Ascending Aortic Stiffness Analysis Using Tissue Doppler Imaging for the Diagnosis of Coronary Artery Stenosis in Suspected Stable Angina: A Retrospective Study

Ling Wang; XiangYu Chen; Feng Yang

doi:doi:10.11648/j.wjph.20240902.17

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Ascending Aortic Stiffness Analysis Using Tissue Doppler Imaging for the Diagnosis of Coronary Artery Stenosis in Suspected Stable Angina: A Retrospective Study

Ling Wang

, XiangYu Chen^*

, Feng Yang

Published in World Journal of Public Health (Volume 9, Issue 2)

Received: 31 March 2024 Accepted: 27 April 2024 Published: 17 May 2024

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Abstract

Background: Coronary artery disease (CAD) and arterial stiffening may coexist. Stable angina pectoris (SAP) is one of the common types of CAD. However, the association between SAP and aortic stiffness metrics remains poorly understood. Tissue Doppler imaging (TDI) measurement of ascending aorta motion velocity may be used to employed to assess the elastic properties of the great arteries. We hypothesized that non-CAD individuals may exhibit higher. TDI velocities in the ascending aorta. Aim: To explore the correlation between ascending aortic stiffness and SAP using parameters derived from two-dimensional and TDI echocardiography of the ascending aorta. Methods: This study comprised 118 patients with clinically suspected SAP. Two-dimensional echocardiography, TDI, electrocardiogram (ECG), and coronary angiography (CAG) were performed on all patients. Patients with coronary lumen area stenosis ≥70% were categorized as having significant CAD (CAD Group n=57) and were compared with patients without significant CAD (non-CAD Group n=61). Using TDI, aortic systolic velocity (SAo), early diastolic velocity (EAo), and late diastolic velocity (AAo) were measured from the anterior wall of the ascending aorta 3 cm above the aortic cusps in the parasternal long-axis view. Aortic stiffness index (β), aortic distensibility (D), and pressure-strain elastic modulus (Ep) were calculated from aortic diameters measured by two-dimensional M-mode echocardiography and blood pressure obtained by sphygmomanometry. Results: SAo was significantly higher in the non-CAD group (11.70 ±1.53 cm/s vs.12.80 ±2.21 cm/s, p < 0.05). EAo and AAo velocities of ascending aorta were similar in control and CAD groups. Based on the receiver operating characteristic curve (ROC curve) for diagnosing non-CAD, the optimal cut-off value of SAo was ≥13.35 cm/s (sensitivity, 85.96%; specificity, 40.98%; area under curve (AUC)=0.64; P<0.05). There was a significant correlation between SAo velocity and β (r=−0.34, P<0.05), D (r=0.32, P<0.05) and Ep (r =−0.29, P<0.05). Conclusions: Arterial stiffness is lower in patients without significant CAD. Measuring SAo of the anterior ascending aorta using TDI echocardiography has good sensitivity but poor specificity in patients without significant coronary artery stenosis in SAP.

Published in	World Journal of Public Health (Volume 9, Issue 2)
DOI	10.11648/j.wjph.20240902.17
Page(s)	177-185
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Aortic Stiffness, Coronary Artery Disease, Tissue Doppler Imaging, Stable Angina Pectoris, Echocardiography

References

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[9]	SALVI P, SCALISE F, ROVINA M, et al. Noninvasive Estimation of Aortic Stiffness Through Different Approaches Comparison With Intra-Aortic Recordings [J]. Hypertension (Dallas, Tex: 1979), 2019, 74(1): 117-29. https://doi.org/10.1161/HYPERTENSIONAHA.119.12853
[10]	LAURENT S, BOUTOUYRIE P. Arterial stiffness: a new surrogate end point for cardiovascular disease? [J]. Journal of nephrology, 2007, 20 Suppl 12: S45-50.
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[12]	WANG K L, CHENG H M, CHUANG S Y, et al. Central or peripheral systolic or pulse pressure: which best relates to target organs and future mortality? [J]. Journal of hypertension, 2009, 27(3): 461-7. https://doi.org/10.1097/hjh.0b013e3283220ea4
[13]	NAMASIVAYAM M, ADJI A, O'ROURKE M F. Influence of aortic pressure wave components determined noninvasively on myocardial oxygen demand in men and women [J]. Hypertension (Dallas, Tex: 1979), 2011, 57(2): 193-200. https://doi.org/10.1161/HYPERTENSIONAHA.110.160200
[14]	WITTEMAN J C, GROBBEE D E, VALKENBURG H A, et al. J-shaped relation between change in diastolic blood pressure and progression of aortic atherosclerosis [J]. Lancet (London, England), 1994, 343(8896): 504-7. https://doi.org/10.1016/s0140-6736(94)91459-1
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[16]	LAURENT S, BOUTOUYRIE P, CUNHA P G, et al. Concept of Extremes in Vascular Aging [J]. Hypertension (Dallas, Tex: 1979), 2019, 74(2): 218-28. https://doi.org/10.1161/HYPERTENSIONAHA.119.12655
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APA Style

Wang, L., Chen, X., Yang, F. (2024). Ascending Aortic Stiffness Analysis Using Tissue Doppler Imaging for the Diagnosis of Coronary Artery Stenosis in Suspected Stable Angina: A Retrospective Study. World Journal of Public Health, 9(2), 177-185. https://doi.org/10.11648/j.wjph.20240902.17

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ACS Style

Wang, L.; Chen, X.; Yang, F. Ascending Aortic Stiffness Analysis Using Tissue Doppler Imaging for the Diagnosis of Coronary Artery Stenosis in Suspected Stable Angina: A Retrospective Study. World J. Public Health 2024, 9(2), 177-185. doi: 10.11648/j.wjph.20240902.17

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AMA Style

Wang L, Chen X, Yang F. Ascending Aortic Stiffness Analysis Using Tissue Doppler Imaging for the Diagnosis of Coronary Artery Stenosis in Suspected Stable Angina: A Retrospective Study. World J Public Health. 2024;9(2):177-185. doi: 10.11648/j.wjph.20240902.17

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@article{10.11648/j.wjph.20240902.17,
  author = {Ling Wang and XiangYu Chen and Feng Yang},
  title = {Ascending Aortic Stiffness Analysis Using Tissue Doppler Imaging for the Diagnosis of Coronary Artery Stenosis in Suspected Stable Angina: A Retrospective Study},
  journal = {World Journal of Public Health},
  volume = {9},
  number = {2},
  pages = {177-185},
  doi = {10.11648/j.wjph.20240902.17},
  url = {https://doi.org/10.11648/j.wjph.20240902.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20240902.17},
  abstract = {Background: Coronary artery disease (CAD) and arterial stiffening may coexist. Stable angina pectoris (SAP) is one of the common types of CAD. However, the association between SAP and aortic stiffness metrics remains poorly understood. Tissue Doppler imaging (TDI) measurement of ascending aorta motion velocity may be used to employed to assess the elastic properties of the great arteries. We hypothesized that non-CAD individuals may exhibit higher. TDI velocities in the ascending aorta. Aim: To explore the correlation between ascending aortic stiffness and SAP using parameters derived from two-dimensional and TDI echocardiography of the ascending aorta. Methods: This study comprised 118 patients with clinically suspected SAP. Two-dimensional echocardiography, TDI, electrocardiogram (ECG), and coronary angiography (CAG) were performed on all patients. Patients with coronary lumen area stenosis ≥70% were categorized as having significant CAD (CAD Group n=57) and were compared with patients without significant CAD (non-CAD Group n=61). Using TDI, aortic systolic velocity (SAo), early diastolic velocity (EAo), and late diastolic velocity (AAo) were measured from the anterior wall of the ascending aorta 3 cm above the aortic cusps in the parasternal long-axis view. Aortic stiffness index (β), aortic distensibility (D), and pressure-strain elastic modulus (Ep) were calculated from aortic diameters measured by two-dimensional M-mode echocardiography and blood pressure obtained by sphygmomanometry. Results: SAo was significantly higher in the non-CAD group (11.70 ±1.53 cm/s vs.12.80 ±2.21 cm/s, p < 0.05). EAo and AAo velocities of ascending aorta were similar in control and CAD groups. Based on the receiver operating characteristic curve (ROC curve) for diagnosing non-CAD, the optimal cut-off value of SAo was ≥13.35 cm/s (sensitivity, 85.96%; specificity, 40.98%; area under curve (AUC)=0.64; P<0.05). There was a significant correlation between SAo velocity and β (r=−0.34, P<0.05), D (r=0.32, P<0.05) and Ep (r =−0.29, P<0.05). Conclusions: Arterial stiffness is lower in patients without significant CAD. Measuring SAo of the anterior ascending aorta using TDI echocardiography has good sensitivity but poor specificity in patients without significant coronary artery stenosis in SAP.
},
 year = {2024}
}

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TY  - JOUR
T1  - Ascending Aortic Stiffness Analysis Using Tissue Doppler Imaging for the Diagnosis of Coronary Artery Stenosis in Suspected Stable Angina: A Retrospective Study
AU  - Ling Wang
AU  - XiangYu Chen
AU  - Feng Yang
Y1  - 2024/05/17
PY  - 2024
N1  - https://doi.org/10.11648/j.wjph.20240902.17
DO  - 10.11648/j.wjph.20240902.17
T2  - World Journal of Public Health
JF  - World Journal of Public Health
JO  - World Journal of Public Health
SP  - 177
EP  - 185
PB  - Science Publishing Group
SN  - 2637-6059
UR  - https://doi.org/10.11648/j.wjph.20240902.17
AB  - Background: Coronary artery disease (CAD) and arterial stiffening may coexist. Stable angina pectoris (SAP) is one of the common types of CAD. However, the association between SAP and aortic stiffness metrics remains poorly understood. Tissue Doppler imaging (TDI) measurement of ascending aorta motion velocity may be used to employed to assess the elastic properties of the great arteries. We hypothesized that non-CAD individuals may exhibit higher. TDI velocities in the ascending aorta. Aim: To explore the correlation between ascending aortic stiffness and SAP using parameters derived from two-dimensional and TDI echocardiography of the ascending aorta. Methods: This study comprised 118 patients with clinically suspected SAP. Two-dimensional echocardiography, TDI, electrocardiogram (ECG), and coronary angiography (CAG) were performed on all patients. Patients with coronary lumen area stenosis ≥70% were categorized as having significant CAD (CAD Group n=57) and were compared with patients without significant CAD (non-CAD Group n=61). Using TDI, aortic systolic velocity (SAo), early diastolic velocity (EAo), and late diastolic velocity (AAo) were measured from the anterior wall of the ascending aorta 3 cm above the aortic cusps in the parasternal long-axis view. Aortic stiffness index (β), aortic distensibility (D), and pressure-strain elastic modulus (Ep) were calculated from aortic diameters measured by two-dimensional M-mode echocardiography and blood pressure obtained by sphygmomanometry. Results: SAo was significantly higher in the non-CAD group (11.70 ±1.53 cm/s vs.12.80 ±2.21 cm/s, p < 0.05). EAo and AAo velocities of ascending aorta were similar in control and CAD groups. Based on the receiver operating characteristic curve (ROC curve) for diagnosing non-CAD, the optimal cut-off value of SAo was ≥13.35 cm/s (sensitivity, 85.96%; specificity, 40.98%; area under curve (AUC)=0.64; P<0.05). There was a significant correlation between SAo velocity and β (r=−0.34, P<0.05), D (r=0.32, P<0.05) and Ep (r =−0.29, P<0.05). Conclusions: Arterial stiffness is lower in patients without significant CAD. Measuring SAo of the anterior ascending aorta using TDI echocardiography has good sensitivity but poor specificity in patients without significant coronary artery stenosis in SAP.

VL  - 9
IS  - 2
ER  -

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Author Information

Ling Wang

Department of Ultrasound, Zhuji People's Hospital of Zhejiang Province, Zhuji, China

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http://orcid.org/0000-0003-4546-6288
XiangYu Chen

Department of Ultrasound, Zhuji People's Hospital of Zhejiang Province, Zhuji, China

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http://orcid.org/0000-0003-1234-7864
Feng Yang

Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China

Contact Email

http://orcid.org/0009-0004-1620-9439

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Plain Text BibTeX RIS

APA Style

Wang, L., Chen, X., Yang, F. (2024). Ascending Aortic Stiffness Analysis Using Tissue Doppler Imaging for the Diagnosis of Coronary Artery Stenosis in Suspected Stable Angina: A Retrospective Study. World Journal of Public Health, 9(2), 177-185. https://doi.org/10.11648/j.wjph.20240902.17

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ACS Style

Wang, L.; Chen, X.; Yang, F. Ascending Aortic Stiffness Analysis Using Tissue Doppler Imaging for the Diagnosis of Coronary Artery Stenosis in Suspected Stable Angina: A Retrospective Study. World J. Public Health 2024, 9(2), 177-185. doi: 10.11648/j.wjph.20240902.17

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AMA Style

Wang L, Chen X, Yang F. Ascending Aortic Stiffness Analysis Using Tissue Doppler Imaging for the Diagnosis of Coronary Artery Stenosis in Suspected Stable Angina: A Retrospective Study. World J Public Health. 2024;9(2):177-185. doi: 10.11648/j.wjph.20240902.17

Copy | Download

@article{10.11648/j.wjph.20240902.17,
  author = {Ling Wang and XiangYu Chen and Feng Yang},
  title = {Ascending Aortic Stiffness Analysis Using Tissue Doppler Imaging for the Diagnosis of Coronary Artery Stenosis in Suspected Stable Angina: A Retrospective Study},
  journal = {World Journal of Public Health},
  volume = {9},
  number = {2},
  pages = {177-185},
  doi = {10.11648/j.wjph.20240902.17},
  url = {https://doi.org/10.11648/j.wjph.20240902.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20240902.17},
  abstract = {Background: Coronary artery disease (CAD) and arterial stiffening may coexist. Stable angina pectoris (SAP) is one of the common types of CAD. However, the association between SAP and aortic stiffness metrics remains poorly understood. Tissue Doppler imaging (TDI) measurement of ascending aorta motion velocity may be used to employed to assess the elastic properties of the great arteries. We hypothesized that non-CAD individuals may exhibit higher. TDI velocities in the ascending aorta. Aim: To explore the correlation between ascending aortic stiffness and SAP using parameters derived from two-dimensional and TDI echocardiography of the ascending aorta. Methods: This study comprised 118 patients with clinically suspected SAP. Two-dimensional echocardiography, TDI, electrocardiogram (ECG), and coronary angiography (CAG) were performed on all patients. Patients with coronary lumen area stenosis ≥70% were categorized as having significant CAD (CAD Group n=57) and were compared with patients without significant CAD (non-CAD Group n=61). Using TDI, aortic systolic velocity (SAo), early diastolic velocity (EAo), and late diastolic velocity (AAo) were measured from the anterior wall of the ascending aorta 3 cm above the aortic cusps in the parasternal long-axis view. Aortic stiffness index (β), aortic distensibility (D), and pressure-strain elastic modulus (Ep) were calculated from aortic diameters measured by two-dimensional M-mode echocardiography and blood pressure obtained by sphygmomanometry. Results: SAo was significantly higher in the non-CAD group (11.70 ±1.53 cm/s vs.12.80 ±2.21 cm/s, p < 0.05). EAo and AAo velocities of ascending aorta were similar in control and CAD groups. Based on the receiver operating characteristic curve (ROC curve) for diagnosing non-CAD, the optimal cut-off value of SAo was ≥13.35 cm/s (sensitivity, 85.96%; specificity, 40.98%; area under curve (AUC)=0.64; P<0.05). There was a significant correlation between SAo velocity and β (r=−0.34, P<0.05), D (r=0.32, P<0.05) and Ep (r =−0.29, P<0.05). Conclusions: Arterial stiffness is lower in patients without significant CAD. Measuring SAo of the anterior ascending aorta using TDI echocardiography has good sensitivity but poor specificity in patients without significant coronary artery stenosis in SAP.
},
 year = {2024}
}

Copy | Download

TY  - JOUR
T1  - Ascending Aortic Stiffness Analysis Using Tissue Doppler Imaging for the Diagnosis of Coronary Artery Stenosis in Suspected Stable Angina: A Retrospective Study
AU  - Ling Wang
AU  - XiangYu Chen
AU  - Feng Yang
Y1  - 2024/05/17
PY  - 2024
N1  - https://doi.org/10.11648/j.wjph.20240902.17
DO  - 10.11648/j.wjph.20240902.17
T2  - World Journal of Public Health
JF  - World Journal of Public Health
JO  - World Journal of Public Health
SP  - 177
EP  - 185
PB  - Science Publishing Group
SN  - 2637-6059
UR  - https://doi.org/10.11648/j.wjph.20240902.17
AB  - Background: Coronary artery disease (CAD) and arterial stiffening may coexist. Stable angina pectoris (SAP) is one of the common types of CAD. However, the association between SAP and aortic stiffness metrics remains poorly understood. Tissue Doppler imaging (TDI) measurement of ascending aorta motion velocity may be used to employed to assess the elastic properties of the great arteries. We hypothesized that non-CAD individuals may exhibit higher. TDI velocities in the ascending aorta. Aim: To explore the correlation between ascending aortic stiffness and SAP using parameters derived from two-dimensional and TDI echocardiography of the ascending aorta. Methods: This study comprised 118 patients with clinically suspected SAP. Two-dimensional echocardiography, TDI, electrocardiogram (ECG), and coronary angiography (CAG) were performed on all patients. Patients with coronary lumen area stenosis ≥70% were categorized as having significant CAD (CAD Group n=57) and were compared with patients without significant CAD (non-CAD Group n=61). Using TDI, aortic systolic velocity (SAo), early diastolic velocity (EAo), and late diastolic velocity (AAo) were measured from the anterior wall of the ascending aorta 3 cm above the aortic cusps in the parasternal long-axis view. Aortic stiffness index (β), aortic distensibility (D), and pressure-strain elastic modulus (Ep) were calculated from aortic diameters measured by two-dimensional M-mode echocardiography and blood pressure obtained by sphygmomanometry. Results: SAo was significantly higher in the non-CAD group (11.70 ±1.53 cm/s vs.12.80 ±2.21 cm/s, p < 0.05). EAo and AAo velocities of ascending aorta were similar in control and CAD groups. Based on the receiver operating characteristic curve (ROC curve) for diagnosing non-CAD, the optimal cut-off value of SAo was ≥13.35 cm/s (sensitivity, 85.96%; specificity, 40.98%; area under curve (AUC)=0.64; P<0.05). There was a significant correlation between SAo velocity and β (r=−0.34, P<0.05), D (r=0.32, P<0.05) and Ep (r =−0.29, P<0.05). Conclusions: Arterial stiffness is lower in patients without significant CAD. Measuring SAo of the anterior ascending aorta using TDI echocardiography has good sensitivity but poor specificity in patients without significant coronary artery stenosis in SAP.

VL  - 9
IS  - 2
ER  -

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