Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China.
Department of Ultrasound, Shenyang Women's and Children's Hospital, Shenyang, China.
J Ultrasound Med. 2021 Dec;40(12):2619-2627. doi: 10.1002/jum.15651. Epub 2021 Feb 8.
We aimed to use speckle-tracking echocardiography (STE) to quantify circumferential aortic strain of abdominal aortic aneurysms (AAA) with different size.
A total of 87 AAA patients were included. The morphological variables, including aortic maximum diameter (MD), end systolic area (ESA), end diastolic area (EDA), and thickness and area of intraluminal thrombus (ILT), were measured by ultrasound. STE was applied to calculate circumferential strain (CS) at 6 equally divided segments of the aorta at MD. We evaluated the mean value of peak strain along the 6 segments as global circumferential strain (GCS).
Large AAA (≥5.5 cm) patients had higher MD, ESA, EDA, AAA length, ILT thickness, and area, but lower fractional area change, GCS, and segmental CSs than small AAA (<5.5 cm) subjects (all P < .05). Compared with AAA <4.5 cm group, AAA patients ≥4.5 cm possessed increased MD, ESA, EDA, AAA length, ILT thickness, and area, which results were also reflected in the comparison between AAA <6.5 and ≥6.5 cm group. In small AAA patients, GCS and regional strains in CS1, CS3, and CS5 segments were lower in AAA subjects ≥4.5 cm than those <4.5 cm (all P<.05). However, no significant differences in the GCS and regional CS between ≥6.5 and <6.5 cm group were found. Correlation analysis revealed a significant negative association of GCS with MD, ESA, and EDA, even after adjusting the potential confounding factors (all P < .05).
Our findings may yield insight into the structural strain characteristics of AAA wall with different size, which adds the benefit of using simple echocardiography-derived biomechanics to stratify AAA patients.
我们旨在使用斑点追踪超声心动图（STE）来量化不同大小的腹主动脉瘤（AAA）的周向主动脉应变。
共纳入 87 例 AAA 患者。通过超声测量形态学变量，包括主动脉最大直径（MD）、收缩末期面积（ESA）、舒张末期面积（EDA）以及腔内血栓（ILT）的厚度和面积。STE 用于计算 MD 处主动脉 6 个等分节段的周向应变（CS）。我们评估了沿 6 个节段的峰值应变的平均值作为整体周向应变（GCS）。
大 AAA（≥5.5cm）患者的 MD、ESA、EDA、AAA 长度、ILT 厚度和面积均较高，但分数面积变化、GCS 和节段 CSs 较低（均 P<.05）。与 AAA<4.5cm 组相比，AAA≥4.5cm 患者的 MD、ESA、EDA、AAA 长度、ILT 厚度和面积均增加，AAA≥6.5cm 组与 AAA<6.5cm 组相比也有类似的结果。在小 AAA 患者中，AAA≥4.5cm 患者的 GCS 和 CS1、CS3 和 CS5 节段的局部应变低于 AAA<4.5cm 患者（均 P<.05）。然而，AAA≥6.5cm 与<6.5cm 组之间的 GCS 和区域 CS 没有显著差异。相关性分析显示，GCS 与 MD、ESA 和 EDA 呈显著负相关，即使在调整潜在混杂因素后（均 P<.05）。
我们的发现可能深入了解不同大小 AAA 壁的结构应变特征，这增加了使用简单的超声心动图衍生生物力学来分层 AAA 患者的益处。
