Aortic arch mechanics measured with two-dimensional speckle tracking echocardiography

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Abstract

Purpose:

To study the feasibility of vascular mechanics at the aortic arch with two-dimensional speckle tracking echocardiography, as well as to define normal values and to compare results between hypertensive patients and healthy patients.

Methods:

We included 107 patients (61 healthy patients and 46 hypertensive patients) who underwent a complete echocardiographic exam, including a short-axis view of the aortic arch. The speckle tracking methodology was used to calculate aortic arch mechanics offline (EchoPAC; GE Healthcare). The analysis was performed for circumferential aortic strain and for the early circumferential aortic strain rate, and we used an average result of the six equidistant segments of the arterial wall. We also assessed the aortic pulse wave velocity with the Complior method.

Results:

The 61 healthy patients had a mean age of 33 ± 9 years, and 59% were women. Of the total 366 aortic arch wall segments, 344 (94%) had adequate waveforms for the speckle tracking analysis. The hypertensive patients had a mean age of 45 ± 12 years, and 54% were women. Of the total 276 aortic wall segments, 261 (95%) had adequate waveforms for analysis. Aortic arch strain and strain rate were lower in the hypertensive patients group than in the healthy patients group (6.3 ± 2.0 vs. 11.2 ± 3.2% and 1.0 ± 0.3 vs. 1.5 ± 0.4 s−1, respectively, both P < 0.01). Aortic arch strain and strain were correlated with age (r = −0.62, r = −0.54; P < 0.01), pulse pressure (r = −0.48, r = −0.39; P < 0.01) and the pulse wave velocity (r = −0.57, r = −0.54; P < 0.01). After adjustments for age, sex and BMI, strain was significantly lower in hypertensive patients, when compared with healthy patients.

Conclusion:

Speckle tracking analysis of aortic arch images is feasible and might serve as a new approach to evaluate arterial function.

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