Alexander J Gregory MD FRCPC Department of Anesthesia University of Calgary Calgary Alberta Canada May 21 2014 Aortopathy Rounds aortaca Why do we care Systemic Diseases Left Ventricular Function ID: 621171
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Using speckle tracking echocardiography to measure aortic compliance: methodology and early resultsAlexander J Gregory MD, FRCPCDepartment of Anesthesia, University of CalgaryCalgary, Alberta, CanadaMay 21, 2014
Aortopathy
Rounds
aorta.caSlide2
Why do we care?
Systemic Diseases
Left Ventricular FunctionCoronary Artery Disease
Aortic AneurysmsHereditary AortopathySurgical InterventionsSlide3
SizeStiffness/ComplianceStrainModeling (ex: Reservoir-Wave Approach)PWVNuclear StudiesHistopathologyGenomics/Proteomics/
Metabolomics
Assessing Aortic Properties
US
CTMRISlide4Slide5Slide6Slide7Slide8Slide9
Displacement and VelocitySlide10
Strain and Strain RateSlide11Slide12
Dr. Randy Moore, Dept. of Vascular Surgery, PLC
Christi Findlay, Dept. of Vascular Surgery, PLCDr. Neal Maher, Dept. of Anesthesia, PLC
Dr. Marelise Kruger, Dept. of Anesthesia, PLCDr. Gary Dobson, Dept. of Anesthesia, PLCSlide13
Methods
n=18
Elective EVAR surgery (PLC): Pre and Post General AnesthesiaArterial line monitoring (radial)
ECGTEE: ME 120⁰ AV LAX DTG AV LAX + PWD Slide14Slide15Slide16
Long Strain Rate
Long Strain Rate
Radial
Velocity
Radial
Velocity
Radial
Velocity
Radial
Velocity
Ao
Root
Prox
Asc
Aorta
SystoleSlide17
Figure 1
Posterior Root
Anterior Root Posterior Prox AscAo Anterior Prox
AscAo
Figure 2
Longitudinal Strain Rate
Radial VelocitySlide18
Figure 1
Aortic Pressure
Aortic FlowRate of changeAortic PressureRate of changeAortic VolumeSlide19
P-V Loop
AoP
& Ao ∆V
Diastole
SystoleSlide20
Next Steps with this data
Separating radial & longitudinal components
Separating root & ascending componentsElastic vs. visco-elastic model
Effects of EVAR on STE complianceEffects of STE compliance on LV diastolic functionRelation of STE compliance to characteristic impedanceComparison of STE compliance to other common measuresSlide21
Next Steps with this method
Comparison with MRI & biomechanical testing in pigs
STE compliance in hereditary aortopathy (Marfans
)STE compliance of ascending aortic aneurysmsChanges following aortic interventions: TEVAR & HARSlide22
Questions