Related Experiment Video
Updated: Nov 23, 2025

Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
Published on: September 8, 2023
Local transversal aortic strain is impaired in ascending aorta dilatation
Marco Cesareo1, Luca Sabia, Dario Leone
1Internal Medicine and Hypertension Division, Department of Medical Sciences, AOU Città della Salute e della Scienza of Turin, University of Turin, Turin, Italy.
Background:
Ascending aorta dilatation is found in 13% of hypertensive patients. Little is known about elastic properties of ascending aorta in such patients. Echo-based transverse aortic strain analysis can describe mechanical properties of ascending aorta but has never been applied to patients with ascending aorta dilatation.
Aim:
To assess mechanical properties of ascending aorta by transverse aortic strain analysis (as β2-stiffness index) in hypertensive patients with ascending aorta dilatation and association between mechanical properties of ascending aorta and cardiovascular damage.
Methods:
A total of 100 hypertensive outpatients underwent transthoracic echocardiography and assessment of pulse wave velocity (PWV). Strain analysis of ascending aorta was performed with echocardiographic speckle-tracking software. Patients were divided in three groups based on ascending aorta diameter: less than 40, 40-45, and at least 45 mm.
Results:
Beta-SI increased exponentially with ascending aorta dimensions (P < 0.001). Patients with ascending aorta dilatation had Beta-SI significantly higher than those with normal ascending aorta diameter. A greater proportion of patient with impaired (i.e., elevated) Beta-SI was present in groups with larger ascending aorta (18.2 vs. 48.4 vs. 80%, respectively, P < 0.05). On multivariate logistic regression only impaired Beta-SI predicted ascending aorta dilatation (P < 0.001). Beta-SI was related to cardiovascular damage in terms of left ventricular (LV) mass (LV mass indexed to BSA, P = 0.030) and PWV (P = 0.028). Patients with high Beta-SI had greater LV mass indexed to BSA (117 ± 47 vs. 94 ± 24 g/m2; P = 0.010) and PWV (10.20 ± 2.99 vs. 8.63 ± 1.88 m/s; P = 0.013).
Conclusion:
Ascending aorta dilatation is associated with increased local aortic stiffness in hypertensive patients. Strain analysis adds functional information to the mere morphological evaluation of aortic diameter and could be a useful tool to better define cardiovascular risk in this population.
Related Concept Videos
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Aneurysm I: Introduction
Aortic Regurgitation I: Introduction
The Aorta
The average diameter of the aorta is approximately 2-3 cm, but the size can vary depending on the section of the aorta and the individual's age, sex, and body size. The aorta is...
Aneurysm III: Interprofessional Care

