Purpose. The aim of this study was to investigate the potential clinical application of tissue Doppler imaging (TDI) for motion measurement of the aortic wall in healthy and hypertensive adults. Methods. We examined 52 hypertensive without a history of coronary artery disease (negative echo-stress test) and 52 age- and sex-matched healthy adults. Pulse wave velocity (PWV) was measured as a standard parameter of arterial stiffness by oscillometric pulse wave analysis system (TensioMed Arteriograph, Hungary). Aortic M-mode and TDI parameters were measured 3 cm above the aortic valve. Aortic distensibility (D) and aortic stiffness index (SI) were calculated using accepted formulae. Maximum velocity of the first and second systolic wall expansion peaks (S, S1,cm/sec), acceleration time (AT, msec), maximum velocity of early (E, cm/sec) and late (L, cm/sec) diastolic retraction velocity peaks of the ascending aorta and wall peak systolic strain (ps-e, %) were determined (EchoPAC, version 9.0, GE Ultrasound). Results. In hypertensive patients S, E and ps-e were significantly lower in hypertensive than in healthy subjects. Reduced D, increased PWV and increased SI indicated increased aortic stiffness in both male and female hypertensive subjects. Age, diastolic blood pressure and sex were significant independent factors modulating S, while diastolic blood pressure and age were significant independent factors modulating E. PWV increased and D decreased with increasing age or systolic blood pressure. Duration of hypertension correlated with SI (r=0.59, p<0.005), distensibility (r=−0.55, p<0.005) and S velocity (r=−0.65, p<0.001). There was a negative correlation between aortic stiffness and S velocity (r=−0.53, p<0.005). Multiple stepwise linear regression analysis in the hypertension group revealed that aortic S velocity (β=0.34, p=0.006), ps-e (β=0.39, p=0.007) and duration of hypertension (β=−0.53, p=0.001) were the main predictors of aortic distensibility (overall R2 = 0.56). Conclusion. Our data show that TDI measurement of ascending aortic wall motion provides wall motion features differentiating hypertensive from healthy adults and reflecting aortic compliance changes related to age and sex.
Assessment of ascending aorta wall distensibility in healthy and hypertensive subjects by Tissue Doppler Imaging / Vitarelli, Antonino; Giordano, Marcello; G., Germanò; Continanza, Giovanna; Dettori, Olga; Capotosto, Lidia; V., DE CICCO; M., DE MAIO; P., Bruno; A., Latorre. - In: HYPERTENSION. - ISSN 0194-911X. - STAMPA. - (2009), pp. 156-157. (Intervento presentato al convegno 63rd High Blood Pressure Research Conference, Chicago, IL tenutosi a Chicago, IL nel September 23-26, 2009).
Assessment of ascending aorta wall distensibility in healthy and hypertensive subjects by Tissue Doppler Imaging
VITARELLI, Antonino;GIORDANO, MARCELLO;CONTINANZA, GIOVANNA;DETTORI, OLGA;CAPOTOSTO, LIDIA;
2009
Abstract
Purpose. The aim of this study was to investigate the potential clinical application of tissue Doppler imaging (TDI) for motion measurement of the aortic wall in healthy and hypertensive adults. Methods. We examined 52 hypertensive without a history of coronary artery disease (negative echo-stress test) and 52 age- and sex-matched healthy adults. Pulse wave velocity (PWV) was measured as a standard parameter of arterial stiffness by oscillometric pulse wave analysis system (TensioMed Arteriograph, Hungary). Aortic M-mode and TDI parameters were measured 3 cm above the aortic valve. Aortic distensibility (D) and aortic stiffness index (SI) were calculated using accepted formulae. Maximum velocity of the first and second systolic wall expansion peaks (S, S1,cm/sec), acceleration time (AT, msec), maximum velocity of early (E, cm/sec) and late (L, cm/sec) diastolic retraction velocity peaks of the ascending aorta and wall peak systolic strain (ps-e, %) were determined (EchoPAC, version 9.0, GE Ultrasound). Results. In hypertensive patients S, E and ps-e were significantly lower in hypertensive than in healthy subjects. Reduced D, increased PWV and increased SI indicated increased aortic stiffness in both male and female hypertensive subjects. Age, diastolic blood pressure and sex were significant independent factors modulating S, while diastolic blood pressure and age were significant independent factors modulating E. PWV increased and D decreased with increasing age or systolic blood pressure. Duration of hypertension correlated with SI (r=0.59, p<0.005), distensibility (r=−0.55, p<0.005) and S velocity (r=−0.65, p<0.001). There was a negative correlation between aortic stiffness and S velocity (r=−0.53, p<0.005). Multiple stepwise linear regression analysis in the hypertension group revealed that aortic S velocity (β=0.34, p=0.006), ps-e (β=0.39, p=0.007) and duration of hypertension (β=−0.53, p=0.001) were the main predictors of aortic distensibility (overall R2 = 0.56). Conclusion. Our data show that TDI measurement of ascending aortic wall motion provides wall motion features differentiating hypertensive from healthy adults and reflecting aortic compliance changes related to age and sex.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
