Department of Ultrasound Diagnosis, Second Xiangya Hospital of Central South University, Changsha, 410000, China.
Int J Cardiovasc Imaging. 2024 Feb;40(2):397-405. doi: 10.1007/s10554-023-03003-9. Epub 2023 Nov 22.
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.
主动脉僵硬度是心血管事件和发病率的一个重要危险因素。主动脉僵硬度的增加与心脏和血管高血压相关的器官损伤的增加有关。使用速度向量成像（VVI）评估动脉高血压（AH）患者的升主动脉（AA）的生物力学特性。前瞻性纳入 95 例 AH 患者和 53 例正常健康对照者。通过 VVI 评估 AA 生物力学特性，即升主动脉整体纵向应变（ALS）、升主动脉整体周向应变（ACS）和面积分数变化（FAC）。计算相对壁厚度（RWT）和左心室质量（LVM）。还获得了脉冲多普勒早期二尖瓣口血流速度（E）、早期舒张二尖瓣环速度（e'）、左心室整体纵向应变（GLS）、顺应性（D）和 AA 僵硬度指数（SI）。与正常健康对照组相比，AH 患者的 ALS、ACS 和 FAC 明显降低，尤其是升主动脉扩张（AAD）患者。AAD 患者的 E/e'比值、RWT、LVM 和 SI 较高，GLS 和 D 较低，而无 AAD 患者和正常健康志愿者则较低（p<0.05）。生物力学特性与 D、SI、E/e'和 GLS 之间存在显著相关性（ALS 和 D：r=0.606，ALS 和 SI：r=-0.645，ALS 和 E/e'：r=-0.489，ALS 和 GLS：r=0.466，ACS 和 D：r=0.564，ACS 和 SI：r=-0.567，ACS 和 E/e'：r=-0.313，ACS 和 GLS：r=0.320，FAC 和 D：r=0.649，FAC 和 SI：r=-0.601，FAC 和 E/e'：r=-0.504，FAC 和 GLS：r=0.524，p<0.05）。AH 患者的 AA 生物力学特性受损，尤其是升主动脉扩张的患者。高血压与舒张和收缩功能障碍以及动脉僵硬度增加的发生率较高有关。需要进一步研究来评估 VVI 对 AA 生物力学特性的临床应用。
