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Guo S, Gu C, Sun L, Qi Z, Wang B. Evaluation of Carotid Stiffness in Metabolic Syndrome by Real-Time Shear Wave Elasticity Imaging and Ultrafast Pulse Wave Velocity. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:1280-1286. [PMID: 38806338 DOI: 10.1016/j.ultrasmedbio.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 04/13/2024] [Accepted: 05/07/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVE This study utilized real-time shear wave elasticity imaging (SWE) and ultrafast pulse wave velocity (ufPWV) to assess carotid arterial stiffness, aiming to predict atherosclerosis risk in patients with metabolic syndrome (MS). METHODS In this study, 181 patients with metabolic syndrome (MS group) were compared with 73 healthy adults. The MS group was divided into three groups: MS I group: CIMT was normal (CIMT < 1.0 mm, no plaque, n = 61); MS II group: CIMT thickening (1.0 mm ≤ CIMT<1.5 mm, no plaque, n = 39); MS III group: plaque group (CIMT ≥ 1.5 mm, plaque, n = 81). Concurrently, the group of 73 healthy individuals was designated as the control set (NC). Parameters assessed include carotid intima-media thickness (CIMT), elastic modulus values of the carotid artery's anterior and posterior walls (Mean, Max, Min), pulse wave velocity at systole's commencement (PWV-BS), and pulse wave velocity at systole's termination (PWV-ES). Differences, distribution characteristics, and correlations across these groups were analyzed. RESULTS A significant association was found between PWV-BS, PWV-ES, and arteriosclerosis severity, with these factors gaining importance as arteriosclerosis progressed. Notably, PWV-ES differences were significant across the four groups (p < 0.05). Both MS III and MS II groups exhibited higher PWV-ES values compared to the MS I group and controls. Statistically significant differences were observed between MS III, MS II, and MS I groups relative to the control group (p < 0.05). Additionally, the Mean, Max, and Min values of the anterior and posterior carotid walls in the MS III group surpassed those of the other groups. CONCLUSION Real-time shear wave elasticity imaging and ultrafast pulse wave velocity are valuable tools for assessing atherosclerosis risk in MS patients. These non-invasive, safe, and reproducible imaging techniques can quantitatively evaluate the stiffness of the common carotid artery's wall, offering important insights into cardiovascular risk assessment.
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Affiliation(s)
- Shuai Guo
- First Hospital of Qin Huangdao, Qin Huangdao, China
| | - Changcong Gu
- First Hospital of Qin Huangdao, Qin Huangdao, China
| | - Lijuan Sun
- First Hospital of Qin Huangdao, Qin Huangdao, China.
| | - Zhengqin Qi
- First Hospital of Qin Huangdao, Qin Huangdao, China
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Jiang X, Ge W, Huang H, Li Y, Liu X, Pang H, He R, Wang H, Zhu Z, He P, Wang Y, Ma X, Ren A, Shen B, Wang M. Arterial stiffness in subclinical atherosclerosis quantified with ultrafast pulse wave velocity measurements: a comparison with a healthy population using propensity score matching. Ultrasonography 2024; 43:263-271. [PMID: 38960742 PMCID: PMC11222132 DOI: 10.14366/usg.24045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 07/05/2024] Open
Abstract
PURPOSE This study aimed to evaluate changes in ultrafast pulse wave velocity (ufPWV) in individuals with arterial stiffness and subclinical atherosclerosis (subAS), and to provide cutoff values. METHODS This retrospective study recruited 231 participants, including 67 patients with subAS. The pulse wave velocity was measured at the beginning and end of systole (PWV-BS and PWVES, respectively) using ultrafast ultrasonography to assess arterial stiffness. The right and left common carotid arteries were measured separately, and laboratory metabolic parameters were also collected. Participants were balanced between groups using propensity score matching (PSM) at a 1:1 ratio, adjusting for age, sex, and waist-to-hip ratio as potential confounders. Cutoff values of ufPWV for monitoring subAS were determined via receiver operating characteristic (ROC) curve analysis. RESULTS PWV-ES, unlike PWV-BS, was higher in the subAS subgroup than in the subAS-free group after PSM (all P<0.05). For each 1 m/s increase in left, right, and bilateral mean PWV-ES, the risk of subAS increased by 23% (95% confidence interval [CI], 1.04 to 1.46), 26% (95% CI, 1.07 to 1.52), and 38% (95% CI, 1.12 to 1.72), respectively. According to ROC analyses, predictive potential was found for left PWV-ES (cutoff value=7.910 m/s, P=0.002), right PWV-ES (cutoff value=6.615 m/s, P=0.003), and bilateral mean PWV-ES (cutoff value=7.415 m/s, P<0.001), but not for PWV-BS (all P>0.05). CONCLUSION PWV-ES measured using ultrafast ultrasonography was significantly higher in individuals with subAS than in those without. Specific PWV-ES cutoff values showed potential for predicting an increased risk of subAS.
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Affiliation(s)
- Xuezhong Jiang
- Department of Ultrasound, Jiangsu Province Official Hospital, Nanjing, China
| | - Weiming Ge
- Department of Geriatric Medicine, Jiangsu Province Official Hospital, Nanjing, China
| | - Hui Huang
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Yating Li
- Department of Ultrasound, Jiangsu Province Official Hospital, Nanjing, China
| | - Xiaojing Liu
- Department of Ultrasound, Jiangsu Province Official Hospital, Nanjing, China
| | - Huiyan Pang
- Department of Ultrasound, Jiangsu Province Official Hospital, Nanjing, China
| | - Rui He
- Department of Ultrasound, Jiangsu Province Official Hospital, Nanjing, China
| | - Hui Wang
- Department of Ultrasound, Jiangsu Province Official Hospital, Nanjing, China
| | - Zhengqiu Zhu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Ping He
- Department of Ultrasound, Jiangsu Province Official Hospital, Nanjing, China
| | - Yinping Wang
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Xuehui Ma
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Airong Ren
- Department of Ultrasound, Jiangsu Province Official Hospital, Nanjing, China
| | - Bixiao Shen
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Meijuan Wang
- Department of Ultrasound, Jiangsu Province Official Hospital, Nanjing, China
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Zhu Z, Chen L, Shen B, Liu W, Zou C, Wang Y, Ma X, Gao H, Xu D, Wu Y, Huang H. Predicting cardiovascular risk stratification in apparently healthy population by using noninvasive ultrafast ultrasound imaging. Acad Radiol 2024:S1076-6332(24)00295-2. [PMID: 38816317 DOI: 10.1016/j.acra.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 04/29/2024] [Accepted: 05/09/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND To investigate the association between cardiovascular risk estimated using the Framingham Risk Score (FRS) and carotid stiffening determined using ultrafast pulse wave velocity (ufPWV) measurements in apparently healthy individuals. METHODS We enrolled 1034 apparently healthy participants without known cardiovascular disease who underwent ufPWV measurements. Clinical and laboratory findings, carotid intima-media thickness (cIMT), pulse wave velocity at the beginning of systole (PWV-BS), and pulse wave velocity at the end of systole (PWV-ES) were assessed. In FRS assessments based on major cardiovascular risk factors (CVRFs), participants were assigned into three risk categories: low risk (<10%, n = 679), intermediate risk (10-20%, n = 191), and high risk (>20%, n = 164); the low-risk category was further subdivided into three subcategories: < 1% (n = 58), 1%- 5% (n = 374) and > 5% (n = 247). Multivariate logistic regression analyses with crude and adjusted odds ratios (ORs) were used to evaluate the association of carotid stiffening and FRS-based risk stratification. RESULTS Carotid stiffening indicated by PWV-BS and PWV-ES differed notably between the FRS-estimated low-risk vs. intermediate-risk and high-risk categories, but only PWV-ES differed notably among the low-risk subcategories (all p < 0.010), and correlated notably with the FRS-estimated risk most obviously in low-risk participants (r = 0.517). In participants with cIMT < 0.050 cm, only PWV-ES differed significantly among the FRS-estimated risk categories (all p < 0.001). Increased PWV-BS (adjusted OR: 1.49; p = 0.003) and PWV-ES (adjusted OR: 1.29; p = 0.007) were both associated with FRS categories independent of conventional CVRFs in low- vs. intermediate-risk categories, but not in low- vs. high-risk categories (all p > 0.050). CONCLUSION In vivo imaging of carotid stiffening by ufPWV measurements is independently linked to FRS categories, and ufPWV indices may help stratify differing levels of cardiovascular risk in apparently healthy young people. AVAILABILITY OF DATA AND MATERIAL Data generated or analyzed during the study are available from the corresponding author by reasonable request.
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Affiliation(s)
- Zhengqiu Zhu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Lingshan Chen
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Bixiao Shen
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Wenjun Liu
- School of Mathematics and Statistics, Nanjing University of Information Science and Technology, Nanjing, China
| | - Chong Zou
- Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China; Center of Good Clinical Practice, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Yinping Wang
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Xuehui Ma
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Hui Gao
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Dahua Xu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Yiyun Wu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Hui Huang
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China.
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De Biasio MJ, Furman M, Clarke A, Hui W, Elia Y, Baranger J, Villemain O, Mertens L, Mahmud FH. Abnormal vascular thickness and stiffness in young adults with type 1 diabetes: new insights from cutting-edge ultrasound modalities. Cardiovasc Diabetol 2024; 23:178. [PMID: 38789969 PMCID: PMC11127355 DOI: 10.1186/s12933-024-02280-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 05/18/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in patients with Type 1 Diabetes (T1D). Early markers of CVD include increased carotid intima-media thickness (CIMT) and pulse wave velocity (PWV), but these existing ultrasound technologies show limited spatial and temporal resolution in young adults. The purpose of this study is to evaluate the utility of high-resolution ultrasound modalities, including high frequency ultrasound CIMT (hfCIMT) and ultrafast ultrasound PWV (ufPWV), in young adults with Type 1 Diabetes. METHODS This is a prospective single-center observational cohort study including 39 participants with T1D and 25 age and sex matched controls. All participants underwent hfCIMT and ufPWV measurements. hfCIMT and ufPWV measures of T1D were compared with controls and associations with age, sex, BMI, A1c, blood pressure, and lipids were studied. RESULTS Mean age was 24.1 years old in both groups. T1D had a greater body mass index (27.7 [5.7] vs 23.1 [3.2] kg/m2), LDL Cholesterol, and estimated GFR, and had a mean A1c of 7.4 [1.0] % (57 mmol/mol) and diabetes duration of 16.1 [3.7] years with 56% using insulin pumps. In T1D, hfCIMT was significantly increased as compared to controls (0.435 ± 0.06 mm vs 0.379 ± 0.06 mm respectively, p < 0.01). ufPWV measures were significantly increased in T1D (systolic foot PWV: 5.29 ± 0.23 m/s vs 5.50 ± 0.37 m/s, p < 0.01; dicrotic notch PWV = 7.54 ± 0.46 m/s vs 7.92 ± 0.41 m/s, p < 0.01). Further, there was an impact of A1c-measured glycemia on hfCIMT, but this relationship was not seen with ufPWV. No significant statistical correlations between hfCIMT and ufPWV measures in either T1D or healthy controls were observed. CONCLUSION Young adults with T1D present with differences in arterial thickness and stiffness when compared with controls. Use of novel high-resolution ultrasound measures describe important relationships between early structural and vascular pathophysiologic changes and are promising tools to evaluate pre-clinical CVD risk in youth with T1D. TRIAL REGISTRATION ISRCTN91419926.
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Affiliation(s)
- Michael J De Biasio
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Michelle Furman
- Department of Pediatrics, Division of Endocrinology and Metabolism, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Antoine Clarke
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Wei Hui
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Yesmino Elia
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jerome Baranger
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Olivier Villemain
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Luc Mertens
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Farid H Mahmud
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Pediatrics, Division of Endocrinology and Metabolism, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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Marshall AG, Neikirk K, Afolabi J, Mwesigwa N, Shao B, Kirabo A, Reddy AK, Hinton A. Update on the Use of Pulse Wave Velocity to Measure Age-Related Vascular Changes. Curr Hypertens Rep 2024; 26:131-140. [PMID: 38159167 PMCID: PMC10955453 DOI: 10.1007/s11906-023-01285-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE OF REVIEW Pulse wave velocity (PWV) is an important and well-established measure of arterial stiffness that is strongly associated with aging. Age-related alterations in the elastic properties and integrity of arterial walls can lead to cardiovascular disease. PWV measurements play an important role in the early detection of these changes, as well as other cardiovascular disease risk factors, such as hypertension. This review provides a comprehensive summary of the current knowledge of the effects of aging on arterial stiffness, as measured by PWV. RECENT FINDINGS This review highlights recent findings showing the applicability of PWV analysis for investigating heart failure, hypertension, and other cardiovascular diseases, as well as cerebrovascular diseases and Alzheimer's disease. It also discusses the clinical implications of utilizing PWV to monitor treatment outcomes, various challenges in implementing PWV assessment in clinical practice, and the development of new technologies, including machine learning and artificial intelligence, which may improve the usefulness of PWV measurements in the future. Measuring arterial stiffness through PWV remains an important technique to study aging, especially as the technology continues to evolve. There is a clear need to leverage PWV to identify interventions that mitigate age-related increases in PWV, potentially improving CVD outcomes and promoting healthy vascular aging.
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Affiliation(s)
- Andrea G Marshall
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Kit Neikirk
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Jeremiah Afolabi
- Department of Medicine, Vanderbilt University Medical Center, 750 Robinson Research Building, 2200 Pierce Ave, Nashville, TN, 37232-0615, USA
| | - Naome Mwesigwa
- Department of Medicine, Vanderbilt University Medical Center, 750 Robinson Research Building, 2200 Pierce Ave, Nashville, TN, 37232-0615, USA
| | - Bryanna Shao
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Annet Kirabo
- Department of Medicine, Vanderbilt University Medical Center, 750 Robinson Research Building, 2200 Pierce Ave, Nashville, TN, 37232-0615, USA
| | - Anilkumar K Reddy
- Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
| | - Antentor Hinton
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA.
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Li X, Li Z, Zhang M, Li G, Yu T. Shear wave elastography to evaluate carotid artery elasticity in long-term drinkers with varying degrees of alcoholic fatty liver disease. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:696-702. [PMID: 36385468 DOI: 10.1002/jcu.23398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/01/2022] [Accepted: 10/18/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To evaluate carotid artery elasticity in long-term drinkers with varying degrees of alcoholic fatty liver disease (AFLD) by shear wave elastography (SWE). METHODS Of the 92 drinkers with alcohol drinking for greater than or equal to 5 years, were fell into three groups depending on the liver ultrasound results: group B (without AFLD), group C (with mild AFLD), and group D (moderate-to-severe AFLD). Another 32 healthy adults were selected as the control group (group A). All participants had no significant carotid plaque. Gray scale ultrasound and color doppler ultrasound were used to obtain the left common carotid peak systolic velocity (PSV), carotid diastolic internal diameter (Dd ), carotid intima-media thickness (IMT), carotid systolic internal diameter (Ds ) and the stiffness coefficient (β). Mean values of mean elastic modulus (MEmean ), minimum elastic modulus (MEmin ), and maximum elastic modulus (MEmax ) of the anterior wall of the left common carotid artery at end-diastole were measured by SWE. RESULTS Dd , Ds , and PSV among the four groups showed no differences. (all P > 0.05). Compared with groups A and B, MEmin , MEmax , and MEmean were significantly higher in group C (all P < 0.05), while IMT and β were not statistically different (all P > 0.05). MEmean , MEmin , MEmax , IMT, and β were significantly higher in group D compared with the other three groups (all P < 0.05). No significant differences were observed in IMT, β, MEmean , MEmax , and MEmin between groups A and B (all P > 0.05). CONCLUSIONS Shear wave elastography can provide a quantitative evaluation for the carotid artery elasticity in long-term drinkers with varying degrees of AFLD.
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Affiliation(s)
- Xiya Li
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Zhen Li
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Mengmeng Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Guangsen Li
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Tingting Yu
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
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Qiaoer GBS, Nianyu XMS. Application and Progress of Ultrasound Technology in Atherosclerosis. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY 2023. [DOI: 10.37015/audt.2023.220030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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Ma X, Zhu Z, Wang Y, Shen B, Jiang X, Liu W, Wu Y, Zou C, Luan Y, Gao H, Huang H. Quantifying carotid stiffness in a pre-hypertensive population with ultrafast ultrasound imaging. Ultrasonography 2023; 42:89-99. [PMID: 36588181 PMCID: PMC9816694 DOI: 10.14366/usg.22039] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/09/2022] [Indexed: 01/13/2023] Open
Abstract
PURPOSE The aim of this study was to assess carotid stiffening in a pre-hypertensive (PHT) population using ultrafast pulse wave velocity (ufPWV). METHODS This study retrospectively enrolled 626 individuals who underwent clinical interviews, serum tests, and assessments of the systolic blood pressure (SBP), diastolic blood pressure (DBP), carotid intima-media thickness (cIMT), pulse wave velocity-beginning of systole (PWV-BS), and pulse wave velocity-end of systole (PWV-ES) between January 2017 and December 2021. The patients were divided into three groups according to their blood pressure (BP)-normal BP (NBP): SBP <130 mmHg and DBP <80 mmHg (n=215); PHT: 130 mmHg≤SBP<140 mmHg and/or 80 mmHg≤DBP<90 mmHg (n=119); hypertensive (HT): SBP ≥140 mmHg and/or DBP ≥90 mmHg (n=292). Correlation analyses and comparisons were performed among the groups and in the cIMT subgroups (cIMT ≥0.050 cm and <0.050 cm). RESULTS cIMT and PWV-ES significantly differed among the BP groups (P<0.05). The BP groups had similar PWV-BS when cIMT <0.050 cm or cIMT ≥0.050 cm (all P>0.05). However, the NBP group had a notably lower PWV-ES than the PHT (P<0.001 and P=0.024) and HT (all P<0.001) groups in both cIMT categories, while the PWV-ES in the PHT group were not significantly lower than in the HT group (all P>0.05). CONCLUSION Carotid morphological and biomechanical properties in the PHT group differed from those in the NBP group. ufPWV could be used for an early evaluation of carotid stiffening linked to pre-hypertension.
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Affiliation(s)
- Xuehui Ma
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Zhengqiu Zhu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Yinping Wang
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Bixiao Shen
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Xuezhong Jiang
- Department of Ultrasound, Jiangsu Province Geriatric Hospital, Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Wenjun Liu
- School of Mathematics and Statistics, Nanjing University of Information Science and Technology, Nanjing, China
| | - Yiyun Wu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Chong Zou
- Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China,Center of Good Clinical Practice, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Yun Luan
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Hui Gao
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Hui Huang
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China,Correspondence to: Hui Huang, MD, Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, 155# Hanzhong Road, Nanjing 210029, China Tel. +86-25-8661-7141 Fax. +86-25-8661-7141 E-mail:
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Abstract
PURPOSE OF REVIEW Aging is an important risk factor for cardiovascular disease and is associated with increased vessel wall stiffness. Pathophysiological stiffening, notably in arteries, disturbs the integrity of the vascular endothelium and promotes permeability and transmigration of immune cells, thereby driving the development of atherosclerosis and related vascular diseases. Effective therapeutic strategies for arterial stiffening are still lacking. RECENT FINDINGS Here, we overview the literature on age-related arterial stiffening, from patient-derived data to preclinical in-vivo and in-vitro findings. First, we overview the common techniques that are used to measure stiffness and discuss the observed stiffness values in atherosclerosis and aging. Next, the endothelial response to stiffening and possibilities to attenuate this response are discussed. SUMMARY Future research that will define the endothelial contribution to stiffness-related cardiovascular disease may provide new targets for intervention to restore endothelial function in atherosclerosis and complement the use of currently applied lipid-lowering, antihypertensive, and anti-inflammatory drugs.
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Affiliation(s)
- Aukie Hooglugt
- Amsterdam UMC, University of Amsterdam, Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences
- Amsterdam UMC, VU University Medical Center, Department of Physiology, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Olivia Klatt
- Amsterdam UMC, University of Amsterdam, Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences
| | - Stephan Huveneers
- Amsterdam UMC, University of Amsterdam, Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences
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Wang Y, Zhu Z, Ma X, Liu W, Jiang X, Wu Y, Zou C, Shen B, Sun H, Gao H, Luan Y, Huang H. Individualized References of Carotid Stiffening Quantified With Ultrafast Ultrasound Imaging: Model Construction and Preliminary Validation. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:1528-1536. [PMID: 35595590 DOI: 10.1016/j.ultrasmedbio.2022.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 06/15/2023]
Abstract
To establish and preliminarily validate an individualized reference of carotid stiffness quantified by ultrafast pulse wave velocity (ufPWV), our study included 225 healthy individuals in the modeling cohort and 628 individuals in the validation cohort. All participants underwent assessment of carotid intima-media thickness (cIMT), pulse wave velocity-beginning of systole and pulse wave velocity-end of systole (PWV-ES). A threshold equation of estimated PWV-ES was obtained by multiple linear regression analysis in the modeling cohort as follows: estimated PWV-ES (m/s) = 0.080 × age (y) + 0.767 × low-density lipoprotein (mmol/L) + 0.040 × systolic blood pressure (mm Hg) + 0.372 × sex (male = 1, female = 0) - 2.803. With this equation, the validation cohort was divided into the low PWV-ES (actual PWV-ES ≤ estimated PWV-ES) and high PWV-ES (actual PWV-ES > estimated PWV-ES) groups. A clear boundary was found to be present between the low PWV-ES and high PWV-ES groups in the validation cohort. Participants with increasing PWV-ES increased with age gradually. We further subdivided participants into cIMT subgroups using a cutoff thickness of 0.050 cm. Diagnostic performance analysis revealed that the sensitivity and specificity of the threshold equation were 78.9% and 73.9%, respectively. We established and validated a novel individualized reference equation for estimated PWV-ES, which can likely expand the application of prospective ufPWV assessment.
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Affiliation(s)
- Yinping Wang
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Zhengqiu Zhu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Xuehui Ma
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Wenjun Liu
- School of Mathematics and Statistics, Nanjing University of Information Science and Technology, Nanjing, China
| | - Xuezhong Jiang
- Department of Ultrasound, Jiangsu Province Geriatric Hospital, Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Yiyun Wu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Chong Zou
- Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China; Center of Good Clinical Practice, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Bixiao Shen
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Hongye Sun
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Hui Gao
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Yun Luan
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Hui Huang
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China.
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Contribution of UltraFast™ Ultrasound and Shear Wave Elastography in the Imaging of Carotid Artery Disease. Diagnostics (Basel) 2022; 12:diagnostics12051168. [PMID: 35626326 PMCID: PMC9140890 DOI: 10.3390/diagnostics12051168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/12/2022] [Accepted: 05/05/2022] [Indexed: 02/01/2023] Open
Abstract
Carotid artery disease is one of the main global causes of disability and premature mortality in the spectrum of cardiovascular diseases. One of its main consequences, stroke, is the second biggest global contributor to disability and burden via Disability Adjusted Life Years after ischemic heart disease. In the last decades, B-mode and Doppler-based ultrasound imaging techniques have become an indispensable part of modern medical imaging of carotid artery disease. However, they have limited abilities in carotid artery plaque and wall characterization and are unable to provide simultaneous quantitative and qualitative flow information while the images are burdened by low framerates. UltraFast™ ultrasound is able to overcome these obstacles by providing simultaneous quantitative and qualitative flow analysis information in high frame rates via UltraFast™ Doppler. Another newly developed ultrasound technique, shear wave elastography, is based on the visualization of induced shear waves and the measurement of the shear wave propagation speed in the examined tissues which enables real-time carotid plaque and wall analysis. These newly developed ultrasound modalities have potential to significantly improve workflow efficiency and are able to provide a plethora of additional imaging information of carotid artery disease in comparison to conventional ultrasound techniques.
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12
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An X, Li Y, Shi S, Ge L, Li Y. Clinical significance and influencing factors of carotid pulse wave velocity in patients with diabetic microangiopathy. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:309-316. [PMID: 35150445 DOI: 10.1002/jcu.23153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/01/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE To evaluate the utility of carotid ultrafast pulse wave velocity (PWV) and explore its influencing factors in patients with type 2 diabetes mellitus (T2DM) microangiopathy. METHODS Seventy-seven patients with T2DM were divided into two groups according to the absence (Group A, n = 45) or presence (Group B, n = 32) of microangiopathy. The control group comprised 1544 healthy volunteers. Two-dimensional ultrasonography was used to measure intima-media thickness (IMT) of the carotid arteries, and ultrafast ultrasound imaging was used to measure PWV of the carotid arteries at the beginning of systole (PWV-BS) and the end of systole (PWV-ES). RESULTS The IMT, PWV-BS, and PWV-ES were higher in the T2DM group than in the control group, and the values in T2DM Group B were higher than those in Group A. IMT was positively correlated with PWV-BS and PWV-ES. Age and uric acid were influencing factors of PWV-ES, while age, uric acid, body mass index, glycated hemoglobin, and urine albumin/creatinine ratio were influencing factors of PWV-BS. PWV-ES was a more sensitive predictor than PWV-BS, and a PWV-ES critical value predicted carotid elasticity in patients with T2DM microangiopathy. CONCLUSION Ultrafast PWV can reflect early atherosclerosis and provide a noninvasive assessment of microangiopathy in patients with T2DM.
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Affiliation(s)
- Xin An
- Department of Ultrasound, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Yihan Li
- Department of Ultrasound, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Shanshan Shi
- Department of Ultrasound, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Lili Ge
- Department of Ultrasound, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Yuhong Li
- Department of Ultrasound, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China
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13
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Alan B, Alan S. Evaluation of carotid artery stiffness in patients with coronary artery disease using acoustic radiation force impulse elastography. Vascular 2022; 31:564-572. [PMID: 35226579 DOI: 10.1177/17085381221076679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES We evaluated carotid artery stiffness in patients with coronary artery disease (CAD) using acoustic radiation force impulse (ARFI) elastography and investigated the relationship between stiffness and CAD. METHODS This study examined 76 CAD patients (aged 60.7 ± 11) and 70 healthy individuals (aged 59.6 ± 9). The left common carotid artery mean shear wave velocity (LCmeanSWV) and the right common carotid artery mean shear wave velocity (RCmeanSWV) of the anterior walls were measured using ARFI elastography, and the results of the patient group and the healthy group were compared. The common carotid intima-media thickness (CIMT) was measured in both groups and compared with mean SWV. RESULTS The RCmeanSWVs in the patient and healthy groups were 3.47 ± 1 m/s and 2.69 ± 0.90 m/s, respectively (p < 0.001). The LCmeanSWVs in the patient and healthy groups were 3.60 ± 0.9 m/s and 2.90 ± 0.80 m/s, respectively (p < 0.001). A significant correlation was found between the RCmeanSWV and the right CIMT values and between the LCmeanSWV and the left CIMT values (r = 0.231, p = 0.03 and r = 0.331, p = 0.002, respectively). CONCLUSIONS The mean SWV values of carotid arteries of CAD patients measured with ARFI elastography were significantly higher than the mean SWV values of the carotid arteries of healthy individuals. Thus, measurement of the carotid artery SWV could be a potential tool in the risk evaluation of cardiovascular disease. Nonetheless, new studies are required to determine whether this method serves as a useful additional tool.
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Affiliation(s)
- Bircan Alan
- Department of Radiology, 52942Bolu Abant İzzet Baysal University Medical Faculty, Bolu, Turkey
| | - Sait Alan
- Department of Cardiology, 52942Bolu Abant İzzet Baysal University Medical Faculty, Bolu, Turkey
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14
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Yin LX, Ma CY, Wang S, Wang YH, Meng PP, Pan XF, Yang J, Zhang YH, Liu MH, Li MX, Gao J, Wu Q, Feng NN, Wu YY, Zhang JX, Xue L, Chang FL, Chen L, Sun YX, Yuan JJ, Yang SS, Xue HY, Ma LZ, Jiang XZ, Li J, Zheng LQ, Ren WD. Reference Values of Carotid Ultrafast Pulse-Wave Velocity: A Prospective, Multicenter, Population-Based Study. J Am Soc Echocardiogr 2021; 34:629-641. [PMID: 33422666 DOI: 10.1016/j.echo.2021.01.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 01/03/2021] [Accepted: 01/04/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Ultrafast ultrasound imaging has been demonstrated to be an effective method to evaluate carotid stiffness through carotid pulse-wave velocity (PWV) with high reproducibility, but a lack of reference values has precluded its widespread use in clinical practice. The aims of this study were to establish reference values of PWV for ultrafast ultrasound imaging in a prospective, multicenter, population-based cohort study and to investigate the main determinants of carotid PWV. METHODS A total of 1,544 healthy Han Chinese volunteers (581 men [38%]; age range, 18-95 years) were enrolled from 32 collaborating laboratories in China. The participants were categorized by age, blood pressure (BP), and body mass index (BMI). Basic clinical parameters and carotid PWV at the beginning of systole (BS) and at end-systole (ES) were measured using ultrafast ultrasound imaging techniques. RESULTS PWV at both BS and ES was significantly higher in the left carotid artery than in the right carotid artery. PWV at BS was significantly higher in men than in women; however, no significant difference was noted in PWV at ES between men and women. Multiple linear regression analyses revealed that age, BP, and BMI were independently correlated with PWV at both BS and ES. PWV at BS and ES progressively increased with increases in age, BP, and BMI. Furthermore, age- and sex-specific reference values of carotid PWV for ultrafast ultrasound imaging were established. CONCLUSIONS Reference values of carotid PWV for ultrafast ultrasound imaging, stratified by sex and age, were determined for the first time. Age, BP, and BMI were the dominant determinants of carotid PWV for ultrafast ultrasound imaging, which should be considered in clinical practice for assessing arterial stiffness.
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Affiliation(s)
- Li-Xue Yin
- Department of Cardiovascular Ultrasound & Noninvasive Cardiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Chun-Yan Ma
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China
| | - Shan Wang
- Department of Cardiovascular Ultrasound & Noninvasive Cardiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Yong-Huai Wang
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China
| | - Ping-Ping Meng
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China
| | - Xiao-Fang Pan
- Health Medical Department, Dalian Municipal Central Hospital, Dalian, China
| | - Jun Yang
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China
| | - Yu-Hua Zhang
- Department of Ultrasound, The Third People's Hospital of Zhengzhou, Zhengzhou, China
| | - Ming-Hui Liu
- Department of Ultrasound Diagnosis, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ming-Xing Li
- Department of Ultrasound Diagnosis, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jie Gao
- Department of Ultrasound, Affiliated Hospital of Yan'an University, Yan'an, China
| | - Qiang Wu
- Ultrasound Department, Central Hospital of Chongqing Three Gorges, Chongqing, China
| | - Ning-Na Feng
- Medical Technology Department, Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Yi-Yun Wu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jian-Xing Zhang
- Ultrasonic Department, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Li Xue
- Department of Cardiac Ultrasound, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Feng-Ling Chang
- Department of Ultrasound, Xinxiang Central Hospital, Xinxiang, China
| | - Li Chen
- Department of Ultrasound, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yi-Xue Sun
- Ultrasonic Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Jian-Jun Yuan
- Ultrasonography Department, Henan Provincial People's Hospital, Zhengzhou, China
| | - Shun-Shi Yang
- Department of Medical Ultrasound, The Central Hospital of Wuhan, Wuhan, China
| | - Hong-Yuan Xue
- Department of Ultrasound, Hebei General Hospital, Shijiazhuang, China
| | - Ling-Zhi Ma
- Department of Ultrasound, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Xue-Zhong Jiang
- Department of Medical Ultrasound, Geriatric Hospital of Nanjing Medical University & Jiangsu Provincial Geriatric Hospital, Nanjing, China
| | - Jing Li
- Ultrasonography Department, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Li-Qiang Zheng
- Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wei-Dong Ren
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China.
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Zhu ZQ, Chen LS, Jiang XZ, Wu YY, Zou C, Luan Y, Gao H, Dai P, Ma XH, Wu LL, Sun HJ, Wang YP, Zou F, Liu FM, Huang H. Absent atherosclerotic risk factors are associated with carotid stiffening quantified with ultrafast ultrasound imaging. Eur Radiol 2020; 31:3195-3206. [PMID: 33068187 DOI: 10.1007/s00330-020-07405-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 09/23/2020] [Accepted: 10/09/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To evaluate carotid stiffening in participants without conventional cardiovascular risk factors (CVRFs) by using ultrafast pulse wave velocity (ufPWV). METHODS The present study enrolled 517 participants without conventional CVRFs (CVRF-Free total population). Subjects in this population were defined as current non-smokers with untreated blood pressure < 140/90 mmHg, fasting blood glucose (FBG) < 7.0 mmol/L, total cholesterol (TC) < 6.2 mmol/L, low-density lipoprotein cholesterol < 4.1 mmol/L, and high-density lipoprotein cholesterol ≥ 1.0 mmol/L. Participants in the subgroup with optimal CVRFs (CVRF-Optimal subgroup; n = 188) were defined as having blood pressure < 120/80 mmHg, TC < 5.2 mmol/L, and FBG < 5.6 mmol/L. Clinical interviews, physical examinations, serum draw, carotid intima-media thickness (cIMT), and ufPWV were evaluated. Adjusted odds ratios (ORs) with 95% confidence intervals and ordinal logistic regression models were used. RESULTS Carotid stiffening was present in 46.2-54.5% of CVRF-Free subjects. Age, male sex, and body mass index (BMI) were independently associated with carotid stiffening in both the CVRF-Free total population and CVRF-Optimal subgroup (OR for age = 1.10-1.11, OR for male sex = 2.65-7.19, OR for BMI = 1.34-1.62; p < 0.05). Carotid stiffening was associated with TC only in the CVRF-Free total population (OR for TC = 1.84; p = 0.034). CONCLUSIONS Many CVRF-Free individuals have carotid stiffening. ufPWV for atherosclerotic stiffening aids the assessment of early atherogenesis and may further clarify the true status of healthy adults without CVRFs. KEY POINTS • CVRF-Optimal individuals have a lower carotid stiffness than CVRF-Free populations. • ufPWV is a quantitative predictor for the early assessment of AS. • Absent major CVRFs cannot be considered low risk for carotid stiffening and atherosclerosis.
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Affiliation(s)
- Zheng-Qiu Zhu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Ling-Shan Chen
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Xue-Zhong Jiang
- Department of Ultrasound, Jiangsu Province Geriatric Hospital, Geriatric Hospital of Nanjing Medical University, Nanjing, 210024, China
| | - Yi-Yun Wu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Chong Zou
- Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China.,Center of Good Clinical Practice, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Yun Luan
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Hui Gao
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Ping Dai
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Xue-Hui Ma
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Lin-Lin Wu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Hui-Juan Sun
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Yin-Ping Wang
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Fei Zou
- Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Fu-Ming Liu
- Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China.
| | - Hui Huang
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China.
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Pan FS, Xu M, Yu L, Luo J, Li MY, Liang JY, Zheng YL, Xie XY. Relationship between carotid intima-media thickness and carotid artery stiffness assessed by ultrafast ultrasound imaging in patients with type 2 diabetes. Eur J Radiol 2018; 111:34-40. [PMID: 30691662 DOI: 10.1016/j.ejrad.2018.12.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 12/03/2018] [Accepted: 12/13/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To evaluate the relationship between carotid stiffness and carotid intima-media thickness (CIMT) in patients with type 2 diabetes (T2DM). MATERIALS AND METHODS Carotid properties were evaluated in 317 consecutive subjects (98 volunteers for controls, 105 patients with normal CIMT for T2DM group 1, and 114 patients with thickened CIMT for T2DM group 2). The CIMT and carotid pulse wave velocity at the beginning (PWV-BS) and at the end of systole (PWV-ES) were measured. RESULTS Apart from PWV-BS in T2DM group 1, CIMT and PWV-ES were significant higher in patients groups than those of in controls. In multiple regression analysis, diabetes was independently associated with PWV-ES and not with PWV-BS. Moreover, when adjusting for baseline covariates, only PWV-ES (odds ratio = 4.27, P < 0.001) distinguished carotid in T2DM group 1 from that of controls. Concerning the relationship between log(CIMT) and PWV-ES, when adjusting for baseline covariates, the association were still significant in controls and T2DM group 1, whereas it was no longer present in T2DM group 2 (P = 0.091). Additionally, the slope (β) after adjustment for the PWV-ES to log(CIMT) was significantly steeper in T2DM group 1 than that of in controls (β= 8.35 vs. 3.31, P < 0.01). CONCLUSIONS The PWV-ES seem to be a better biomarker candidate than PWV-BS to assess the carotid stiffness in diabetic patients. Compared with controls, diabetic patients showed more advanced functional changes than morphological changes despite normal CIMT, whereas the relationship trend was not present when thickened CIMT emerged.
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Affiliation(s)
- Fu-Shun Pan
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Ming Xu
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Liang Yu
- Department of Vascular and Thyroid Surgery, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Jia Luo
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Man-Ying Li
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Jin-Yu Liang
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Yan-Ling Zheng
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
| | - Xiao-Yan Xie
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, PR China.
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17
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Zhu ZQ, Chen LS, Wang H, Liu FM, Luan Y, Wu LL, Liu N, Wang P, Huang H. Carotid stiffness and atherosclerotic risk: non-invasive quantification with ultrafast ultrasound pulse wave velocity. Eur Radiol 2018; 29:1507-1517. [PMID: 30187117 DOI: 10.1007/s00330-018-5705-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 07/25/2018] [Accepted: 08/06/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the value of ultrafast pulse wave velocity (ufPWV) for the quantitative assessment of carotid stiffness and its associated with atherosclerosis (AS) risk. METHODS The present study included 233 patients with hyperlipoidaemia (AS risk group) and 114 healthy adults as the control group. The carotid (n = 694) intima-media thickness (cIMT), pulse wave velocity-beginning of systole (PWV-BS) and pulse wave velocity-end of systole (PWV-ES) were measured on sample images. Differences, distributive characteristics and correlation evaluation were assessed in patients (ages 18-29, 30-39, 40-49, 50-59, 60-69 and ≥70) and carotids (control group vs AS risk group). RESULTS The cIMT, PWV-BS and PWV-ES increased with age; PWV-ES and cIMT showed an early significant increase in the 30-39 years group, whereas PWV-BS displayed a significant increase at 40-49 years compared with the 18- to 29-years group. Besides, PWV-ES correlated well with age compared with PWV-BS and cIMT. For carotid level, cIMT, PWV-BS and PWV-ES measurements were higher in the AS risk group compared with control. To compare the value of ufPWV and cIMT in early AS assessment, we subdivided groups into cIMT subgroups using a cut-off thickness of 0.050 cm. PWV-ES measurements were higher in the AS risk group compared with the control in the 0.040-0.050 cm (not thickened) and 0.051-0.060 cm (thickened) cIMT subgroups. CONCLUSIONS Carotid ufPWV measurement at PWV-ES is a novel modality for the early diagnosis and quantitative assessment of arterial stiffness associated with atherosclerotic risk. KEY POINTS • ufPWV technique is real-time and well repeatable for assessing carotid stiffness • ufPWV measurements increase and correlate well with age • PWV-ES is a quantitative predictor for the early assessment of AS.
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Affiliation(s)
- Zheng-Qiu Zhu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of CM, Nanjing, 210029, China
| | - Ling-Shan Chen
- Department of Radiology, Affiliated Hospital of Nanjing University of CM, Nanjing, 210029, China
| | - Han Wang
- Department of Geratology, Affiliated Hospital of Nanjing University of CM, Nanjing, 210029, China
| | - Fu-Ming Liu
- Department of Cardiology, Affiliated Hospital of Nanjing University of CM, Nanjing, 210029, China
| | - Yun Luan
- Department of Ultrasound, Affiliated Hospital of Nanjing University of CM, Nanjing, 210029, China
| | - Lin-Lin Wu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of CM, Nanjing, 210029, China
| | - Niu Liu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of CM, Nanjing, 210029, China
| | - Pin Wang
- Department of Endocrinology, Sichuan Academy of Medical Science and Sichuan Provincial People's Hospital, Chengdu, 610000, China
| | - Hui Huang
- Department of Ultrasound, Affiliated Hospital of Nanjing University of CM, Nanjing, 210029, China.
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