Assessment of aortic elasticity and its relation with left ventricular filling and diastolic parameters by transthoracic and transesophageal echocardiography

Yıl 2013, Cilt: 2 Sayı: 2, 76 - 81, 01.05.2013

Mustafa Kurt Ibrahim Halil Tanboga Mehmet Fatih Karakaş Eyup Büyükkaya Adnan Burak Akcay Nihat Sen

https://doi.org/10.5505/abantmedj.2013.08370

Öz

OBJECTIVE: There are limited data comparing aortic dimensions and elastic properties between transthoracic echocardiography TTE and transesophageal echocardiography TEE . Therefore, we aimed to investigate aortic dimensions and indices of aortic elastic properties as well as their relation with left ventricular LV filling and diastolic parameters obtained from TTE and TEE. METHODS: Forty two patients were included in the study. Aortic dimensions and related elasticity parameters, LV filling and diastolic parameters, left atrial volume index LAVi , LV mass index were calculated from TTE and TEE recordings in all patients. The correlation analyses were performed for aortic elasticity indices and LV filling and diastolic parameters obtained from TTE and TEE. RESULTS: There were no significant differences in aortic dimensions and elasticity indexes obtained from TTE and TEE. The correlation analysis revealed that while age E/A, E/E` and LAVi were significantly correlated with aortic elasticity indexes obtained from both TTE and TEE, LV mass index was significantly correlated with only TEE aortic elasticity indices. CONCLUSION: When compared to TTE, aortic elastic properties obtained from TEE were more closely related with LV filling and diastolic parameters. In addition, the indexes of aortic function were comparable between TEE and TTE with good intra and interobserver variability

Anahtar Kelimeler

aortic dimensions, transthoracic echocardiography and transesophageal echocardiography

Aortik elastisite ve aortik elastisitenin sol ventrikül dolum ve diyastolik parametreleri ile ilişkisinin transtorasik ve transözofajiyal ekokardiyografi değerlendirilmesi

Öz

AMAÇ: Aort boyutlar ve elastik özelliklerini transtorasik ekokardiyografi TTE ve transözofageal ekokardiyografi TEE ile karşılaştıran sınırlı veri vardır. Bu nedenle, TTE ve TEE elde edilen aort boyutlar ve aortik elastik indekslerinin karşılaştırmanın yanı sıra bunların sol ventrikül LV dolum ve diyastolik parametreleri ile ilişkisini araştırmayı amaçladıkYÖNTEMLER: Çalışmaya kırk iki hasta dahil edildi. Tüm hastaların TTE ve TEE kayıtlarından aort boyutları ve ilgili elastikiyet parametreleri, sol ventrikül dolum ve diyastolik parametreleri, sol atriyal volüm indeksi LAVİ , sol ventrikül kütle indeksi hesaplandı. TTE ve TEE elde edilen aort elastikiyeti indeksleri ve sol ventrikül dolum ve diyastolik parametreleri için korelasyon analizi yapıldı.BULGULAR: TTE ve TEE ile elde edilen aort boyutları ve elastikiyeti indeksleri arasında anlamlı bir fark yoktu. Korelasyon analizinde yaş, E / A, E / E`ve LAVİ hem TTE hem de TEE ile edilen aort elastikiyeti indeksleri ile anlamlı derecede ilişkili iken, sol ventrikül kitle indeksi sadece TEE ile elde edilen aort elastikiyeti indeksleri ile ilişkili saptandıSONUÇ: TTE ile karşılaştırıldığında, TEE elde edilen aortik elastik özellikleri sol ventrikül dolum ve diyastolik parametreleri ile daha yakından ilişkili bulunmuştur. Buna ek olarak, TEE ve TTE ile elde edilen aort fonksiyon indeksleri iyi gözlemci içi ve gözlemciler arası değişkenliği ile benzerdir.

Anahtar Kelimeler

aort boyutları, transtorasik ve transözofageal ekokardiyografi

Kaynakça

• Eren M, Gorgulu S, Uslu N, Celik S, Dagdeviren B, Tezel T. Relation between aortic stiffness and left ventricular diastolic function in patients with hyper- tension, diabetes, or both. Heart 2004;90:37-43.
• Karamitsos TD, Karvounis HI, Didangelos TP, Papado- poulos CE, Kachrimanidou MK, Selvanayagam JB, Par- haridis GE. Aortic elastic properties are related to left ventricular diastolic function in patients with type 1 diabetes mellitus. Cardiology 2008;109:99-104.
• Mottram PM, Haluska BA, Leano R, Carlier S, Case C, Marwick TH. Relation of arterial stiffness to diastolic dysfunction in hypertensive heart disease. Heart 2005;91:1551-6.
• Seyfeli E, Duru M, Saglam H, Akgul F, Kuvandik G, Kaya H, Yalcin F.Association of left ventricular diastol- ic function abnormalities with aortic elastic properties in asymptomatic patients with type 2 diabetes melli- tus. A tissue doppler echocardiographic study. Int J Clin Pract 2008;62:1358-65.
• Tsioufis C, Chatzis D, Dimitriadis K, Stougianos P, Kakavas A, Vlasseros I, Tousoulis D, Stefanadis C, Kal- likazaros I. Left ventricular diastolic dysfunction is ac- companied by increased aortic stiffness in the early stages of essential hypertension: a TDI approach. J Hypertens 2005;23:1745-50.
• Safar ME, Levy BI, Struijker-Boudier H. Current per- spectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases. Circulation 2003;107:2864-9.
• Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, Pannier B, Vlachopoulos C, Wilkinson I, Struijker-Boudier H. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006;27:2588- 605.
• Ganten MK, Krautter U, von Tengg-Kobligk H, Bockler D, Schumacher H, Stiller W, Delorme S, Kauczor HU, Kauffmann GW, Bock M. Quantification of aortic dis- tensibility in abdominal aortic aneurysm using ECG- gated multi-detector computed tomography. Eur Ra- diol 2008;18:966-73.
• Stefanadis C, Stratos C, Boudoulas H, Kourouklis C, Toutouzas P. Distensibility of the ascending aorta: comparison of invasive and non-invasive techniques in healthy men and in men with coronary artery dis- ease. Eur Heart J 1990;11:990-6.
• Vitarelli A, Conde Y, Cimino E, D'Orazio S, Stellato S, Battaglia D, Padella V, Caranci F, Continanza G, Detto- ri O, Capotosto L. Assessment of ascending aorta dis- tensibility after successful coarctation repair by strain Doppler echocardiography. J Am Soc Echocardiogr 2008;21:729-36.
• Honma H, Ohno T, Fujimoto H, Matsuzaki T, Murata H, Mizuno K. Evaluation of the elastic properties of the thoracic descending aorta with strain-rate meas- urement with transesophageal echocardiography: its correlation with the left ventricular diastolic function assessed with transthoracic echocardiography. J Nip- pon Med Sch 2010;77:145-54.
• Kim KH, Park JC, Yoon HJ, Yoon NS, Hong YJ, Park HW, Kim JH, Ahn Y, Jeong MH, Cho JG, Kang JC. Usefulness of aortic strain analysis by velocity vector imaging as a new echocardiographic measure of arterial stiffness. J Am Soc Echocardiogr 2009;22:1382-8.
• Vitarelli A, Conde Y, Cimino E, D'Angeli I, D'Orazio S, Stellato S, Padella V, Caranci F. Aortic wall mechanics in the Marfan syndrome assessed by transesophageal tissue Doppler echocardiography. Am J Cardiol 2006;97:571-7.
• Pasierski TJ, Binkley PF, Pearson AC. Evaluation of aortic distensibility with transesophageal echocardi- ography. Am Heart J 1992;123:1288-92.
• Petrini J, Yousry M, Rickenlund A, Liska J, Hamsten A, Eriksson P, Franco-Cereceda A, Caidahl K, Eriksson MJ. The feasibility of velocity vector imaging by transesophageal echocardiography for assessment of elastic properties of the descending aorta in aortic valve disease. J Am Soc Echocardiogr 2010;23:985-92.
• Sako H, Miura S, Kumagai K, Saku K. Associations between augmentation index and severity of athero- ma or aortic stiffness of the descending thoracic aorta by transesophageal echocardiography. Circ J 2009;73:1151-6.
• Kurt M, Karakas MF, İpek G, Arslantaş U, Bilen E, Yüksel İÖ, Yaşar AS, Bilge M. Assessment of right ven- tricular function in patients with rheumatic mild mi- tral involvement by tissue Doppler Echocardiography. Abant Med J, 2012;1:39-44.
• Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pel- likka PA, Evangelista A. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. 2009;22:107-33. Soc Echocardiogr
• Foppa M, Duncan BB, Rohde LE. Echocardiography- based left ventricular mass estimation. How should we define hypertrophy? Cardiovasc Ultrasound 2005;3:17.
• Ulusoy RE YM, Baysan O, Kırılmaz A,Kılıcaslan F,Cebeci BS. Ventricular functions, aortic elastic properties, and endothelial functions in patients with hyperten- sive response to treadmill exercise testing. Turk J Med Sci 2011;41:781-787.
• Tanboga IH, Ekinci M, Isik T, Kurt M, Kaya A, Sevimli S. Reproducibility of Syntax Score: From Core Lab to Re- al World. J Interv Cardiol 2011.
• Redfield MM, Jacobsen SJ, Burnett JC, Jr., Mahoney DW, Bailey KR, Rodeheffer RJ. Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. JAMA 2003;289:194-202.
• Wang CP, Hung WC, Yu TH, Hsu HL, Chen YH, Chiu CA, Lu LF, Chung FM, Cheng YA, Lee YJ. Brachial-ankle pulse wave velocity as an early indicator of left ven- 81
• Abant Med J 2013;2:76-81 tolic heart failure and correlate with exercise intoler- ance. J Am Coll Cardiol 2001;38:796-802.
• Stefanadis C, Wooley CF, Bush CA, Kolibash AJ, Bou- doulas H. Aortic distensibility abnormalities in coro- nary artery disease. Am J Cardiol 1987;59:1300-4.
• Kang SM, Ha JW, Chung N, Jang KJ, Shin MS, Rim SJ, Cho SY. Assessment of elastic properties of the de- scending thoracic aorta by transesophageal echocar- diography with acoustic quantification in patients with a stroke. Echocardiography 2000;17:713-20.
• Al-Mallah MH, Nasir K, Katz R, Takasu J, Lima JA, Bluemke DA, Hundley G, Blumenthal RS, Budoff MJ. Thoracic aortic distensibility and thoracic aortic calci- um (from the Multi-Ethnic Study of Atherosclerosis [MESA]). Am J Cardiol 2010;106:575-80.