Aortic function in a longitudinal 4D flow MRI study in Marfan syndrome patients receiving Resveratrol

Abstract

Background: New treatment strategies are required to reduce aortic events in Marfan syndrome (MFS). Resveratrol is a dietary supplement that intervenes in aortic wall cellular metabolism and may benefit MFS patients.

Purpose: To evaluate whether treatment with Resveratrol affects aorta hemodynamics derived from 4D flow MRI in MFS.

Study Type: Prospective single-arm open-label multicenter trial. Population: 46 MFS patients (mean age 36 +/- 9 years, 23 female), 20 with and 26 without a history of aortic root surgery (RR and native MFS), and 25 age- and sex-matched healthy controls. Field Strength/Sequence 3T, temporally resolved 3D phase contrast (4D flow MRI) and 3D mDixon sequences. Assessment: MFS patients underwent 4D flow MRI before (baseline) and after 1 year of 500 mg daily Resveratrol treatment (follow-up). Velocity magnitude and wall shear stress (WSS) in six regions in the thoracic aorta were evaluated. Incidence maps showing abnormal hemodynamics compared to healthy controls were generated. Pulse wave velocity (PWV) was assessed in 45 subjects. The relationships between MRI parameters and annual aortic growth from the 3D mDixon scans and age were investigated. Statistical Tests: Student's paired and unpaired t-tests, Fisher's exact tests, McNemar's exact test, and Pearson correlation coefficients (r). Statistical significance was defined as p < 0.05. Results: No significant changes in any of the hemodynamic parameters were observed: inner descending aorta WSS (Pa), native: from 1.08 +/- 0.21 to 1.08 +/- 0.17, p = 0.818, RR: from 1.02 +/- 0.29 to 0.98 +/- 0.21, p = 0.270; velocity (m/s), native: from 0.64 +/- 0.10 to 0.65 +/- 0.10, p = 0.359, RR: 0.68 +/- 0.15, to 0.67 +/- 0.12, p = 0.629; abnormally directed WSS incidence: native: from 17 (65%) to 14 (54%), p = 0.453, RR: 13 (65%) to 13 (65%), p = 1.000; PWV (m/s) native: from 7.7 +/- 1.9 to 7.9 +/- 1.8, p = 0.582, RR: 9.2 +/- 1.6 to 8.2 +/- 3.2, p = 0.184. PWV correlated with age in RR MFS patients (r = 0.59, n = 19). Data Conclusion: No significant changes in aortic hemodynamics derived from 4D flow MRI were observed after 1 year of Resveratrol treatment.