Aortic stiffness is strikingly increased with age ≥ 50 years in clinically normal individuals and preclinical patients with cardiovascular risk factors: assessment by the new technique of 2D strain echocardiography.

Cardiovascular Section, Higashi Tokushima Medical Center, National Hospital Organization, 1-1 Ohmukai-kita, Ohtera, Itano, Tokushima 779-0193, Japan.
Journal of Cardiology (Impact Factor: 2.3). 02/2011; 57(3):354-9. DOI: 10.1016/j.jjcc.2010.12.003
Source: PubMed

ABSTRACT Various measures of aortic stiffness have been proposed as cardiovascular risk markers, but interest has now shifted to more direct and easier evaluation of aortic function. The present study was conducted to determine the feasibility of measuring aortic stiffness (β) with two-dimensional (2D) strain echocardiography and the impact of age and gender on preclinical atherosclerosis.
The peak circumferential strain of the abdominal aorta was measured using 2D strain echocardiography, and β was determined in 54 clinically normal individuals and 104 patients with cardiovascular risk factors and no evidence of cardiovascular disease. The β correlated significantly with age in all 158 patients. However, the relationship was nonlinear, and β was markedly greater in patients ≥ 50 years. In 54 clinically normal individuals, the relationship was comparatively linear. The systolic blood pressure and pulse pressure were significantly greater in patients ≥ 50 years. There were no significant differences in β and blood pressure parameters between genders.
The β increased dramatically with advanced age (≥ 50 years), regardless of gender, in clinically healthy and community-based patients with cardiovascular risk factors. The aortic circumferential strain was measured with 2D strain echocardiography which is a new tool that can be used to directly and easily evaluate aortic stiffness.

  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: Augmentation index (AIx) and pulse pressure amplification (PPA, here the aortic/brachial pulse pressure ratio) are an age-related emerging risk factor for cardiovascular disease. However, it has not been clearly shown that AIx and PPA predict a high risk of coronary artery disease (CAD). OBJECTIVES: The aim of the study was to investigate the association between non-invasively measured aortic wave reflection (AWR) and PPA and CAD. METHODS: The study group consisted of 80 patients who were admitted to our institute for elective coronary angiography. We non-invasively measured augmentation pressure (AP), AIx, and PPA using radial applanation tonometry. RESULTS: When the extent of CAD was divided by no or minimal CAD, 1- or 2- and 3-vessel disease (VD), there was a significant association between the extent of CAD and AIx and PPA in patients aged <65 years, but not in patients aged ≥65 years. In multivariate regression analysis after controlling the traditional risk factors, the odds ratio of having 3VD was significant in patients aged <65 years: 2.15 (1.04-4.44; p=0.039) per 5% increase of AIx and 2.02 (1.15-3.55; p=0.015) per 0.05 increase of PPA, but not in patients aged ≥65 years. The severity of CAD expressed as a Gensini score showed a significant correlation with AP, AIx, and PPA in patients aged <65 years, but not in patients aged ≥65 years. CONCLUSION: Increasing of non-invasively measured AWR and PPA is related to the severity of CAD, particularly in younger patients up to 65 years of age.
    Journal of Cardiology 05/2013; · 2.30 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND Carotid arterial stiffness measured by techniques of speckle tracking echocardiography is helpful to assess vascular wall deformation. We conducted a study to investigate the relationship between vascular deformation of the carotid artery and ischemic stroke in the elderly.METHODS We recruited 89 consecutive individuals aged ≥60 years (mean age = 72±6 years; 31 men) from a community health survey program. Ten (11%) had a history of ischemic stroke. Carotid B-mode images were acquired using a high-resolution vascular probe equipped on an echocardiographic system. Circumferential strain (CS) and strain rate (CSR) were obtained by speckle tracking techniques with a region of interest covering the entire depth of the common carotid arterial wall.RESULTSBoth CS and CSR were significantly correlated with beta index and distensibility but not with carotid intima-medial thickness and pulse wave velocity. In the comparison between patients with or without history of stroke, carotid CS (1.46% ± 0.54% vs. 2.75% ± 1.23%; P = 0.002) and CSR (0.30±0.13 1/s vs. 0.47±0.18 1/s; P = 0.007) were significantly lower in patients with stroke. Multivariable analysis showed that both carotid CS and CSR were independent factors associated with previous strokes.CONCLUSIONS Carotid wall deformation indices are useful for assessment of local carotid arterial stiffness. CS and CSR of carotid artery measured by speckle tracking techniques were associated with previous ischemic stroke in the elderly.
    American Journal of Hypertension 03/2013; · 3.67 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: In this study, a novel echocardiographic parameter in the evaluation of the presence of coronary artery disease (CAD) and aortic stiffness, aortic propagation velocity, was measured and compared with other conventional aortic stiffness parameters such as aortic strain and aortic distensibility. Also, the relation between aortic propagation velocity and carotid intima media thickness was evaluated. METHOD AND RESULTS: A total of 51 patients with CAD and 42 patients with normal coronary arteries as a non-CAD group were included in the study. Aortic propagation velocity was significantly lower in the CAD group (p<0.001). A statistically significant relation was detected between aortic propagation velocity and the maximum, mean, and overall carotid intima media thickness values for right and left carotid arteries (p<0.001). There was a statistically significant relation between aortic propagation velocity, aortic strain, and aortic distensibility (r=0.556, p<0.001 and r=0.483, p<0.001 respectively). CONCLUSION: Aortic propagation velocity is a novel and simple echocardiographic parameter of aortic stiffness which is feasible for non invasive cardiovascular risk stratification and selection of high risk individuals for CAD.
    Journal of Cardiology 06/2013; · 2.30 Impact Factor