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Carotid Vascular Strain Predicts Cardiovascular Events in Patients with Hypertension
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  • Wei-Chuan Tsai,
  • Wen-Huang Lee,
  • Huey-Ru Tsai,
  • Mu-Shiang Huang
Wei-Chuan Tsai
National Cheng Kung University Medical Center

Corresponding Author:[email protected]

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Wen-Huang Lee
National Cheng Kung University Medical Center
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Huey-Ru Tsai
National Cheng Kung University Medical Center
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Mu-Shiang Huang
National Cheng Kung University Medical Center
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Abstract

Background: We aim to investigate prognostic effects of carotid strain (CS) and strain rate (CSR) in hypertension. Methods: We prospectively recruited 120 patients being treated for hypertension (65.8 ± 11.8 years, 58% male) in this observational study. Peak circumferential CS and peak CSR after ejection were identified using two-dimensional speckle tracking ultrasound. Major cardiovascular events were any admission for stroke, acute coronary syndrome, and heart failure. Results: After a mean follow-up period of 63.6 ± 14.5 months, 14 (12%) patients had cardiovascular events. Age (75.3 ± 9.2 vs. 64.6 ± 11.6 years; p = 0.001), systolic blood pressure (131.8 ± 15.5 vs. 143.1 ± 16.6 mmHg; p = 0.021), diastolic blood pressure (74.6 ±11.4 vs. 82.1 ± 12.2 mmHg; p = 0.039), use of diuretics (71 vs. 92 %; p = 0.014), carotid CS (2.17 ± 1.02 vs. 3.28 ± 1.14 %; p = 0.001), and CSR (0.28 ± 0.17 vs. 0.51 ± 0.18 1/s; p <0.001) were significantly different between the patients who did and did not reach the end-points. Multivariate Cox regression analysis controlling for age, systolic blood pressure, diastolic blood pressure, and use of diuretics showed that CS (HR 0.425, 95%CI 0.223-0.811, p = 0.009) and CSR (HR 0.001, 95%CI 0.000-0.072, p = 0.001) were independent predictors for cardiovascular events. Conclusion: In conclusions, decreased CS and CSR were associated with cardiovascular events in hypertension.
24 May 2021Submitted to Echocardiography
24 May 2021Submission Checks Completed
24 May 2021Assigned to Editor
01 Jun 2021Reviewer(s) Assigned
05 Aug 2021Review(s) Completed, Editorial Evaluation Pending
06 Aug 2021Editorial Decision: Revise Minor
11 Aug 20211st Revision Received
11 Aug 2021Submission Checks Completed
11 Aug 2021Assigned to Editor
27 Aug 2021Reviewer(s) Assigned
09 Oct 2021Editorial Decision: Accept
Nov 2021Published in Echocardiography volume 38 issue 11 on pages 1900-1906. 10.1111/echo.15231