Assessment of Aortic Root Mechanics in Hypertensive Patients by Speckle Tracking Echocardiography

Abstract

Objectives: Hypertension is a major risk factor for several cardiovascular diseases, including stroke, atherosclerosis and coronary heart disease. Remodeling of the aortic root may be expected to occur in hypertensive subjects as a result of increased stress on the aortic wall due to the repeated hemodynamic overload. Two-dimensional speckle tracking echocardiography is a promising new imaging modality. The aim of this study is to assess aortic root mechanics in relation to left ventricular mechanics in hypertensive patients by speckle tracking echocardiography. Methods: The study included 50 individuals, 30 patients with hypertension compared with 20 age and sex matched healthy volunteers as control group. For both groups, conventional echo was done and speckle tracking echocardiography of the LV including longitudinal, circumferential, radial strain, LV rotation and the longitudinal strain of the ascending aorta and aortic distensibility were measured. Results: Aortic longitudinal strain of both anterior and posterior walls, andalso LV longitudinal peak systolic strain were lower significantly in patient group, and also in the same group, the apical rotation was higher than control; aortic longitudinal strain was negatively correlated with E/E, and LV global longitudinal strain was correlated positively with septal annular E wave peak velocity and with aortic distensibility. Conclusion: Hypertension significantly lowers ascending aortic longitudinal strain and the changes are correlated significantly with LV longitudinal systolic function and with echo parameters of elevated LV filling pressure.