Skip to main content

13.07.2019 | Original Paper Open Access

Validation of simple measures of aortic distensibility based on standard 4-chamber cine CMR: a new approach for clinical studies

Clinical Research in Cardiology
Lukas Stoiber, Niky Ghorbani, Marcus Kelm, Titus Kuehne, Nina Rank, Tomas Lapinskas, Christian Stehning, Burkert Pieske, Volkmar Falk, Rolf Gebker, Sebastian Kelle
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00392-019-01525-8) contains supplementary material, which is available to authorized users.



Aortic distensibility (AD) represents a well-established parameter of aortic stiffness. It remains unclear, however, whether AD can be obtained with high reproducibility in standard 4-chamber cine CMR images of the descending aorta. This study investigated the intra- and inter-observer agreement of AD based on different angles of the aorta and provided a sample size calculation of AD for future trials.


Thirty-one patients underwent CMR. Angulation of the descending aorta was performed to obtain strictly transversal and orthogonal cross-sectional aortic areas. AD was obtained both area and diameter based.


For area-based values, inter-observer agreement was highest for 4-chamber AD (ICC 0.97; 95% CI 0.93–99), followed by orthogonal AD (ICC 0.96; 95% CI 0.91–98) and transversal AD (ICC 0.93; 95% CI 0.80–97). For diameter-based values, agreement was also highest for 4-chamber AD (ICC 0.97; 95% CI 0.94–99), followed by orthogonal AD (ICC 0.96; 95% CI 0.92–98) and transversal AD (ICC 0.91; 95% CI 0.77–96). Bland–Altman plots confirmed a small variation among observers. Sample size calculation showed a sample size of 12 patients to detect a change in 4-chamber AD of 1 × 10−3 mmHg−1 with either the area or diameter approach.


AD measurements are highly reproducible and allow an accurate and rapid assessment of arterial compliance from standard 4-chamber cine CMR.

Graphic abstract

Unsere Produktempfehlungen

Neuer Inhalt


e.Med Interdisziplinär


Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Jetzt e.Med bestellen und 100 € sparen!

Über diesen Artikel

Neu im Fachgebiet Kardiologie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Kardiologie und bleiben Sie gut informiert – ganz bequem per eMail.