Evaluation of aortic wall assessed by strain rate in exercise therapy and drug medication

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Background : Although brachial-ankle pulse wave velocity (PWV) is a widely used index of arterial stiffness, there are several limitations of this method. The actual length of an artery used for measuring PWV is estimated based on an anatomical correction value, and brachial-ankle PWV is directly affected by systemic blood pressure or vascular occlusion. Thus, the aim of this study to determine whether aortic wall strain rate as measured by tissue Doppler echocardiography is a more useful modality for evaluating regional aortic compliance than brachial-ankle PWV. Methods: Seventy-two patients (18- to 79- years- old) with normal cardiac function and without large vessel complications were enrolled in this study. Results : A significant positive correlation was found between brachial-ankle PWV and age, and brachial-ankle PWV increased with age (r=0.73, p<0.05). A significant negative correlation was found between strain rate and age, and strain rate decreased with age (r=-0.44, p<0.05). A significant correlation also was found between brachial-ankle PWV and systolic blood pressure (r=0.45, p<0.001), but not between strain rate and systolic blood pressure. There was no significant difference in brachial-ankle PWV between hyperlipidemic and normolipidemic subjects. However, strain rate was lower in hyperlipidemic than in normolipidemic subjects (p<0.05). Conclusion : Strain rate on the ascending aortic wall is a novel and more accurate index of regional main aortic wall compliance than brachial-ankle PWV.