Ultrasonic assessment of thoracic aortic contractility using 2D speckle tracking

Aim. To evaluate the applicability of two-dimensional speckle tracking echocardiography (2D STE) for quantitative assessment of global aortic circumferential strain (GCSao) and to study the intraand inter-operator reproducibility of measurements, as well as the diagnostic value of this indicator in patients with thoracic aortic dilation/aneurysm compared with healthy volunteers.

Methods. The study included 51 healthy volunteers (aged 21 [20; 23] years) and 13 patients with an aortic diameter > 45 mm (aged 48 [36; 49] years). All subjects underwent standard transthoracic echocardiography (Vivid E90, M5SC D transducer, 1.5–4.5 MHz) with DICOM loop recording and subsequent offline analysis in EchoPAC PC v201. GCSao (%) was calculated using a previously proposed method. Two experts (E₁ – the developer of the method; E₂ – a physician specializing in functional diagnostics with 10-year work experience) performed independent measurements and repeated them 2 weeks later. Reproducibility was assessed using the intraclass correlation coefficient, the Bland–Altman test. Group comparisons were performed using the Mann–Whitney U test.

Results. GCSao in patients with dilation/aneurysm was statistically lower than in volunteers (−5.31 [7.56; 3.01] % versus −8.79 [10.18; 6.40] %; U = 168; p = 0.005). Intra-operator reproducibility: ICC = 0.915 (E₁) and 0.913 (E₂) – high. Inter-operator reproducibility: ICC = 0.882 (first measurement) and 0.897 (second) – good/high. According to Bland-Altman, the mean difference is close to 0, the limits of agreement are narrow; isolated outliers are associated with the initial stage of mastering the technique.

Conclusion. 2D STE allows for reproducible measurement of GCSao and detection of strain reduction in patients with thoracic aortic dilation/aneurysm. The technique is promising for risk stratification and monitoring; studies of prognostic thresholds and validation against MRI are needed.

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