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Evaluation of aortic stiffness by a new simplified 2D speckle tracking analysis

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Abstract

Arterial stiffness is a marker of cardiovascular damage and an independent predictor of major cardiovascular events, usually assessed via Carotid-Femoral Pulse Wave Velocity (cfPWV). The aim of this study was to test the feasibility and usefulness of aortic strain analysis using a simplified transthoracic echocardiography (TTE) speckle-tracking (ST) based method. 60 consecutive patients with normal blood pressure and aortic dimensions underwent TTE and cfPWV evaluation. Strain analysis was performed on the largest section of the ascending aorta (aA) with a dedicated software; three couples of speckles were identified within the anterior and posterior aortic wall and transverse segments connecting each couple traced. Peak ascending Aorta Strain (PaAS) was defined as the averaged peak percentage deformation of these segments during the cardiac cycle; aortic stiffness index β2 was defined as 100 × Ln(SBP/DBP)/PaAS. 17 patients were excluded for suboptimal TTE images. In the 43 analyzed individuals (male 58%, age 63 years) PaAS was 5.5 [3.7–8.6] % with excellent inter and intra observer reproducibility (ICC 95% for both). PaAS showed significant correlation with age (r = − 0.64), aA diameter (r = − 0.45), cfPWV (r = − 0.41), stroke volume (r = − 0.41) and heart rate (r = − 0.49). Age remained the only independent determinant of PaAS in a multivariate analysis. β2 (10.8 [5.9–15.0]) showed significant direct correlation with age, Pulse pressure, aA diameter and cfPWV. A simplified strain analysis of the ascending aorta is technically feasible with good reproducibility; PaAS and β2 index correlate well with established parameters of arterial stiffness and might represent a new index in evaluating vascular biomechanics.

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Abbreviations

aA:

Ascending aorta

cfPWV:

Carotid-femoral pulse wave velocity

PaAS:

Peak ascending aorta strain

ST:

Speckle tracking

TTE:

Transthoracic echocardiography

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Author notes

  1. Luca Sabia and Eleonora Avenatti contributed equally to this work.

Authors and Affiliations

  1. Internal Medicine and Hypertension Division, Department of Medical Sciences, AOU Città della Salute e della Scienza of Turin, University of Turin, Turin, Italy

    Luca Sabia, Eleonora Avenatti, Marco Cesareo, Dario Leone, Francesco Tosello, Franco Veglio & Alberto Milan

Authors
  1. Luca Sabia
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  2. Eleonora Avenatti
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  3. Marco Cesareo
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  4. Dario Leone
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  5. Francesco Tosello
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  6. Franco Veglio
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  7. Alberto Milan
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Correspondence to Alberto Milan.

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Sabia, L., Avenatti, E., Cesareo, M. et al. Evaluation of aortic stiffness by a new simplified 2D speckle tracking analysis. Int J Cardiovasc Imaging 34, 1753–1760 (2018). https://doi.org/10.1007/s10554-018-1400-7

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  • DOI: https://doi.org/10.1007/s10554-018-1400-7

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