Proximal aorta longitudinal strain by two-dimension speckle-tracking echocardiography: Feasibility and variability of different methods

Background Strain by speckle-tracking imaging with 2D echocardiography could be a new non-invasive tool to evaluate aortic stiffness, and could help in the evaluation of aortic events risk in patients with aortopathy. Aim We aimed to assess which method for strain measurement of ascending aorta has the best reproducibility and feasibility. Methods A complete 2D TTE was performed in patients referred in our Marfan clinic. Global longitudinal strain (GLS) of the ascending aorta was assessed with: – a ROI divided into 1, 2 or 3 segments; – different location: including sinus of Valsalva sinus (method SoV), excluding SoV (method non-SoV), or beginning 2 cm above the aortic valve (method 2 cm). Measurements were repeated three times on different cardiac cycles. Results Eleven patients were included. They were a majority of young men (63% of men, median age of 29.5 ± 11.5 years old). Mean aortic GLS was 18.18%. Feasibility was excellent. There was less variability between measurements with the method VS than the methods non-VS and method 2 cm (SD (log) respectively was 2.02; IP 95% [1.89–2.16] versus 2.73; IP 95% [2.58–2.88] and 2.89; IP 95% [2.75–3.03]). There was less variability with the method of 1 segment. Measurements on the anterior aortic wall were more reliable than on the posterior wall. Conclusion Aortic GLS is a reliable, reproducible measurement, with an excellent feasibility when it is realized with a specific method and good echogenicity. Studies evaluating the relation of global longitudinal strain (GLS) of the ascending aorta and aortic risk are warranted.