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Biomechanical properties of the ascending aorta in patients with arterial hypertension by velocity vector imaging

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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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Abbreviations

AA:

Ascending aorta

AH:

Arterial hypertension

VVI:

Velocity vector imaging

ALS:

Ascending aortic global longitudinal strain

ACS:

Ascending aortic global circumferential strain

FAC:

Fractional area change

PP:

Pulse pressure

E:

Pulsed Doppler early transmitral peak flow velocity

e′:

Early diastolic mitral annular velocity

D:

Distensibility

SI:

Stiffness index

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

LAD:

Left atrial diameter

LVEDD:

LV end-diastolic diameter

RWT:

Relative wall thickness

LVM:

Left ventricular mass

HR:

Heart rate

EF:

Ejection fraction

SOV:

Sinus of valsalva

ASCs:

Ascending aorta

GLS:

The global longitudinal strain

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Acknowledgements

We thank all the patients and control subjects for their participation in this study.

Funding

This work was supported by the State Natural Sciences Foundation of China (Nos. 81871372 and 81801721) and the Natural Science Foundation of Hunan Province (Nos. 2019JJ40425 and 2019JJ50880).

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Authors and Affiliations

  1. Department of Ultrasound Diagnosis, Second Xiangya Hospital of Central South University, Changsha, 410000, China

    Li Yu, Ganqiong Xu, Qichang Zhou, Mingzhi Ouyang, Lei Gao & Shi Zeng

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  1. Li Yu
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  4. Mingzhi Ouyang
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Contributions

GQ, X and ZR, Y collected general clinical data of the patients and measured blood pressure. SZ and LY consulted the relevant literature. LY performed ultrasound ex-amination and analyzed the patient data. LY was the main contributor to the manuscripts. All authors reviewed the manuscript.

Corresponding author

Correspondence to Shi Zeng.

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The authors declare no competing interests.

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Supplementary Information

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10554_2023_3003_MOESM1_ESM.jpg

In figure A, the velocity vector image of the traced ascending aorta is shown in the parasternal long-axis view. In figure B, green and white represent the anterior wall of the ascending aorta, and blue and yellow represent the posterior wall of the ascending aorta. In figure C, the velocity vector image of the traced ascending aorta is shown in the great artery short-axis view. In figure D, green represents the anterior wall of the ascending aorta, white represents the left lateral wall of the ascending aorta, blue represents the posterior wall of the ascending aorta, and purple represents the right lateral wall of the ascending aorta. Supplementary material 1 (JPG 8124.7 kb)

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Yu, L., Xu, G., Zhou, Q. et al. Biomechanical properties of the ascending aorta in patients with arterial hypertension by velocity vector imaging. Int J Cardiovasc Imaging 40, 397–405 (2024). https://doi.org/10.1007/s10554-023-03003-9

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  • DOI: https://doi.org/10.1007/s10554-023-03003-9

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