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Yu L, Xu G, Zhou Q, Ouyang M, Gao L, Zeng S. Biomechanical properties of the ascending aorta in patients with arterial hypertension by velocity vector imaging. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2024; 40:397-405. [PMID: 37991691 DOI: 10.1007/s10554-023-03003-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 10/31/2023] [Indexed: 11/23/2023]
Abstract
Aortic stiffness is an important risk factor for cardiovascular events and morbidity. Increased aortic stiffness is associated with an increase in cardiac and vascular hypertension-related organ damage. To evaluate the biomechanical properties of the ascending aorta (AA) in patients with arterial hypertension (AH) by velocity vector imaging (VVI). Ninety-five patients with AH and 53 normal healthy control participants were prospectively enrolled. AA biomechanical properties, i.e., ascending aortic global longitudinal strain (ALS), ascending aortic global circumferential strain (ACS), and fractional area change (FAC), were evaluated by VVI. Relative wall thickness (RWT) and left ventricular mass (LVM) were calculated. Pulsed Doppler early transmitral peak flow velocity (E), early diastolic mitral annular velocity (e'), left ventricular global longitudinal strain (GLS), distensibility (D) and stiffness index (SI) of AA were also obtained. The ALS, ACS and FAC were significantly lower in the AH patients, especially in those with ascending aorta dilatation (AAD), than in the normal healthy control subjects. The patients with AAD had a higher E/e' ratio, RWT, LVM and SI and a lower GLS and D than patients without AAD and normal healthy volunteers (p < 0.05). There were significant associations between biomechanical properties and D, SI, E/e' and GLS (ALS and D: r = 0.606, ALS and SI: r = - 0.645, ALS and E/e': r = - 0.489, ALS and GLS: r = 0.466, ACS and D: r = 0.564, ACS and SI: r = - 0.567, ACS and E/e': r = - 0.313, ACS and GLS: r = 0.320, FAC and D: r = 0.649, FAC and SI: r = - 0.601, FAC and E/e': r = - 0.504, FAC and GLS: r = 0.524, respectively, p < 0.05). The biomechanical properties of AA were impaired in patients with AH, especially patients with ascending aorta dilatation. Hypertension is associated with a high prevalence of diastolic and systolic dysfunction and increased arterial stiffness. Further study is needed to evaluate the clinical application of AA biomechanical properties by VVI.
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Affiliation(s)
- Li Yu
- Department of Ultrasound Diagnosis, Second Xiangya Hospital of Central South University, Changsha, 410000, China
| | - Ganqiong Xu
- Department of Ultrasound Diagnosis, Second Xiangya Hospital of Central South University, Changsha, 410000, China
| | - Qichang Zhou
- Department of Ultrasound Diagnosis, Second Xiangya Hospital of Central South University, Changsha, 410000, China
| | - Mingzhi Ouyang
- Department of Ultrasound Diagnosis, Second Xiangya Hospital of Central South University, Changsha, 410000, China
| | - Lei Gao
- Department of Ultrasound Diagnosis, Second Xiangya Hospital of Central South University, Changsha, 410000, China
| | - Shi Zeng
- Department of Ultrasound Diagnosis, Second Xiangya Hospital of Central South University, Changsha, 410000, China.
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Wang Y, Gong M. Evaluation of aortic biomechanics in patients with aortic disease via imaging: A review. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:458-466. [PMID: 34669189 DOI: 10.1002/jcu.23087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/26/2021] [Accepted: 10/01/2021] [Indexed: 06/13/2023]
Abstract
As a bridge between the heart and the arteries, the aorta plays an important role in the cardiovascular system. The morbidity and mortality of aortic disease are extremely high, which is a serious threat to human life. The biomechanical abnormality of the aorta is an important factor of a series of pathological changes in the aortic wall. At present, there are many imaging methods to evaluate the biomechanics of the aorta, which will benefit to the early diagnosis and treatment of aortic disease. In this review, we describe the application of various imaging methods and parameters in aortic disease.
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Affiliation(s)
- Yanli Wang
- Department of Cardiovascular Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Min Gong
- Department of Cardiovascular Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
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Oliveira MFRA, Rocha WEM, Soares JD, L'Armée VMFS, Martins MPG, Rocha AM, Feitosa ADM, Lima RC, Oliveira PPM, Silveira-Filho LM, Coelho-Filho OR, Matos-Souza JR, Petrucci O, Sposito AC, Nadruz W. Impact of Hypertension History and Blood Pressure at Presentation on Cardiac Remodeling and Mortality in Aortic Dissection. Front Cardiovasc Med 2022; 8:803283. [PMID: 35127863 PMCID: PMC8813851 DOI: 10.3389/fcvm.2021.803283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 12/20/2021] [Indexed: 01/20/2023] Open
Abstract
Objective This study compared clinical, echocardiographic, and prognostic characteristics among patients with aortic dissection (AD) with (HypHist) and without (No-HypHist) hypertension history and evaluated the association of blood pressure (BP) at presentation with 1-year mortality, left ventricular (LV) remodeling and renal dysfunction. Methods We investigated clinical and echocardiographic characteristics and 1-year mortality among 367 patients with AD (81% HypHist, 66% Type-A) from three Brazilian centers. Results Patients with No-HypHist were more likely to have Marfan syndrome, bicuspid aortic valve, to undergo surgical therapy, were less likely to have LV hypertrophy and concentricity, and had similar mortality compared with HypHist patients. Adjusted restricted cubic spline analysis showed that systolic BP (SBP) and diastolic BP (DBP) at presentation had a J-curve association with mortality among patients with No-HypHist, but did not associate with death among patients with HypHist (p for interaction = 0.001 for SBP and = 0.022 for DBP). Conversely, the association between SBP at presentation and mortality was influenced by previous use of antihypertensive medications in the HypHist group (p for interaction = 0.002). Results of multivariable logistic regression analysis comprising the whole sample showed direct associations of SBP and DBP at presentation with LV hypertrophy (p = 0.009) and LV concentricity (p = 0.015), respectively, and an inverse association between pulse pressure at presentation and estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 (p = 0.008). Conclusion Combined information on BP at presentation, previous diagnosis of hypertension, and use of antihypertensive medications might be useful to predict mortality risk and to estimate extra-aortic end-organ damage among patients with AD.
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Affiliation(s)
- Matheus F. R. A. Oliveira
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas, São Paulo, Brazil
| | - Walter E. M. Rocha
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas, São Paulo, Brazil
| | - Julia D. Soares
- Pronto Socorro Cardiológico de Pernambuco, University of Pernambuco, Recife, Brazil
| | | | - Mayara P. G. Martins
- Department of Cardiology, Pontifical Catholic University of Campinas, Campinas, Brazil
| | - Aloísio M. Rocha
- Department of Cardiology, Pontifical Catholic University of Campinas, Campinas, Brazil
| | - Audes D. M. Feitosa
- Pronto Socorro Cardiológico de Pernambuco, University of Pernambuco, Recife, Brazil
- Catholic University of Pernambuco Clinical Research Institute, Catholic University of Pernambuco, Recife, Brazil
| | - Ricardo C. Lima
- Pronto Socorro Cardiológico de Pernambuco, University of Pernambuco, Recife, Brazil
| | - Pedro P. M. Oliveira
- Department of Surgery, School of Medical Sciences, State University of Campinas, São Paulo, Brazil
| | | | - Otavio R. Coelho-Filho
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas, São Paulo, Brazil
| | - José R. Matos-Souza
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas, São Paulo, Brazil
| | - Orlando Petrucci
- Department of Surgery, School of Medical Sciences, State University of Campinas, São Paulo, Brazil
| | - Andrei C. Sposito
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas, São Paulo, Brazil
| | - Wilson Nadruz
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas, São Paulo, Brazil
- *Correspondence: Wilson Nadruz Jr.
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