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The Effects of Age and Gender on Cardiac Structure and Function in Healthy Chinese Adult Population: A Multiparameter Cardiac Magnetic Resonance Imaging Study1Department of Medical Imaging, Jinling Hospital, Nanjing Clinical School, Southern Medical University, Nanjing, China, Nan Jing, China, 2Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China, Nan Jing, China, 3GE Healthcare，MR Research China，Bejing, P.R. China, Beijing, China, 4GE Healthcare, MR Enhanced Application China, Beijing, P.R. China., Beijing, China
Synopsis
With gender difference and age growing, the cardiac structure and function maychange in healthy population. The present study aimed to for the first time systematically investigate the impact of age and gender on cardiac structure and function by using cine MR, T1 mapping and intravoxel incoherent motion diffusion weighted imaging (IVIM DWI). In the present study, we have found cardiac structure and function significant difference between male and female healthy volunteers.Further studies are ongoing to examine a large cohort.
Introduction
CMR has been widely used as a non-invasive tool for diagnosis or differential diagnosis in many cardiac disease 1. It is important to investigate the effects of age and gender on cardiac structure and function. To the best of our knowledge, no previous multiparameter cardiac MR studies had been published in the Chinese population.Therefore, the present study aims to investigate the impact of age and gender on cardiac structure and function by using cine MR, T1 mapping and intravoxel incoherent motion diffusion weighted imaging (IVIM DWI) in Chinese healthy adults
Materials and Methods
This clinical study was approved by the local Institution Review Board. Written informed consent was obtained from all subjects.
Subjects: Twenty-eight (17 males and 11 females) healthy volunteers were enrolled in this study.The inclusions criteria are: 1) age≥ 18 years, 2) without any cardiovascular diseases,3) without hypertension, hyperglycemia, hyperlipidemia or severe anemia. The subjects were grouped according to sex (male and female groups) and age (younger[≤ 45 years] and older groups [＞ 45 years]). The characteristics of these subjects can be seen in Table 1.
MRI experiment: All subjects underwent cine-MRI, pre- and post-contrast T1 mapping and IVIM DWI on a 3.0-T scanner (Discovery 750, GE healthcare, USA) with an 8-channel cardiac dedicated phased coil with respiratory gating and pulse gating applied. The corresponding scan parameters of these techniques can be found in Table 2.
Data analysis: The cine data and T1 maps were analyzed by using CVI42 software (Circle Cardiovascular Imaging Inc., Calgary, Canada). The IVIM DWI data were analyzed using Functool software embedded in a GE workstation (AW 4.6). Bothmono-exponential (ME) model and bi-exponential (BE) model2 were employed to analyze IVIM-DWI data. The resultant standard apparent diffusion coefficient (ADC)from ME model as well as the fast and slow ADCs from BE model were thus obtained.The defined region of interest (ROI) was shown in Figure 1. In addition, the ECV was calculated by using the formula defined as ECV = (Δ[1/T1Myo]/ Δ[1/T1Blood]) * [1-Hct])1
All statistical analyses were performed using IBM SPSS Statistics 20. All continuous variables were expressed as mean ±standard deviation. For quantitative continuous variables, the independent student’s t-test was performed if normal distribution was found between female and male groups and between younger and older groups.Correlation analyses were performed by using Pearson (normal distribution data) or Spearman correlation analysis (non-normal distribution data). All statistical tests were two-tailed, and p-values of less than 0.05 were considered statistically significant.
Results
The effect of gender on cardiac structure and function was found. Healthy male volunteers had higher left ventricular ejection fraction (LVEF), cardiac output (CO),myocardial mass diastolic (MMD), myocardial mass systolic (MMS) than those in females (all P＜ 0.05). Native T1 measured at blood pool in male was lower than that in female subjects (P < 0.05), while post-contrast T1 values and ECV had no difference between male and female (all P＞ 0.05). Comparable values were found for all IVIM-DWI parameters (all P＞ 0.05) (Tables 3 and 4).No significant difference was found for all above-mentioned cardiac MR parameters between young subjects and older subjects (all P＞ 0.05).Significant correlation was only found between age and standard ADC (r=-0.533,p=0.033), while no correlations were observed between age/sex and other cardiac MR parameters (all P＞ 0.05).Discussion and conclusion
We investigated the impact of age and gender on cardiac structure and function in a cohort of healthy Chinese adults using multi parameter CMR imaging techniques. We then found sex had an effect on cardiac structure and function evaluated by cine-MRI and T1 mapping, while age had no effect on cardiac structure and function. To the best of our knowledge, this is the first study investigating the effect of age and sex effect on cardiac diffusion and perfusion measured with IVIM-DWI. Additionally, we also observed that there is a negative correlation between standard ADC and age.In conclusion, the present study showed that gender has an impact on cardiac structure and function in a healthy adult Chinese population. Further studies are ongoing to examine a large cohort.Acknowledgements
NoneReferences
1. Moon JC, Messroghli DR, Kellman P, et al. Myocardial T1 mapping and extracellular volume quantification: a society for cardiovascular magnetic resonance (SCMR) and CMR working group of the European Society ofCardiology consensus statement. J Cardiovasc Magn Reson, 2013, 15: 922.
2. Bai Y, Lin Y, Tian J, et al. Grading of Gliomas by Using Monoexponential, Biexponential, and Stretched Exponential Diffusion-weighted MR Imaging and Diffusion Kurtosis MR Imaging. Radiology 2016; 278:496-504
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