Assessment of ascending aorta wall stiffness in hypertensive patients by tissue Doppler imaging and strain Doppler echocardiography

Vitarelli, Antonio; Giordano, M.; Germanò, Giuseppe; Pergolini, Mario; Cicconetti, P.; Tomei, Francesco; Sancini, A.; Battaglia, Daniela; Dettori, Olga; Capotosto, Lidia; Cicco, Valentina De; Maio, Melissa De; Vitarelli, Massimo; Bruno, Pierdonato

doi:10.1136/hrt.2010.198358

Cited by 73 publications

(86 citation statements)

References 35 publications

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“…In particular, medical treatment and left ventricular stroke volume might be confounding factors in such studies. [24][25][26] Among drugs, b-blockers are important because they affect the rate at which the pressure wave develops and thus the rate of change in arterial wall expansion. However, the inclusion of treatment with b-blockers in the analyses did not affect the relationship of Doppler with oscillometric ABI values or their association with other clinical parameters.…”

Section: Discussionmentioning

confidence: 99%

Automated determination of the ankle-brachial index using an oscillometric blood pressure monitor: validation vs. Doppler measurement and cardiovascular risk factor profile

et al. 2011

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The ankle-brachial index (ABI) is a method used widely for peripheral arterial disease (PAD) diagnosis and cardiovascular risk prediction. This study validated automated ABI measurements taken using an oscillometric blood pressure (BP) monitor allowing simultaneous arm-leg BP measurements. A total of 93 patients (hypertension 83%; dyslipidemia 72%; diabetes 45%; cardiovascular disease 23%; smoking 15%) were submitted to Doppler and automated ABI measurements, performed using a professional oscillometric BP monitor (Microlife WatchBP Office; triplicate simultaneous arm-leg BP measurements), in a randomized order. The mean difference between the Doppler reading (1.08±0.17) and (1) the first oscillometric ABI reading was 0.03±0.11, (2) the average of two oscillometric readings was 0.02±0.10 and (3) the average of three oscillometric readings was 0.02 ± 0.09 (Po0.01 for all). Strong correlations were found between oscillometric and Doppler ABI (r 0.80, 0.85 and 0.86 for single and average of two and three oscillometric readings, respectively; Po0.001 for all). Agreement between oscillometric and Doppler ABI in diagnosing PAD (Doppler ABI o0.9) was found in 95% of cases (j 0.79; agreement in diabetics: 94%, j 0.79). A receiver operating characteristic (ROC) curve revealed area under the curve at 0.98, with a 0.97 oscillometric ABI cutoff for optimal sensitivity (92%) and specificity (92%) in diagnosing PAD. Average time for automated ABI measurement was 5.8 vs. 9.3 min for Doppler (Po0.001). Doppler and oscillometric ABI were associated and predicted (multivariate regression analysis) by the same cardiovascular risk factors (pulse pressure, smoking and cardiovascular disease history). Automated ABI measurement using a professional BP monitor allowing simultaneous arm-leg BP measurements appears to be a reliable and faster alternative to Doppler measurement.

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Section: Discussionmentioning

confidence: 99%

Automated determination of the ankle-brachial index using an oscillometric blood pressure monitor: validation vs. Doppler measurement and cardiovascular risk factor profile

et al. 2011

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“…Ascending aorta was imaged at 3 cm above the aortic valve from the parasternal long‐axis view26 (Figure 1A). Systolic aortic diameter (A s ) was measured at the point of maximal anterior motion of the ascending aorta (systole), and diastolic aortic diameter (A d ) was measured at the q wave on ECG (end diastole) using M‐mode echocardiography.…”

Section: Methodsmentioning

confidence: 99%

Ascending Aortic Strain Analysis Using 2‐Dimensional Speckle Tracking Echocardiography Improves the Diagnostics for Coronary Artery Stenosis in Patients With Suspected Stable Angina Pectoris

Fan

et al. 2018

JAHA

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BackgroundArterial stiffening and atherosclerosis tend to coexist. Strain imaging, using a 2‐dimensional speckle tracking (2D‐ST) method, has been used for arterial stiffness assessment and early identification of atherosclerosis. We investigated whether the ascending aortic strain assessed by 2D‐ST echocardiography at rest can predict the presence of coronary artery disease (CAD).Methods and ResultsTwo hundred seventy‐one consecutive patients with suspected stable angina pectoris sequentially underwent exercise treadmill testing, 2‐dimensional echocardiography, M‐mode echocardiography, 2D‐ST echocardiography, and coronary angiography. Circumferential ascending aortic strain (CAAS) and radial ascending aortic strain were assessed by 2D‐ST echocardiography. Ninety‐two patients with coronary lumen area stenosis ≥70% were categorized as having significant CAD. Global CAAS was significantly lower in patients with significant CAD (7.41±2.30% versus 11.54±4.03%; P<0.001) and remained an independent predictor of significant CAD (odds ratio, 0.64 [0.54–0.75]; P<0.001) after multivariate regression. Based on the receiver operating characteristic curve for diagnosing significant CAD, the optimal cut‐off value of global CAAS was ≤9.22% (sensitivity, 86%; specificity, 70%; area under curve=0.82; P<0.001). Global CAAS decreased with increasing severity of CAD and was significantly associated with 3‐vessel disease (odds ratio, 0.58 [0.42–0.79]; P<0.001). Diagnostics for significant CAD were remarkably better for global CAAS combined with exercise treadmill testing than for exercise treadmill testing alone (area under curve=0.88 versus 0.78; P<0.001).ConclusionsGlobal CAAS assessed by 2D‐ST echocardiography at rest was able to predict the presence of significant CAD and identify multivessel disease. In addition, global CAAS combined with exercise treadmill testing remarkably improved the diagnostics for significant CAD.

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“…In each site, the pulse wave progresses, pressure and blood flow velocity change, and ultimately, aortic wall activities are observed (6,25). Thus, aortic wall movements, which bring about differentiation in the diameter of the proximal aortic lumen, enable us capture images of the changes in aortic elastic properties (14)(15)(16)(17)25). Arterial stiffness index determines the elastic properties of the arterial wall, in a manner relatively independent of blood pressure, and aortic distensibility evaluates the ability of the arteries to dilate during the cardiac cycle, and measures the function of the artery (6,7,25).…”

Section: Discussionmentioning

confidence: 99%

“…Aortic systolic diameter (AoS) was measured at the maximum anterior motion of the aorta, and aortic diastolic diameter (AoD) was measured at the peak of the QRS complex on the recorded electrocardiogram, simultaneously (Figure 1). Distensibility and stiffness index of the ascending aorta were calculated by using the following formulaes (14)(15)(16)(17).…”

Section: Echocardiographic Studymentioning

confidence: 99%

“…But the vast majority of these techniques are invasive and time-consuming and may require complex equipment and training. Conventional and tissue Doppler imaging (TDI) echocardiography have been shown to be useful methods in the evaluation of global ventricular functions and elastic properties of the aorta (13)(14)(15)(16)(17). Although increased arterial stiffness index has been formerly shown in various patient groups, including those with CAD, diabetes mellitus (DM), overt hypothyroidism, and SCH on different vascular beds and in different sites such as the radial artery, carotid artery, and aorta (14)(15)(16)(17)(18)(19)(20), as far as we know, no report has evaluated elastic properties of the ascending aorta by TDI in patients with SCH.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of the elasticity properties of the ascending aorta in patients with subclinical hypothyroidism by tissue Doppler imaging

Yurtdaş¹,

Gen

Özcan

et al. 2013

Arq Bras Endocrinol Metab

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Objective: We aimed to investigate whether aortic elastic properties were affected in subclinical hypothyroidism (SCH) by using tissue Doppler imaging (TDI). Subjects and methods: Forty-three patients with newly diagnosed SCH and forty-eight healthy controls were included to the study. Systolic and diastolic diameters of the ascending aorta were measured by M-mode transthoracic echocardiography, and the upper wall velocities of ascending aorta and mitral annulus velocities were measured by TDI. Aortic stiffness index (ASI) and aortic distensibility were computed using the formulas accepted in literature. Results: The clinical and demographic features of both groups were comparable. Aortic distensibility was significantly lower, and ASI was significantly higher in SCH patients than in controls. Systolic aortic upper wall velocity (Sao) was also significantly lower in SCH patients. Early (Eao) and late diastolic aortic upper wall (Aao) velocities did not differ between the two groups. Mitral annulus (Sm, Em, and Am) velocities were also similar between the groups. Sao was negatively correlated with ASI, and positively correlated with aortic distensibility. TSH level was positively correlated with ASI, total cholesterol and low-density lipoprotein-cholesterol, and negatively correlated with aortic distensibility and Sao. Conclusions: In this study, our results showed that SCH is associated with impaired elasticity of the ascending aorta. Elastic properties of the ascending aorta can be directly evaluated by the reproducibly measurement of the upper wall movements of the ascending aorta by TDI in SCH patients. Arq Bras Endocrinol Metab. 2013;57(2):132-8 Keywords Tissue Doppler imaging; subclinical hypothyroidism; stiffness RESUMO Objetivo: Nosso objetivo foi investigar se as propriedades elásticas da aorta são afetadas no hipotireoidismo subclínico (HSC), utilizando o Doppler tecidual (UDT). Sujeitos e métodos: Quarenta e três pacientes com diagnóstico recente de HSC e 48 indivíduos saudáveis foram incluí-dos no estudo. Os diâmetros sistólico e diastólico da aorta foram medidos por ecocardiografia transtorácica modo M e as velocidades de fluxo da parede superior da aorta ascendente e de fluxo transvalvar mitral foram medidas por UDT. O índice de rigidez da aorta (IRA) e a distensibilidade aórtica foram calculados usando fórmulas aceitas na literatura. Resultados: As características clínicas e demográficas dos dois grupos foram comparáveis. A distensibilidade aórtica foi significativamente menor e IRA significativamente maior nos pacientes com HSC do que nos controles. A velocidade de fluxo sistólico na parede aórtica superior (Sao) foi significantemente menor em pacientes com HSC. A velocidade de fluxo diastólico inicial (Eao) e tardio (Aao) na parede aórtica superior e as velocidades de fluxo transvalvar (Sm, Em e Am) não diferiram entre os dois grupos. Sao foi negativamente correlacionada com IRA e positivamente correlacionada com a distensibilidade aórtica. O nível de TSH foi positivamente correlacionado ...

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Assessment of ascending aorta wall stiffness in hypertensive patients by tissue Doppler imaging and strain Doppler echocardiography

Abstract: Ascending aorta TDI provides wall velocity and strain data differentiating hypertensive from healthy adults and reflecting aortic compliance changes related to age and sex and LV diastolic function.

Cited by 73 publications

References 35 publications

Automated determination of the ankle-brachial index using an oscillometric blood pressure monitor: validation vs. Doppler measurement and cardiovascular risk factor profile

Automated determination of the ankle-brachial index using an oscillometric blood pressure monitor: validation vs. Doppler measurement and cardiovascular risk factor profile

Ascending Aortic Strain Analysis Using 2‐Dimensional Speckle Tracking Echocardiography Improves the Diagnostics for Coronary Artery Stenosis in Patients With Suspected Stable Angina Pectoris

Assessment of the elasticity properties of the ascending aorta in patients with subclinical hypothyroidism by tissue Doppler imaging

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