Longitudinal and circumferential strain of the proximal aorta.
Longitudinal and circumferential strain of the proximal aorta.
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DOI：
10.1161/jaha.114.001536
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发表时间：
2014-12
影响因子：
5.4
通讯作者：
Mitchell GF
中科院分区：
文献类型：
--
作者：
Bell V;Mitchell WA;Sigurðsson S;Westenberg JJ;Gotal JD;Torjesen AA;Aspelund T;Launer LJ;de Roos A;Gudnason V;Harris TB;Mitchell GF
准确评估近端主动脉的力学特性是阐明单纯收缩期高血压病理生理学的必要的第一步。在心脏收缩期，近端主动脉轴向位移产生纵向应变，我们假设这会导致与纵向约束的降主动脉中的值相比，升主动脉周向应变的可变低估。为了评估纵向应变的影响，我们对年龄、基因/环境易感性-雷克雅未克研究中的375名参与者（72至94岁，204名女性）进行了磁共振成像，并测量了主动脉周向和纵向应变。未校正纵向应变的周向升主动脉面积应变在女性和男性中相当（平均值[95% CI]，分别为8.3 [7.8，8.9] vs 7.9 [7.4，8.5]%，P=0.3）。然而，女性的纵向应变更大（8.5±2.5 vs 7.0± 2.5%，P<0.001），导致纵向校正的周向升主动脉应变更大（14.4 [13.6，15.2] vs 13.0 [12.4，13.7]%，P=0.010）。观察到的不需要矫正的周向降主动脉应变（女性：14.0 [13.2，14.8] %，男性：12.4 [11.6，13.2]%，P=0.005）大于未矫正的应变（P<0.001），但与纵向矫正的周向升主动脉应变（P=0.12）相当。颈动脉-股动脉脉搏波速度与未校正的升主动脉应变无关（R=-0.04，P=0.5），但与纵向校正的升主动脉应变和观察到的降主动脉应变呈负相关（分别为R=-0.15，P=0.004; R=-0.36，P<0.001）。纵向应变也与颈动脉-股动脉脉搏波速度和其他主动脉僵硬度较高的风险因素（包括治疗的高血压）呈负相关。纵向应变在环周升主动脉面积应变测量中产生大量和可变的误差，特别是在女性中，应考虑避免升主动脉僵硬的错误分类。
Accurate assessment of mechanical properties of the proximal aorta is a requisite first step for elucidating the pathophysiology of isolated systolic hypertension. During systole, substantial proximal aortic axial displacement produces longitudinal strain, which we hypothesize causes variable underestimation of ascending aortic circumferential strain compared to values in the longitudinally constrained descending aorta. To assess effects of longitudinal strain, we performed magnetic resonance imaging in 375 participants (72 to 94 years old, 204 women) in the Age, Gene/Environment Susceptibility‐Reykjavik Study and measured aortic circumferential and longitudinal strain. Circumferential ascending aortic area strain uncorrected for longitudinal strain was comparable in women and men (mean [95% CI], 8.3 [7.8, 8.9] versus 7.9 [7.4, 8.5]%, respectively, P=0.3). However, longitudinal strain was greater in women (8.5±2.5 versus 7.0±2.5%, P<0.001), resulting in greater longitudinally corrected circumferential ascending aortic strain (14.4 [13.6, 15.2] versus 13.0 [12.4, 13.7]%, P=0.010). Observed circumferential descending aortic strain, which did not require correction (women: 14.0 [13.2, 14.8], men: 12.4 [11.6, 13.2]%, P=0.005), was larger than uncorrected (P<0.001), but comparable to longitudinally corrected (P=0.12) circumferential ascending aortic strain. Carotid‐femoral pulse wave velocity did not correlate with uncorrected ascending aortic strain (R=−0.04, P=0.5), but was inversely related to longitudinally corrected ascending and observed descending aortic strain (R=−0.15, P=0.004; R=−0.36, P<0.001, respectively). Longitudinal strain was also inversely related to carotid‐femoral pulse wave velocity and other risk factors for higher aortic stiffness including treated hypertension. Longitudinal strain creates substantial and variable errors in circumferential ascending aortic area strain measurements, particularly in women, and should be considered to avoid misclassification of ascending aortic stiffness.