Impact of Arterial Stiffness on Echocardiographic Myocardial Work Indices in Patients with Isolated Bicuspid Aortic Valve (original) (raw)
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European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology, 2009
Patients with heart failure (HF) show abnormal arterial stiffening. We examined 60 patients (52.1 +/- 12, 8 years) with non-ischaemic dilated cardiomyopathy (NIDC), New York Heart Association II-III, in sinus rhythm, left ventricular ejection fraction 30.1 +/- 8.6%, and 44 normals. All subjects underwent an echocardiographic study and a cardiopulmonary exercise test. We evaluated the segmental proximal aorta (AO) pulse wave velocity (PWV) in the region of aortic arch with a new echo-method: from the suprasternal view, the distance between ascending and descending AO was measured with two-dimensional ultrasound, and the aortic flow wave transit time (TT) was measured with pulsed-wave Doppler. Pulse wave velocity was calculated as aortic distance/TT. Patients showed increased PWV (7.4 +/- 2.9 vs. 4.8 +/- 1.1 m/s, P < 0.001), compared with controls. Patients with advanced left ventricular (LV) (restrictive or pseudo-normal filling pattern) diastolic dysfunction showed increased PWV ...
An Echocardiographic Study for Assessment the Indices of Arterial and Ventricular Stiffness
IFMBE Proceedings, 2010
Arterial stiffness represents an important risk factor for cardiovascular diseases. The cardio-ankle vascular index (CAVI) has been recently reported as a new index of arterial stiffness, which is less influenced by blood pressure than pulse wave velocity. We investigated the relationship between CAVI and myocardial ischemia as assessed by supine exercise echocardiography (SEE). In order to study the ejection characteristics of the left ventricle (LV) a computer model describing the LV systole in different preloading conditions was developed, allowing the evaluation of the wall stress at end-systole and the end-systolic pressure. Using echocardiographic recordings, we investigated the relationship between the vascular and ventricular stiffness indices.
Journal of Cardiac Failure, 2007
Arterial stiffness (AS) has a detrimental effect on cardiovascular system particularly on left ventricle (LV). The aim of the study was to evaluate the impact of AS on LV functions in patients with rheumatoid arthritis (RA). Forty patients with RA and 25 age-sex matched control subjects (mean age 48.5 ± 6.3 vs. 45.1 ± 6.9 years, respectively, p=0.06) were enrolled in study. AS was assessed by carotidfemoral pulse wave velocity (CF-PWV) and heart rate corrected augmentation index (AIx@75) measured by applanation tonometry (SphygmoCor). LV function was evaluated using tissue Doppler-derived myocardial performance index (MPI) from lateral mitral annulus. CF-PWV (28.3±10.3 vs. 21.8±9.3 m/s, p=0.03), AIx@75 (10.2±2.3 vs. 9.2±1, %, p=0.01) and MPI (0.46±0.12 vs. 0.36±0.1, p<0.001) were significantly higher in patients with RA than in controls. LV MPI was found to be significantly positive correlated with CF-PWV, AIx@75, and ESR (r=0.360, p=0.005; r=0.334, p=0.009; r=0.293, p=0.023, respectively). Arterial stiffness parameters including CF-PWVand AIx@75 are associated with subclinical left ventricular dysfunction in patients with RA.
European Heart Journal – Cardiovascular Imaging, 2016
Background: To evaluate the interventricular cardiac relationship, Doppler measurement of Qp/Qs by transthoracic echocardiography (TTE) has been used. It is complicated to do, however, and cannot evaluate interventricular relationship in the same cardiac phase. In recent echocardiographic examination, TAPSE (tricuspid annular plane of systolic excursion) and MAPSE (mitral annular plane of systolic excursion) have become widely used to assessment and quantification of the ventricular function. TAPSE and MAPSE can be evaluated using single echocardiographic view of four chamber view, but could not be evaluate in same cardiac cycle until the speckle tracking method introduce. To conquer this problem, we suppose to use the speckle tracking method. Speckle tracking method is an image analyzing technique to trace the local speckle pattern in B-mode of TTE. In practice, on simply placing ROI (region of interesting) to both the lateral tricuspid annulus and the lateral mitral annulus, based to apex, we will be able to evaluate TAPSE and MAPSE in the same cardiac cycle. We have hypothesized these; 1) the relationship of TAPSE and MAPSE in the same cardiac cycle could be a new surrogate indicator of interventricular functional relationship or dyssynchrony. 2) In AS patients, this relation could be different from healthy individuals. Purpose: This study was conducted to evaluate whether the relationship of TAPSE and MAPSE on the same cardiac cycle using the speckle tracking method could be a indicator of interventricular relationship in the patients with severe aortic stenosis. Methods: This study has been approved by our institutional review board. We prospectively recruited 20 healthy adult volunteers and 20 patients with severe AS that were indicated for TAVI. Using TTE, we measured TAPSE and MAPSE with speckle tracking method under a resting condition in addition to standard measurements. We analyzed maximum distance and duration time of tricuspid and mitral annular displacement in trans-apical 4ch view by Q-LABV R (Phillips electronicsV C) and a2DQ (auto 2D quantification) software in EPIQ 7G(Phillips electronicsV C). Statistical analysis was made with ANOVA and the Pearson's correlation analysis, and p < 0.05 was considered significant. Result: Healthy adult volunteers have no difference in TAPSE and MAPSE time phase (p ¼ 0.1516). Severe AS patients have restricted MAPSE (p ¼ 4.331*10-10) and retracted time phase (p ¼ 0.0014). (Figure) Conclusion: This study showed that the large interventricular mismatch in cardiac time phase has occurred in severe AS patients whereas not in healthy volunteers. The time phase deviation between TAPSE and MAPSE might become one of the possible indicators of the severity in a reduced ventricular function.
Central pulse pressure and augmentation index in asymptomatic bicuspid aortic valve disease
International Journal of Cardiology, 2011
Increased central pulse pressure (CPP) and augmentation index (AIx) relate to cardiovascular events in healthy individuals and were shown to be increased in persons with heritable aortic disease such as Marfan syndrome or Marfan-like syndromes . Bicuspid aortic valve disease has a prevalence of ≤2% in the general population, and affected persons may be at risk for cardiovascular complications including aortic aneurysm and aortic dissection. We scrutinized whether CPP and AIx were increased in bicuspid aortic valve disease under standard medical care and whether these increases related to other clinical characteristics.
Journal of the American College of Cardiology, 2015
Aortic stenosis (AS) and aortic regurgitation (AR) are associated with congenital isolated bicuspid aortic valve (BAV) disease. The chronic pressure overload of AS and the volume overload of AR are known to impair the left ventricular function. This study assessed whether two-dimensional speckle tracking echocardiography (2D-STE) is capable of detecting the myocardial dysfunction associated with BAV caused by various aortic valve lesions in patients retaining normal ejection fraction (EF). Thirty-two isolated BAV patients and 20 healthy tricuspid aortic valve (TAV) volunteers were recruited. BAV patients were divided into 4 subgroups based on aortic valvular lesion types: normal function (NF) group, isolated AS group, isolated AR group, and a group who had both AS&AR. Myocardial strain and degree of twist were analyzed and compared between the BAV and TAV groups, as well as between valvular lesion groups and the NF group. Compared with healthy TAV controls, global radial strain (GRS), global circumferential strain (GCS), global longitudinal strain (GLS), and twist angle absolute values were lower in the BAV group (P < 0.05). The AS, AR, and AS&AR groups all demonstrated a significant decrease in GRS and GCS when compared with the TAV group. The AS and AS&AR groups demonstrated lower GLS than the TAV group, and the smallest degree of twist was detected in the AR group. There were no significant differences between the NF and TAV groups. The AR and AS&AR groups demonstrated significant differences in multiple parameters of cardiac mechanics compared with the NF group. 2D-STE is able to detect altered cardiac mechanics associated with aortic lesion types in BAV patients with normal EF compared with normal TAV controls, and so can provide valuable information for clinical decision-making.