PP.32.06

Abstract

Objective: Our groups has previously demonstrated that aortic arch mechanics with 2D-speckle tracking (2D-ST) echocardiography was a feasible methodology. We have proved that hypertensive patients had lower values of vascular mechanics when compared to an age-matched control group. We have also demonstrated a significant association of aortic arch mechanics with aortic stiffness. To assess the influence of aortic arch mechanics in the left ventricular (LV) hypertensive remodelling process. Design and method: We included 46 consecutive patients with hypertension and performed a complete echocardiographic exam. We included a high frame rate, short axis view of the aortic arch. The 2D-ST methodology was used to off-line calculate aortic arch mechanics (EchoPAQ, GE Healthcare®). The aortic arch mechanics parameters analyzed were circumferential aortic strain (CAS) and early circumferential aortic strain rate (CASR). The LV mass was calculated according to the Devereux's formula. We divided our sample in two groups: Group A (normal LV mass) n = 34; Group B (elevated LV mass) n = 12. Results: Mean age was 45 ± 12 years with a gender balance. Patients had hypertension for a median time of 5 (2 – 8) years, and were medicated with a median of 2 (1 -3) drugs. There were no difference between groups regarding gender, blood pressure and heart rate. Left ventricular systolic function, aortic dimensions, systemic arterial compliance and the Beta1 index (4.8 ± 3.3 vs 4.3 ± 1.9) were also similar. Group B patients were older, had a higher left atrial volume (28 ± 6 vs 33 ± 7 ml/m2, p = 0.02) and lower myocardial relaxation velocities. CAS (6.7 ± 2.1 vs 5.0 ± 1.0%, p < 0.01) and CASR (1.0 ± 0.3 vs 0.8 ± 0.3s1,p = 0.049) were also lower for the Group B patients. A CAS < 6.1% had a sensitivity of 91.7% and a specificity of 61.8% for an increase in indexed LV mass. CAS (area under curve [AUC] 0.77) had a superior accuracy than Beta1 index (AUC 0.5, pairwise comparisons of ROC curves p = 0.02) and the pulse pressure (AUC 0.52, pairwise comparisons of ROC curves p < 0.01) to estimate an increase in LV mass. Conclusions: Our investigation proved the association aortic arch vascular mechanics with the LV remodelling process.