Juan Wu1, Yongkai Pei1, Yanli Wang1, Jiamei Ji1, Min Gong1, Wenhui Gu2, Haibo Wu3, Yanru Jiang1, Jun Wu4. 1. Department of Ultrasound, the Second Affiliated Hospital of Dalian Medical University, Dalian, China. 2. Department of Health Management Center, the Second Affiliated Hospital of Dalian Medical University, Dalian, China. 3. Department of Cardiovascular Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, China. 4. Department of Cardiovascular Ultrasound, the Second Affiliated Hospital of Dalian Medical University, Dalian, China.
Abstract
OBJECTIVE: To explore the value of ascending aortic longitudinal strain (LS) in identification of hypertensive (HP) patients with a high risk of type A aortic dissection (AAD). METHODS: Total 40 primary HP patients with AAD (group C), 80 selected age- and sex-matched primary HP patients (group A, normal-sized ascending aorta (AA), n = 40; group B, dilated AA, n = 40) and 40 healthy volunteers were enrolled in this study. Brachial blood pressures were measured, and the aortic stiffness index (β) determined by M-mode analysis was calculated as a conventional parameter of arterial stiffness. The LS of the anterior and posterior ascending aortic wall (AW-LS and PW-LS) were determined. RESULTS: Compared to the control group (34.21 ± 5.25%), the mean LS of AA in HP patients (group A 28.6 ± 5.95%; group B 23.64 ± 4.98%; group C 17.93 ± 3.96%; P < .001) were significantly reduced. Multivariate logistic regression analysis showed that the mean LS (OR 0.719, 95% CI 0.615-0.839, P < .001) and pulse pressure (PP) (OR 1.055, 95% CI 1.006-1.106, P = .028) were identified as independent predictors of AAD in HP patients. The AUC of mean LS combined with PP reached 0.926 (sensitivity, 95.0%; specificity, 82.5%), which was higher than the mean LS, PP, stiffness index, and ascending aortic diameter (AAd) separately. Besides, the AW-LS and PW-LS were negatively correlated with the AAd, stiffness index, stroke volume, systolic blood pressure, and PP, respectively (P < .001). CONCLUSION: The LS of AA evaluated by two-dimensional speckle tracking echocardiography decreased significantly along with the expansion of aortic lumen and the occurrence of AAD in HP patients. It is also an independent predictor of AAD in HP patients.
OBJECTIVE: To explore the value of ascending aortic longitudinal strain (LS) in identification of hypertensive (HP) patients with a high risk of type A aortic dissection (AAD). METHODS: Total 40 primary HP patients with AAD (group C), 80 selected age- and sex-matched primary HP patients (group A, normal-sized ascending aorta (AA), n = 40; group B, dilated AA, n = 40) and 40 healthy volunteers were enrolled in this study. Brachial blood pressures were measured, and the aortic stiffness index (β) determined by M-mode analysis was calculated as a conventional parameter of arterial stiffness. The LS of the anterior and posterior ascending aortic wall (AW-LS and PW-LS) were determined. RESULTS: Compared to the control group (34.21 ± 5.25%), the mean LS of AA in HP patients (group A 28.6 ± 5.95%; group B 23.64 ± 4.98%; group C 17.93 ± 3.96%; P < .001) were significantly reduced. Multivariate logistic regression analysis showed that the mean LS (OR 0.719, 95% CI 0.615-0.839, P < .001) and pulse pressure (PP) (OR 1.055, 95% CI 1.006-1.106, P = .028) were identified as independent predictors of AAD in HP patients. The AUC of mean LS combined with PP reached 0.926 (sensitivity, 95.0%; specificity, 82.5%), which was higher than the mean LS, PP, stiffness index, and ascending aortic diameter (AAd) separately. Besides, the AW-LS and PW-LS were negatively correlated with the AAd, stiffness index, stroke volume, systolic blood pressure, and PP, respectively (P < .001). CONCLUSION: The LS of AA evaluated by two-dimensional speckle tracking echocardiography decreased significantly along with the expansion of aortic lumen and the occurrence of AAD in HP patients. It is also an independent predictor of AAD in HP patients.
Authors: Matheus F R A Oliveira; Walter E M Rocha; Julia D Soares; Victor M F S L'Armée; Mayara P G Martins; Aloísio M Rocha; Audes D M Feitosa; Ricardo C Lima; Pedro P M Oliveira; Lindemberg M Silveira-Filho; Otavio R Coelho-Filho; José R Matos-Souza; Orlando Petrucci; Andrei C Sposito; Wilson Nadruz Journal: Front Cardiovasc Med Date: 2022-01-21