: Whole body cardiovascular MRI (WB-CVMR) can quantify cardiac and atheroma burden, and can detect differences in these metrics between ethnic groups that, if validated, may suggest that the paradoxical high risk of CVD compared with PVD risk may be due to an adverse cardiac haemodynamic status incurred by the smaller heart rather than atherosclerosis.ADVANCES IN KNOWLEDGE: WB-CVMR can be used to stratify and compare disease between ethnicities.

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DO - 10.1259/bjr.20160342

M3 - Article

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VL - 89

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JO - British Journal of Radiology

JF - British Journal of Radiology

SN - 0007-1285

IS - 1065

M1 - 20150887

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