High Resolution Strain Analysis Comparing Aorta and Abdominal Aortic Aneurysm with Real Time Three Dimensional Speckle Tracking Ultrasound W. Derwich,

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High Resolution Strain Analysis Comparing Aorta and Abdominal Aortic Aneurysm with Real Time Three Dimensional Speckle Tracking Ultrasound W. Derwich, A. Wittek, K. Pfister, K. Nelson, J. Bereiter-Hahn, C.P. Fritzen, C. Blase, T. Schmitz-Rixen European Journal of Vascular and Endovascular Surgery Volume 51, Issue 2, Pages 187-193 (February 2016) DOI: 10.1016/j.ejvs.2015.07.042 Copyright © 2015 European Society for Vascular Surgery Terms and Conditions

Figure 1 Image processing with a real time three dimensional speckle tracking algorithm. The wall of the infrarenal aorta was manually masked in the sagittal and coronal cross sections of an end diastolic reference volume. The image shows two longitudinal sections (A and B) and three cross sections (C3, C5, C7) of the volumetric data. European Journal of Vascular and Endovascular Surgery 2016 51, 187-193DOI: (10.1016/j.ejvs.2015.07.042) Copyright © 2015 European Society for Vascular Surgery Terms and Conditions

Figure 2 Systolic displacement vector field (colored pegs) mapped on subdivided diastolic reference geometry (blue) of aortic segments from (A) a volunteer (aged 30 years) without cardiovascular disease and (B) from a patient with an infrarenal aortic aneurysm. (A) Mean length 23 mm, mean diastolic diameter 11 mm, maximum diameter 25 mm. (B) Mean length 48 mm, mean diastolic diameter 28 mm, maximum diameter 32 mm. European Journal of Vascular and Endovascular Surgery 2016 51, 187-193DOI: (10.1016/j.ejvs.2015.07.042) Copyright © 2015 European Society for Vascular Surgery Terms and Conditions

Figure 3 (A) Age and (B) diameter from non-aneurysmal aorta in patients aged <60 years (young), non-aneurysmal aorta in patients aged >60 years (old), and aneurysmal abdominal aorta (AAA). Boxes mark the interquartile range; center lines are the median value; lower and upper whisker ends mark minimum and maximum values, respectively. *p < .05, **p < .01, ***p < .001. European Journal of Vascular and Endovascular Surgery 2016 51, 187-193DOI: (10.1016/j.ejvs.2015.07.042) Copyright © 2015 European Society for Vascular Surgery Terms and Conditions

Figure 4 (A) Mean and (B) maximum local circumferential wall strain (CWS) from young, old, and abdominal aortic aneurysm (AAA) groups, calculated from four dimensional ultrasound data. Boxes mark the interquartile range; center lines are the median value; lower and upper whisker ends mark minimum and maximum values, respectively. *p < .05, **p < .01, ***p < .001. European Journal of Vascular and Endovascular Surgery 2016 51, 187-193DOI: (10.1016/j.ejvs.2015.07.042) Copyright © 2015 European Society for Vascular Surgery Terms and Conditions

Figure 5 (A) Systolic delay and (B) systolic dyssynchrony index from young, old, and abdominal aortic aneurysm (AAA) groups, calculated from four dimensional ultrasound data. Boxes mark the interquartile range; center lines are the median value; lower and upper whisker ends mark the minimum and maximum value, respectively. *p < .05, **p < .01, ***p < .001. European Journal of Vascular and Endovascular Surgery 2016 51, 187-193DOI: (10.1016/j.ejvs.2015.07.042) Copyright © 2015 European Society for Vascular Surgery Terms and Conditions

Figure 6 (A) Spatial heterogeneity index and (B) local strain ratio from young, old, and abdominal aortic aneurysm (AAA) groups, calculated from four dimensional ultrasound data. Boxes mark the interquartile range; center lines are the median value; lower and upper whisker ends mark the minimum and maximum value, respectively. *p < .05, **p < .01, ***p < .001. European Journal of Vascular and Endovascular Surgery 2016 51, 187-193DOI: (10.1016/j.ejvs.2015.07.042) Copyright © 2015 European Society for Vascular Surgery Terms and Conditions