Proximal aortic compliance and diastolic function assessed by speckle tracking imaging

Abstract

Purpose Speckle tracking imaging (STI) is a recent technique that evaluates an echocardiographic image throughout the cardiac cycle and provides dynamic variables such as tissue velocities and strain rates. The objective of our study was to determine 1) if STI can be used to quantify proximal aortic compliance and 2) if decreased aortic compliance determined by STI will reproduce the previously reported correlation with diastolic function. Methods This was a retrospective observational case series using previously obtained intraoperative transesophageal images. Diastolic performance was quantified by STI-based longitudinal velocities of the basal-septal and basal-lateral walls of the left ventricle in early diastole (LV E 0 ). Change in proximal aortic volume was calculated using STI to measure peak longitudinal and radial velocities in early diastole. After normalizing for mean arterial pressure, compliance was calculated and then compared with basal-septal and basal-lateral LV E 0 using single regression analysis.Results Twenty patients were included in our analysis. Linear regression of basal-septal LV E 0 and basal-lateral LV E 0 vs proximal aortic compliance during diastole each resulted in an R 2 value of 0.26 (P \ 0.05). Conclusion Speckle tracking can be used to describe the physical motion of the aortic wall and to calculate its compliance. We confirm that variation in diastolic function can be attributed, in part, to aortic compliance. Our novel approach of measuring compliance throughout the cardiac cycle, isolating radial and longitudinal contributions, and evaluating previously obtained images retrospectively provides advantages over previously reported measures of aortic compliance. Speckle tracking promises new insights into ventricular function, aortic mechanics, and the interaction between these structures. RésuméObjectif L'imagerie de suivi de pixel, ou speckle tracking imaging (STI) en anglais, est une technique re´cente qui permet d'e´valuer une image e´chocardiographique tout au long du cycle cardiaque et d'obtenir des variables dynamiques telles que les ve´locite´s tissulaires et les vitesses de de´formation. L'objectif de notre e´tude e´tait de de´terminer si 1) la STI pouvait eˆtre utilise´e pour quantifier la compliance de l'aorte proximale, et si 2) une compliance aortique re´duite telle que de´termine´e par la STI reproduisait la corre´lation avec la fonction diastolique rapporte´e pre´ce´demment. Méthode Cette e´tude est une se´rie de cas observationnelle re´trospective se fondant sur des images transoesophagiennes perope´ratoires obtenues par le passe´. La performance diastolique a e´te´quantifie´e par les ve´locite´s longitudinales fonde´es sur la STI des parois basales septales et basales late´rales du ventricule gauche en de´but de diastole (LV E 0 ). Les changements de volume de l'aorte proximale ont e´teć alcule´s à l'aide de la STI afin de mesurer les ve´locite´s

Increased Arterial Stiffness Is Associated With Reduced Diastolic Function in Youth With Obesity and Type 2 Diabetes

“…Adult studies have demonstrated that increased pulse pressure (a crude surrogate for arterial stiffness) is independently predictive of not only diastolic dysfunction ( 15 – 17 ) but also heart failure with preserved ejection fraction ( 18 , 19 ). In addition, carotid artery wall stiffness ( 20 , 21 ) and aortic compliance, a similar parameter, positively correlate with LV diastolic function ( 22 ). Similar to our results, increased PWV is independently associated with diastolic dysfunction in patients with hypertension ( 23 ), type 2 diabetes ( 24 ), clustered CV risk factors ( 25 ), and suspected coronary artery disease ( 26 , 27 ).…”

From concept to publication: Celebrating mentorship and knowledge generation through research during postgraduate residency training

“…Dr. A. Gregory et al from the University of Calgary reports on the utility of TEE to calculate aortic compliance and ventricular mechanics using relatively new ''speckle tracking'' software in combination with a blood pressure trace. 5 This is a further demonstration of the increasing potential for ultrasound in clinical practice. It is also obvious that further research is required before this methodology can be employed; however, this study shows feasibility in the clinical context.…”

“…Dr A. Gregory et coll., de l'Université de Calgary, décrivent l'utilité de l'É TO pour calculer la compliance aortique et la mécanique ventriculaire à l'aide d'un logiciel de 'suivi de pixel' relativement nouveau, combiné à un tracé de la tension artérielle. 5 Il s'agit ici d'une autre démonstration du potentiel grandissant de l'échographie dans la pratique clinique. Il est également évident que des recherches supplémentaires seront nécessaires avant que cette méthodologie ne puisse être employée; toutefois, cette étude montre la faisabilité d'une telle application dans le contexte clinique.…”

Non-invasive Determination of Aortic Mechanical Properties and Their Effects on Left Ventricular Function Following Endovascular Abdominal Aneurysm Repair

“…STI analysis was further applied to the ascending aorta using the EchoPac software's pre-set for two-chamber LV images using a method we have previously described [4]. This method includes adjusting the software's pre-set spatial and timing filters to the lowest level.…”

“…Elevated measures of arterial stiffness (central and peripheral) have been shown to negatively impact LV systolic and diastolic function, impair coronary blood flow, and have been identified as a risk factor for cardiovascular disease and mortality [1][2][3][4][5][6][7][8][9]. One possible mechanism for these findings is that increased arterial stiffness can create additional LV work while simultaneously making coronary perfusion less efficient.…”