Bieseviciene Monika, Vaskelyte Jolanta Justina, Mizariene Vaida, Karaliute Rasa, Lesauskaite Vaiva, Verseckaite Raimonda
Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Eivenių Str. 2, Kaunas, 50009, Lithuania.
Institute of Cardiology at Lithuanian University of Health Sciences, Kaunas, Lithuania.
BMC Cardiovasc Disord. 2017 Jan 13;17(1):27. doi: 10.1186/s12872-016-0434-9.
Two-dimensional (2D) echocardiography is one of the most feasible, noninvasive methods for assessing the aortic diameter and biomechanical changes. We studied possible interfaces between noninvasive biomechanical and speckle-tracking (ST) echocardiographic data from dilated aortas.
Altogether, 44 patients with dilative pathology of ascending aorta (DPAA) were compared with subjects without ascending aortic dilation (diameter <40 mm). DPAA patients formed two groups based on diameter size: group 1, ≤45 mm diameter; group 2, >45 mm. Conventional and 2D-ST echocardiography were performed to evaluate peak longitudinal strain (LS), longitudinal (LD) and transverse (TD) displacement, and longitudinal velocity (VL). Aortic strain, distensibility, elastic modulus, stiffness index β of Valsalva sinuses and ascending aorta were also evaluated. SPSS version 20 was used for all analyses.
All linear diameters of the ascending aorta were increased in group 2 (>45 mm diameter) (p < 0.05). LD of the anterior aortic wall (p < 0.05) and TD of both aortic walls (p < 0.001) were least in group 2. VL of the posterior and anterior walls diminished in group 2 (p = 0.01). Aortic strain and distensibility were least (p = 0.028 and p = 0.001, respectively) and elastic modulus and stiffness index β values were greatest in group 2, although without statistical significance.
Ascending aortas of both DPAA groups had reduced elasticity and increased stiffness. The greatest changes in biomechanical parameters occurred in ascending aortas >45 mm. Longitudinal ascending aortic wall motion was mostly impaired in patients with aortas >45 mm (i.e., anterior aortic wall LD, VL of the posterior and anterior walls. TD of the posterior and anterior aortic walls was significantly lower in >45 mm aortic diameter patients. TD of 5.2 mm could predict aortic dilation >45 mm (area under the curve 0.76, p < 0.001, confidence interval 0.65-0.87; sensitivity 87%; specificity 63%). Greater aortic dilation is associated with reduced aortic stiffness parameters and increased elastic modulus and stiffness index β. Lower LD and LS were associated with less aortic strain and distensibility. There were no significant differences in 2D-ST echocardiographic or stiffness parameters between patients with tricuspid or bicuspid aortic valves.
二维超声心动图是评估主动脉直径和生物力学变化最可行的无创方法之一。我们研究了扩张主动脉的无创生物力学与斑点追踪（ST）超声心动图数据之间可能的关联。
总共44例升主动脉扩张病变（DPAA）患者与升主动脉未扩张（直径<40mm）的受试者进行比较。DPAA患者根据直径大小分为两组：1组，直径≤45mm；2组，直径>45mm。进行传统和二维ST超声心动图检查，以评估纵向峰值应变（LS）、纵向（LD）和横向（TD）位移以及纵向速度（VL）。还评估了主动脉应变、扩张性、弹性模量、主动脉窦和升主动脉的硬度指数β。所有分析均使用SPSS 20版。
2组（直径>45mm）升主动脉的所有线性直径均增加（p<0.05）。2组主动脉前壁的LD（p<0.05）和主动脉两壁的TD（p<0.001）最小。2组后壁和前壁的VL降低（p=0.01）。2组主动脉应变和扩张性最小（分别为p=0.028和p=0.001），弹性模量和硬度指数β值最大，尽管无统计学意义。
两个DPAA组的升主动脉弹性降低，硬度增加。生物力学参数的最大变化发生在直径>45mm的升主动脉中。主动脉直径>45mm的患者升主动脉壁纵向运动大多受损（即主动脉前壁LD、后壁和前壁的VL。主动脉直径>45mm患者的主动脉后壁和前壁TD明显更低。5.2mm的TD可预测主动脉扩张>45mm（曲线下面积0.76，p<0.
