Abstract 12714: Superior Longitudinal Aortic Strain and Ventriculoarterial Coupling in Older Women is Independent of Body Size, Blood Pressure, and Moderately Correlated With Framingham 10-year Risk

Background: Traditional risk factors are less helpful in predicting cardiovascular (CV) risk in women (1, 2). We used a novel cardiac MRI (CMR) method to determine sex differences in aortic global longitudinal strain (AoGLS), pulse wave velocity (AAPWV), and ventriculoarterial coupling (VAC) and correlated to Framingham Risk Scores (FRS).

Methods: Community adults without CV disease underwent CMR. AoGLS was the maximal absolute Lagrangian strain tracking the phasic distance between brachiocephalic artery origin and aortic annulus. VAC was calculated as AAPWV divided by LVGLS. Sex-specific simplified FRS 10-year risk (TYR) and Heart/Vascular Age (HVA) were derived from pooled cohort equations (3).

Results: These n=202 subjects (46% female) were similar in age (69.7 vs. 70.7, p=0.433). Women had better AAPWV (8.4m/s vs. 9.1m/s, p=0.020), AoGLS (6.2% vs. 5.2%, p=0.030), LVGLS (-21.9% vs. -20.1%, p=0.021), RVGLS (-32.8% vs. -29.9%, p=0.020), VAC (-0.39m/s·% vs. -0.47m/s·%, p=0.006), and smaller cardiac volumes (Table A). Female sex was associated with better AoGLS (β=0.838, p=0.030; R ² =0.103) and VAC (β=-0.93, p=0.006; R ² =0.113) independent of smoking, DBP, and BSA. Age only weakly correlated with AoGLS (β=-0.128 p<0.001; R ² =0.277). AoGLS correlated moderately with FRS in women (TYR r=-0.400 p=<0.001; HVA r=-0.621 p<0.001) and weakly in men (TYR r=-0.354 p=<0.001; HVA r=-0.365 p=<0.001). VAC was associated with adverse TYR (β=-6.915, p=0.017; R ² =0.145) and HVA (β=-14.948, p=0.001; R ² =0.084); VAC correlated moderately with FRS in women (TYR r=-0.233 p=0.024; HVA r=-0.364 p<0.001) but not in men (TYR r=-0.175 p=0.068; HVA r=-0.183 p=0.056).

Conclusion: Novel CMR-derived aortic strain identified sex differences in aortic age correlating with 10-year CV risk. Women had better aorto-ventricular strain and coupling independent of DBP and BSA. Chronological age was not useful in estimating aortic age. Advanced aortic imaging may augment CV risk assessment in women.