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Published online: 2021-01-11
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Intravascular ultrasound imaging in evaluation of aortic stiffness: A proof-of-concept study

Niya Boykova Mileva, Dobrin Iotkov Vassilev
DOI: 10.5603/CJ.a2021.0003
·
Pubmed: 33438178

open access

Ahead of print
Original articles
Published online: 2021-01-11

Abstract

Background: Aortic stiffness is a well-known cardio-vascular risk factor. For years, different methods have been studied in the assessment of aortic elastic properties and large arterial stiffness for risk stratification. Herein is an assessment of the role of intravascular ultrasound (IVUS) imaging for the evaluation of aortic elastic properties.

Methods: Intravascular ultrasound imaging of the aorta was performed in 12 patients with transthoracic echocardiography (TTE) and computed tomography (CT) evidence for enlargement of the ascending aorta — diameter ≥ 40.0 mm. Mechanical properties of the aorta were derived from the measured diameters and intra-aortic pressure. Paired samples T-test analyses were performed to determine differences between measurements derived by TTE, CT and IVUS.

Results: Mean values of the calculated elastic properties via IVUS of the ascending aorta were as follows: compliance 0.021 ± 0.02; strain 205 ± 4.3; aortic stiffness index 4.3 ± 0.75; elastic modulus 0.31 ± 0.05. On paired T-test analysis maximum ascending aortic diameter measured by CT aortography and IVUS did not differ significantly (t = –0.19, p = 0.985), but a significant difference between IVUS measurements and TTE derived diameters was found (t = 13.118, p = 0.034). On average, IVUS diameters were 2.3 mm larger than the results acquired by TTE (95% confidence interval: 14.21–17.13).

Conclusions: Intravascular ultrasound examination of the ascending aorta provided larger diameters than the ones collected by means of TTE. However, IVUS measurements did not differ significantly from diameters derived by CT aortography.

Abstract

Background: Aortic stiffness is a well-known cardio-vascular risk factor. For years, different methods have been studied in the assessment of aortic elastic properties and large arterial stiffness for risk stratification. Herein is an assessment of the role of intravascular ultrasound (IVUS) imaging for the evaluation of aortic elastic properties.

Methods: Intravascular ultrasound imaging of the aorta was performed in 12 patients with transthoracic echocardiography (TTE) and computed tomography (CT) evidence for enlargement of the ascending aorta — diameter ≥ 40.0 mm. Mechanical properties of the aorta were derived from the measured diameters and intra-aortic pressure. Paired samples T-test analyses were performed to determine differences between measurements derived by TTE, CT and IVUS.

Results: Mean values of the calculated elastic properties via IVUS of the ascending aorta were as follows: compliance 0.021 ± 0.02; strain 205 ± 4.3; aortic stiffness index 4.3 ± 0.75; elastic modulus 0.31 ± 0.05. On paired T-test analysis maximum ascending aortic diameter measured by CT aortography and IVUS did not differ significantly (t = –0.19, p = 0.985), but a significant difference between IVUS measurements and TTE derived diameters was found (t = 13.118, p = 0.034). On average, IVUS diameters were 2.3 mm larger than the results acquired by TTE (95% confidence interval: 14.21–17.13).

Conclusions: Intravascular ultrasound examination of the ascending aorta provided larger diameters than the ones collected by means of TTE. However, IVUS measurements did not differ significantly from diameters derived by CT aortography.

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Keywords

aortic stress, intravascular ultrasound, aortic compliance

About this article
Title

Intravascular ultrasound imaging in evaluation of aortic stiffness: A proof-of-concept study

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2021-01-11

DOI

10.5603/CJ.a2021.0003

Pubmed

33438178

Keywords

aortic stress
intravascular ultrasound
aortic compliance

Authors

Niya Boykova Mileva
Dobrin Iotkov Vassilev

References (35)
  1. Kassab GS. Biomechanics of the cardiovascular system: the aorta as an illustratory example. J R Soc Interface. 2006; 3(11): 719–740.
  2. Belz GG. Elastic properties and Windkessel function of the human aorta. Cardiovasc Drugs Ther. 1995; 9(1): 73–83.
  3. Redheuil A, Yu WC, Wu CO, et al. Reduced ascending aortic strain and distensibility: earliest manifestations of vascular aging in humans. Hypertension. 2010; 55(2): 319–326.
  4. Mattace-Raso FUS, van der Cammen TJM, Knetsch AM, et al. Arterial stiffness and risk of coronary heart disease and stroke: the Rotterdam Study. Circulation. 2006; 113(5): 657–663.
  5. Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol. 2010; 55(13): 1318–1327.
  6. O'Rourke MF, Staessen JA, Vlachopoulos C, et al. Clinical applications of arterial stiffness; definitions and reference values. Am J Hypertens. 2002; 15(5): 426–444.
  7. Reference Values for Arterial Stiffness' Collaboration. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: 'establishing normal and reference values'. Eur Heart J. 2010; 31(19): 2338–2350.
  8. Cavalcante J, Lima J, Redheuil A, et al. Aortic stiffness: current understanding and future directions. J Am Coll Cardiol. 2011; 57(14): 1511–1522.
  9. Lee JMS, Shirodaria C, Jackson CE, et al. Multi-modal magnetic resonance imaging quantifies atherosclerosis and vascular dysfunction in patients with type 2 diabetes mellitus. Diab Vasc Dis Res. 2007; 4(1): 44–48.
  10. Stacey RB, Bertoni AG, Eng J, et al. Modification of the effect of glycemic status on aortic distensibility by age in the multi-ethnic study of atherosclerosis. Hypertension. 2010; 55(1): 26–32.
  11. Safar M, London G, Plante G. Arterial stiffness and kidney function. Hypertension. 2004; 43(2): 163–168.
  12. Doyle A, Mark PB, Johnston N, et al. Aortic stiffness and diastolic flow abnormalities in end-stage renal disease assessed by magnetic resonance imaging. Nephron Clin Pract. 2008; 109(1): c1–c8.
  13. Gillebert TC, Lew WY. Influence of systolic pressure profile on rate of left ventricular pressure fall. Am J Physiol. 1991; 261(3 Pt 2): H805–H813.
  14. Chirinos JA, Segers P, Hughes T, et al. Large-Artery stiffness in health and Disease: JACC state-of-the-art review. J Am Coll Cardiol. 2019; 74(9): 1237–1263.
  15. O'Rourke MF, Safar ME. Relationship between aortic stiffening and microvascular disease in brain and kidney: cause and logic of therapy. Hypertension. 2005; 46(1): 200–204.
  16. Hashimoto J, Ito S. Central pulse pressure and aortic stiffness determine renal hemodynamics: pathophysiological implication for microalbuminuria in hypertension. Hypertension. 2011; 58(5): 839–846.
  17. Laurent S, Boutouyrie P, Asmar R, et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension. 2001; 37(5): 1236–1241.
  18. Laurent S, Katsahian S, Fassot C, et al. Aortic stiffness is an independent predictor of fatal stroke in essential hypertension. Stroke. 2003; 34(5): 1203–1206.
  19. Ben-Shlomo Y, Spears M, Boustred C, et al. Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects. J Am Coll Cardiol. 2014; 63(7): 636–646.
  20. Townsend RR, Wilkinson IB, Schiffrin EL, et al. Recommendations for Improving and Standardizing Vascular Research on Arterial Stiffness: A Scientific Statement From the American Heart Association. Hypertension. 2015; 66(3): 698–722.
  21. Lehmann ED, Parker JR, Hopkins KD, et al. Validation and reproducibility of pressure-corrected aortic distensibility measurements using pulse-wave-velocity Doppler ultrasound. J Biomed Eng. 1993; 15(3): 221–228.
  22. Asmar RG, Topouchian JA, Benetos A, et al. Non-invasive evaluation of arterial abnormalities in hypertensive patients. J Hypertens Suppl. 1997; 15(2): S99–107.
  23. Williams B, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur Heart J. 2018; 39(33): 3021–3104.
  24. Laurent S, Cockcroft J, Van Bortel L, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006; 27(21): 2588–2605.
  25. Sugawara J, Hayashi K, Yokoi T, et al. Brachial-ankle pulse wave velocity: an index of central arterial stiffness? J Hum Hypertens. 2005; 19(5): 401–406.
  26. Weintraub AR, Schwartz SL, Pandian NG, et al. Evaluation of acute aortic dissection by intravascular ultrasonography. N Engl J Med. 1990; 323(22): 1566–1567.
  27. Alfonso F, Goicolea J, Aragoncillo P, et al. Diagnosis of aortic intramural hematoma by intravascular ultrasound imaging. Am J Cardiol. 1995; 76(10): 735–738.
  28. Mileva N, Vassilev D, Gil R, et al. Misdiagnosed Aortic Intramural Hematoma and the Role of Intravascular Ultrasound Imaging in Detection of Acute Aortic Syndrome: A Case Report. Cardiovasc Innov Appl. 2018; 2(4): 447–449.
  29. Wei Hu, Schiele F, Meneveau N, et al. The value of intravascular ultrasound imaging in diagnosis of aortic penetrating atherosclerotic ulcer. EuroIntervention. 2006; 1(4): 432–437.
  30. Hughes DJ, Fearnot NE, Babbs CF, et al. Continuous measurement of aortic radius change in vivo with an intra-aortic ultrasonic catheter. Med Biol Eng Comput. 1985; 23(3): 197–202.
  31. Hansen ME, Yucel EK, Megerman J, et al. In vivo determination of human arterial compliance: preliminary investigation of a new technique. Cardiovasc Intervent Radiol. 1994; 17(1): 22–26.
  32. Latham RD, Westerhof N, Sipkema P, et al. Regional wave travel and reflections along the human aorta: a study with six simultaneous micromanometric pressures. Circulation. 1985; 72(6): 1257–1269.
  33. Boutouyrie P, Lacolley P, Girerd X, et al. Sympathetic activation decreases radial artery compliance in humans. Am J Physiol . 1994; 267: H1368–H1376.
  34. Giannattasio C, Failla M, Lucchina S, et al. Arterial stiffening influence of sympathetic nerve activity: evidence from hand transplantation in humans. Hypertension. 2005; 45(4): 608–611.
  35. Giannattasio C, Failla M, Stella ML, et al. Angiotensin-converting enzyme inhibition and radial artery compliance in patients with congestive heart failure. Hypertension. 1995; 26(3): 491–496.

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