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Xiong L, Zhang Y, He B, Zhang K, Zhu J, Lang X. Optimum Parameters in Ultrasound Coherent Plane Wave Compounding for High LPWV Estimation: Validation on Phantom and Feasibility in 10 Subjects. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:1469-1487. [PMID: 38700113 DOI: 10.1002/jum.16469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 04/12/2024] [Accepted: 04/13/2024] [Indexed: 05/05/2024]
Abstract
OBJECTIVES The aim of this study is to determine the optimum and fine values of the number and transmission angles of tilted plane waves for coherent plane-wave compounding (CPWC)-based high local pulse wave velocity (LPWV) estimation. METHODS A Verasonics system incorporating a linear array probe L14-5/38 with 128 elements and a pulsatile pump, CompuFlow1000, were used to acquire radio frequency data of 3, 5, 7, and 9 tilted plane wave sequences with angle intervals from 0° to 12° with a coarse interval increment step of 1°, and the angle intervals from 0° to 2° with a fine interval increment step of 0.25° from a carotid vessel phantom with the LPWV of 13.42 ± 0.90 m/s. The mean value, standard deviation, and coefficients of variation (CV) of the estimated LPWVs were calculated to quantitatively assess the performance of different configurations for CPWC-based LPWV estimation. Ten healthy human subjects of two age groups were recruited to assess the in vivo feasibility of the optimum parameter values. RESULTS The CPWC technique with three plane waves (PRF of 12 kHz corresponding to a frame rate of 4000 Hz) with an interval of 0.75° had LPWVs of 13.52 ± 0.08 m/s with the lowest CV of 1.84% on the phantom, and 5.49 ± 1.46 m/s with the lowest CV of 12.35% on 10 subjects. CONCLUSIONS The optimum parameters determined in this study show the best repeatability of the LPWV measurements with a vessel phantom and 10 healthy subjects, which support further studies on larger datasets for potential applications.
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Affiliation(s)
- Li Xiong
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, China
| | - Yufeng Zhang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, China
| | - Bingbing He
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, China
| | - Kexin Zhang
- The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jingying Zhu
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, China
| | - Xun Lang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, China
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Gu O, He B, Xiong L, Zhang Y, Li Z, Lang X. Reconstructive interpolation for pulse wave estimation to improve local PWV measurement of carotid artery. Med Biol Eng Comput 2024; 62:1459-1473. [PMID: 38252371 DOI: 10.1007/s11517-023-03008-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 12/21/2023] [Indexed: 01/23/2024]
Abstract
Ultrasonic transit time (TT)-based local pulse wave velocity (PWV) measurement is defined as the distance between two beam positions on a segment of common carotid artery (CCA) divided by the TT in the pulse wave propagation. However, the arterial wall motions (AWMs) estimated from ultrasonic radio frequency (RF) signals with a limited number of frames using the motion tracking are typically discrete. In this work, we develop a method involving motion tracking combined with reconstructive interpolation (MTRI) to reduce the quantification errors in the estimated PWs, and thereby improve the accuracy of the TT-based local PWV measurement for CCA. For each beam position, normalized cross-correlation functions (NCCFs) between the reference (the first frame) and comparison (the remaining frames) RF signals are calculated. Thereafter, the reconstructive interpolation is performed in the neighborhood of the NCCFs' peak to identify the interpolation-deduced peak locations, which are more exact than the original ones. According to which, the improved AWMs are obtained to calculate their TT along a segment of the CCA. Finally, the local PWV is measured by applying a linear regression fit to the time-distance result. In ultrasound simulations based on the pulse wave propagation models of young, middle-aged, and elderly groups, the MTRI method with different numbers of interpolated samples was used to estimate AWMs and local PWVs. Normalized root mean squared errors (NRMSEs) between the estimated and preset values of the AWMs and local PWVs were calculated and compared with ones without interpolation. The means of the NRMSEs for the AWMs and local PWVs based on the MTRI method with one interpolated sample decrease from 1.14% to 0.60% and 7.48% to 4.61%, respectively. Moreover, Bland-Altman analysis and coefficient of variation were used to validate the performance of the MTRI method based on the measured local PWVs of 30 healthy subjects. In conclusion, the reconstructive interpolation for the pulse wave estimation improves the accuracy and repeatability of the carotid local PWV measurement.
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Affiliation(s)
- Ouyang Gu
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, 650091, Yunnan, China
| | - Bingbing He
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, 650091, Yunnan, China.
| | - Li Xiong
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, 650091, Yunnan, China
| | - Yufeng Zhang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, 650091, Yunnan, China
| | - Zhiyao Li
- Department of Ultrasound, the Third Affiliated Hospital of Kunming Medical College, Kunming, 650118, China
| | - Xun Lang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, 650091, Yunnan, China
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Shin S, Choi S, Kim C, Mousavi AS, Hahn JO, Jeong S, Jeong H. BCG Signal Quality Assessment Based on Time-Series Imaging Methods. SENSORS (BASEL, SWITZERLAND) 2023; 23:9382. [PMID: 38067755 PMCID: PMC10708708 DOI: 10.3390/s23239382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/01/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023]
Abstract
This paper describes a signal quality classification method for arm ballistocardiogram (BCG), which has the potential for non-invasive and continuous blood pressure measurement. An advantage of the BCG signal for wearable devices is that it can easily be measured using accelerometers. However, the BCG signal is also susceptible to noise caused by motion artifacts. This distortion leads to errors in blood pressure estimation, thereby lowering the performance of blood pressure measurement based on BCG. In this study, to prevent such performance degradation, a binary classification model was created to distinguish between high-quality versus low-quality BCG signals. To estimate the most accurate model, four time-series imaging methods (recurrence plot, the Gramain angular summation field, the Gramain angular difference field, and the Markov transition field) were studied to convert the temporal BCG signal associated with each heartbeat into a 448 × 448 pixel image, and the image was classified using CNN models such as ResNet, SqueezeNet, DenseNet, and LeNet. A total of 9626 BCG beats were used for training, validation, and testing. The experimental results showed that the ResNet and SqueezeNet models with the Gramain angular difference field method achieved a binary classification accuracy of up to 87.5%.
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Affiliation(s)
- Sungtae Shin
- Department of Mechanical Engineering, Dong-A University, Busan 49315, Republic of Korea; (S.S.); (S.C.)
| | - Soonyoung Choi
- Department of Mechanical Engineering, Dong-A University, Busan 49315, Republic of Korea; (S.S.); (S.C.)
| | - Chaeyoung Kim
- Institute for Digital Antiaging and Healthcare, Inje University, Gimhae 50834, Republic of Korea;
| | - Azin Sadat Mousavi
- Department of Mechanical Engineering, University of Maryland, College Park, MD 20742, USA; (A.S.M.); (J.-O.H.)
| | - Jin-Oh Hahn
- Department of Mechanical Engineering, University of Maryland, College Park, MD 20742, USA; (A.S.M.); (J.-O.H.)
| | - Sehoon Jeong
- Institute for Digital Antiaging and Healthcare, Inje University, Gimhae 50834, Republic of Korea;
- Department of Healthcare Information Technology, Inje University, Gimhae 50834, Republic of Korea
- Paik Institute for Clinical Research, Inje University, Busan 50834, Republic of Korea
| | - Hyundoo Jeong
- Department of Mechatronics Engineering, Incheon National University, Incheon 22012, Republic of Korea
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Bianchini E, Guala A, Golemati S, Alastruey J, Climie RE, Dalakleidi K, Francesconi M, Fuchs D, Hartman Y, Malik AEF, Makūnaitė M, Nikita KS, Park C, Pugh CJA, Šatrauskienė A, Terentes-Printizios D, Teynor A, Thijssen D, Schmidt-Trucksäss A, Zupkauskienė J, Boutouyrie P, Bruno RM, Reesink KD. The Ultrasound Window Into Vascular Ageing: A Technology Review by the VascAgeNet COST Action. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:2183-2213. [PMID: 37148467 DOI: 10.1002/jum.16243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/24/2023] [Accepted: 04/14/2023] [Indexed: 05/08/2023]
Abstract
Non-invasive ultrasound (US) imaging enables the assessment of the properties of superficial blood vessels. Various modes can be used for vascular characteristics analysis, ranging from radiofrequency (RF) data, Doppler- and standard B/M-mode imaging, to more recent ultra-high frequency and ultrafast techniques. The aim of the present work was to provide an overview of the current state-of-the-art non-invasive US technologies and corresponding vascular ageing characteristics from a technological perspective. Following an introduction about the basic concepts of the US technique, the characteristics considered in this review are clustered into: 1) vessel wall structure; 2) dynamic elastic properties, and 3) reactive vessel properties. The overview shows that ultrasound is a versatile, non-invasive, and safe imaging technique that can be adopted for obtaining information about function, structure, and reactivity in superficial arteries. The most suitable setting for a specific application must be selected according to spatial and temporal resolution requirements. The usefulness of standardization in the validation process and performance metric adoption emerges. Computer-based techniques should always be preferred to manual measures, as long as the algorithms and learning procedures are transparent and well described, and the performance leads to better results. Identification of a minimal clinically important difference is a crucial point for drawing conclusions regarding robustness of the techniques and for the translation into practice of any biomarker.
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Affiliation(s)
| | - Andrea Guala
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | - Spyretta Golemati
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jordi Alastruey
- Department of Biomedical Engineering, King's College London, London, UK
| | - Rachel E Climie
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- INSERM, U970, Paris Cardiovascular Research Center (PARCC), Université de Paris, Hopital Europeen Georges Pompidou - APHP, Paris, France
| | - Kalliopi Dalakleidi
- Biomedical Simulations and Imaging (BIOSIM) Laboratory, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Martina Francesconi
- Institute of Clinical Physiology, CNR, Pisa, Italy
- University of Pisa, Pisa, Italy
| | - Dieter Fuchs
- Fujifilm VisualSonics, Amsterdam, The Netherlands
| | - Yvonne Hartman
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Afrah E F Malik
- CARIM School for Cardiovascular Diseases and Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Monika Makūnaitė
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Konstantina S Nikita
- Biomedical Simulations and Imaging (BIOSIM) Laboratory, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Chloe Park
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Christopher J A Pugh
- Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Agnė Šatrauskienė
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Centre of Cardiology and Angiology, Vilnius University Hospital Santaros klinikos, Vilnius, Lithuania
| | - Dimitrios Terentes-Printizios
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandra Teynor
- Faculty of Computer Science, Augsburg University of Applied Sciences, Augsburg, Germany
| | - Dick Thijssen
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Division Sport and Exercise Medicine, University of Basel, Basel, Switzerland
| | - Jūratė Zupkauskienė
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Pierre Boutouyrie
- INSERM, U970, Paris Cardiovascular Research Center (PARCC), Université de Paris, Hopital Europeen Georges Pompidou - APHP, Paris, France
| | - Rosa Maria Bruno
- INSERM, U970, Paris Cardiovascular Research Center (PARCC), Université de Paris, Hopital Europeen Georges Pompidou - APHP, Paris, France
| | - Koen D Reesink
- CARIM School for Cardiovascular Diseases and Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, The Netherlands
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Walser M, Schlichtiger J, Dalla-Pozza R, Mandilaras G, Tengler A, Ulrich S, Oberhoffer FS, Oberhoffer-Fritz R, Böhm B, Haas NA, Jakob A. Oscillometric pulse wave velocity estimated via the Mobil-O-Graph shows excellent accuracy in children, adolescents and young adults: an invasive validation study. J Hypertens 2023; 41:597-607. [PMID: 36723480 DOI: 10.1097/hjh.0000000000003374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
AIMS Increased arterial stiffness, measured as arterial pulse wave velocity (PWV) is associated with an elevated cardiovascular risk. Although noninvasive PWV measurement methods have been validated by invasive measurement, there is little such data on pediatric patients. The purpose of this study was to 'fill the gap' by validating PWV obtained by Mobil-O-Graph in children, adolescents in comparison to young adults. METHODS Sixty patients (25 male, mean age 16.6 years; range 3-35 years) were included in this study. Fifty-one patients underwent cardiac catheterization after a heart transplantation (HTX) and nine for interventional atrial septal defect-closure. Specific invasive pulse wave velocities were assessed for the ascending aorta (aPWV) and entire central aorta (cPWV). These invasive PWV results were compared to simultaneously measured brachial cuff readings using Mobil-O-Graph (oPWV) stratified by age in two groups (PEDIATRICS <18 years|ADULTS ≥18 years). RESULTS Correlation analysis showed a positive linear relation between both invasive PWV measurements and the oPWV in all ages (cPWV/oPWV: r = 0.417, aPWV/oPWV: r = 0.628; P < 0.001). The oPWV data agreed better with the aPWV in mean-value comparisons and correlations with mean difference in PEDIATRICS was 0.41 ± 0.41 m/s (95% confidence interval 0.27-0.55). We also found the cPWV to be faster than the aPWV particularly in adults. In addition, cPWV correlated closer with age ( r = 0.393, P < 0.05). CONCLUSION Estimated oPWV using the Mobil-O-Graph demonstrated excellent accuracy in adults and pediatric patients. Therefore, the Mobil-O-Graph can be implemented as an ambulatory PWV measuring tool for pediatric cardiovascular risk stratification. CLINICAL TRIAL REGISTRATION German clinical trial registration, DRKS00015066.
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Affiliation(s)
- Matthias Walser
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University of Munich
| | - Jenny Schlichtiger
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University of Munich
| | - Robert Dalla-Pozza
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University of Munich
| | - Guido Mandilaras
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University of Munich
| | - Anja Tengler
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University of Munich
| | - Sarah Ulrich
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University of Munich
| | - Felix Sebastian Oberhoffer
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University of Munich
| | - Renate Oberhoffer-Fritz
- Institute of Preventive Pediatrics, Faculty of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Birgit Böhm
- Institute of Preventive Pediatrics, Faculty of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Nikolaus A Haas
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University of Munich
| | - André Jakob
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University of Munich
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Pruijssen JT, Wilbers J, Meijer FJA, Pegge SAH, Loonen JJ, de Korte CL, Kaanders JHAM, Hansen HHG. Assessing radiation-induced carotid vasculopathy using ultrasound after unilateral irradiation: a cross-sectional study. Radiat Oncol 2022; 17:130. [PMID: 35871069 PMCID: PMC9308928 DOI: 10.1186/s13014-022-02101-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Increased head and neck cancer (HNC) survival requires attention to long-term treatment sequelae. Irradiated HNC survivors have a higher ischemic stroke risk. However, the pathophysiology of radiation-induced vasculopathy is unclear. Arterial stiffness could be a biomarker. This study examined alterations in intima-media thickness (IMT) and stiffness-related parameters, shear wave (SWV) and pulse wave velocity (PWV), in irradiated compared to control carotids in unilateral irradiated patients. Methods Twenty-six patients, median 40.5 years, 5–15 years after unilateral irradiation for head and neck neoplasms underwent a bilateral carotid ultrasound using an Aixplorer system with SL18-5 and SL10-2 probes. IMT, SWV, and PWV were assessed in the proximal, mid, and distal common (CCA) and internal carotid artery (ICA). Plaques were characterized with magnetic resonance imaging. Measurements were compared between irradiated and control sides, and radiation dose effects were explored. Results CCA-IMT was higher in irradiated than control carotids (0.54 [0.50–0.61] vs. 0.50 [0.44–0.54] mm, p = 0.001). For stiffness, only anterior mid-CCA and posterior ICA SWV were significantly higher in the irradiated side. A radiation dose–effect was only (weakly) apparent for PWV (R2: end-systolic = 0.067, begin-systolic = 0.155). Ultrasound measurements had good–excellent intra- and interobserver reproducibility. Plaques had similar characteristics but were more diffuse in the irradiated side. Conclusions Increased CCA-IMT and SWV in some segments were seen in irradiated carotids. These alterations, even in young patients, mark the need for surveillance of radiation-induced vasculopathy. Trial registration: clinicaltrials.gov (https://clinicaltrials.gov/ct2/show/NCT04257968).
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van den Bos-van de Steeg MGM, Fekkes S, Saris AECM, de Korte CL, Hansen HHG. In Vivo Comparison of Pulse Wave Velocity Estimation Based on Ultrafast Plane Wave Imaging and High-Frame-Rate Focused Transmissions. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:2335-2343. [PMID: 35999121 DOI: 10.1016/j.ultrasmedbio.2022.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 05/16/2022] [Accepted: 06/03/2022] [Indexed: 06/15/2023]
Abstract
Ultrasound-based local pulse wave velocity (PWV) estimation, as a measure of arterial stiffness, can be based on fast focused imaging (FFI) or plane wave imaging (PWI). This study was aimed at comparing the accuracy of in vivo PWV estimation using FFI and PWI. Ultrasound radiofrequency data of carotid arteries were acquired in 14 healthy volunteers (25-57 y) by executing the FFI (12 lines, 7200 Hz) and PWI (128 lines, 2000 Hz) methods consecutively. PWV was derived at two time-reference points, dicrotic notch (DN) and systolic foot (SF), for multiple pressure cycles by fitting a linear function through the positions of the peaks of low-pass filtered wall acceleration curves as a function of time. The accuracy of PWV estimation was determined for various cutoff frequencies (10-200 Hz). No statistically significant difference was observed between PWVs estimated by both approaches. The PWV and R2 at DN were higher, on average, than those at SF (PWV/R2: FFI SF 5.5/0.92, FFI DN 6.1/0.92; PWI SF 5.4/0.89, PWI DN 6.3/0.95). The use of cutoff frequencies between 40 and 80 Hz provided the most accurate PWVs. Both methods seemed equally suitable for use in clinical practice, although we have a preference for the PWV at DN given the higher R2 values.
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Affiliation(s)
- Melissa G M van den Bos-van de Steeg
- Department of Medical Imaging, Medical Ultrasound Imaging Center, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Medical Physics, Catharina Hospital, Eindhoven, The Netherlands
| | - Stein Fekkes
- Department of Medical Imaging, Medical Ultrasound Imaging Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anne E C M Saris
- Department of Medical Imaging, Medical Ultrasound Imaging Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Chris L de Korte
- Department of Medical Imaging, Medical Ultrasound Imaging Center, Radboud University Medical Center, Nijmegen, The Netherlands; Physics of Fluid Group, TechMed Centrum, University of Twente, Enschede, The Netherlands.
| | - Hendrik H G Hansen
- Department of Medical Imaging, Medical Ultrasound Imaging Center, Radboud University Medical Center, Nijmegen, The Netherlands
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8
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Mo H, Lang X, Zhang Y, Li Z, He B. Optimally filtering and matching processing for regional upstrokes to improve ultrasound transit time-based local PWV estimation. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 224:106997. [PMID: 35809369 DOI: 10.1016/j.cmpb.2022.106997] [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: 03/04/2021] [Revised: 06/19/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Pulse wave velocity (PWV) is an important index for quantifying the elasticity of artery. Local PWV estimates based on ultrasonic transit time (TT) methods, however, are affected by the reflected waves and ultrasonic noise, biasing the spatiotemporal propagation of the time fiduciary point (TFP) positioning in the distension waveforms. In this study, an optimally filtering and matching processing for regional upstrokes is proposed to improve the ultrasound TT-based local PWV estimation. METHOD (i) Smooth the pulse waves (PWs) using the Savitzky-Golay filter with one set of randomly combined parameters. (ii) An arbitrary region at the first beam upstroke of the smoothed PWs is selected as the curve template, and then matched with the upstrokes of other PWs by calculating the sum of square differences (SSD) between the template and matching regions to find its similar regions. (iii) Update the filter parameters and the template using the moth-flame optimization (MFO) feedback for computing the new SSD value. When the new SSD value is smaller than the historical one, the later will be replaced. (iv) Repeat the above steps until the MFO algorithm converges to the minimum SSD value. (v) Output the optimal filter parameters and the locations of regional curves corresponding to the minimum SSD value. Then the time delay of the PWs propagation can be detected by using the starting points of the regional curves as the TFPs. RESULTS We conducted performance comparison with the advanced TT method through both simulation and clinical experiments. The results demonstrate that the proposed work observes considerable reductions on both the normalized root mean square error ± the standard deviation (from 6.73 ± 2.27% to 1.57 ± 0.72%) and the coefficient of variation (from 13.39% to 8.87%). CONCLUSIONS The results of this study support that the proposed method may facilitate the early diagnosis and prevention of local arterial stiffness .
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Affiliation(s)
- Hong Mo
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Xun Lang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Yufeng Zhang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China.
| | - Zhiyao Li
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650031, China
| | - Bingbing He
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
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9
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Anderson CP, Park SY. Assessing pulse transit time to the skeletal muscle microcirculation using near-infrared spectroscopy. J Appl Physiol (1985) 2022; 133:593-605. [PMID: 35834626 PMCID: PMC9448340 DOI: 10.1152/japplphysiol.00173.2022] [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] [Received: 03/22/2022] [Revised: 06/06/2022] [Accepted: 07/08/2022] [Indexed: 11/22/2022] Open
Abstract
Pulse transit time (PTT) is the time it takes for pressure waves to propagate through the arterial system. Arterial stiffness assessed via PTT has been extensively examined in the conduit arteries; however, limited information is available about PTT to the skeletal muscle microcirculation. Therefore, the purpose of this study was to assess PTT to the skeletal muscle microcirculation (PTTm) with near-infrared spectroscopy (NIRS) and to determine whether PTTm provides unique information about vascular function that PTT assessed in the conduit arteries (PTTc) cannot provide. This pilot study was conducted with 10 (male = 5; female = 5) individuals of similar age (21.5 ± 1.2 yr). The feasibility of using the intersecting tangents method to derive PTTm with NIRS was assessed during reactive hyperemia with the cross-correlation of PTTm produced by the intersecting tangents method and a different algorithm that used signal spectral properties. To determine whether PTTm was distinct from PTTc, the cross-correlation of PTTm and PTTc during reactive hyperemia was assessed. Cross-correlation indicated agreement between PTTm derived from both algorithms (r2 = 0.77, P < 0.01) and a lack of agreement between PTTm and PTTc during reactive hyperemia (r2 = 0.07, P < 0.01). Therefore, we conclude that it is feasible to assess PTTm using NIRS, and PTTm provides unique information about vascular function, including skeletal muscle microvascular elasticity, which cannot be achieved with traditional PTTc. PTTm with NIRS may provide a comprehensive and noninvasive assessment of vascular function and health.NEW & NOTEWORTHY Pulse transit time to the skeletal muscle microcirculation can be assessed using near-infrared spectroscopy and the intersecting tangents method. Pulse transit analysis to the microcirculation provides a comprehensive assessment of the vascular response to postocclusive reactive hyperemia that pulse transit analysis in the conduit arteries cannot provide. Pulse transit time to the skeletal muscle microcirculation using near-infrared spectroscopy provides unique information about microvascular elasticity in the skeletal muscle. These findings indicate that the combination of near-infrared spectroscopy and pulse transit analysis may be a useful method for assessing the skeletal muscle microcirculation.
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Affiliation(s)
- Cody P Anderson
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska
| | - Song-Young Park
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska
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Raj KV, Nabeel PM, Joseph J. Image-Free Fast Ultrasound for Measurement of Local Pulse Wave Velocity: In Vitro Validation and In Vivo Feasibility. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:2248-2256. [PMID: 35503839 DOI: 10.1109/tuffc.2022.3172265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Local pulse wave velocity (PWV), a metric of the target artery's stiffness, has been emerging in its clinical value and adoption. State-of-the-art ultrasound technologies used to evaluate local PWV based on pulse waves' features are sophisticated, non-real-time, and are not amenable for field and resource-constrained settings. In this work, we present an image-free ultrasound system to measure local PWV in real-time by employing a pair of ultrasound transducer elements. An in vitro study was performed on the arterial phantom to: 1) characterize the design aspects of the system and 2) validate its accuracy against beat-by-beat (invasive) local PWV measured by a reference dual-element catheter. Furthermore, a repeatability and reproducibility study on 33 subjects (21-52 years) investigated the in vivo measurement feasibility from the carotid artery. With the experimentally deduced optimal design (frame-rate =500 Hz, RF sampling rate =125 MHz, LPF cutoff =14 Hz, and order =4 ), the system yielded repeatable beat-to-beat measurements (variability =1.9 % and over 15 cycles) and achieved a high accuracy (root-mean-square-error =0.19 m/s and absolute-percentage-error =2.4 %) over a wide range of PWVs (2.7-11.4 m/s) from the phantom. Subsequently, on human subjects, the intra- and inter-operator PWV measurements were highly repeatable (intraclass correlation coefficient ). The system does not impose a demand for special processors with high-computational power while offering real-time feedback on acquisition and measurement quality and provides local PWV online. Future large population and animal studies are required to establish the device's clinical usability.
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V RK, Manoj R, S I, P N, Joseph J. Operator Variabilities in Carotid Pulse Wave Velocity Measured by an Image-free Ultrasound Device. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:4018-4021. [PMID: 36085973 DOI: 10.1109/embc48229.2022.9871607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Local pulse wave velocity (PWV) has gained much attention in the last decade due to its ability to provide localized stiffness information from a target vessel and cater to several applications beyond regional PWV. Transit time-based methods are the most straightforward, but their reliability is highly dependent on the blood pulse sensing modality. Conventional ultrasound systems directly measure the blood pulse (as diameter or flow velocity); however, they offer limited frame rates resulting in poor resolution signals. Advanced systems supporting high frame rates are expensive, complex, and not amenable to field and resource-constraint settings. We have developed a high frame image-free ultrasound system to address this gap for automated and online measurement of local PWV. In an earlier in-vitro study, we have demonstrated its accuracy. In this work, we aim to investigate its in-vivo reliability. A study on 15 young, healthy subjects was conducted to assess the intra-and inter-operator repeatability of the developed system. The yielded local PWVs from the left carotid artery were within the range of 2.5 to 5.8 m/s. The device provided highly repeatable intra- and inter-operator measurements with ICC of 0.94 and 0.88, respectively. The bias for the intra- and inter-operator trials was statistically negligible (p > 0.005). The study demonstrated the potential of the high frame rate device to perform reliable measurements in-vivo. Clinical Relevance- This work aims to provide and validate an easy-to-use affordable and fully-automated high frame rate ultrasound technology for the measurement of online local PWV that is currently lacking.
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Leone D, Buraioli I, Mingrone G, Lena D, Sanginario A, Vallelonga F, Tosello F, Avenatti E, Cesareo M, Astarita A, Airale L, Sabia L, Veglio F, Demarchi D, Milan A. Accuracy of a new instrument for noninvasive evaluation of pulse wave velocity: the Arterial sTiffness faitHful tOol aSsessment project. J Hypertens 2021; 39:2164-2172. [PMID: 34261956 DOI: 10.1097/hjh.0000000000002925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Large artery stiffness, assessed by carotid--femoral pulse wave velocity (cfPWV), is a major risk factor for cardiovascular events, commonly used for risk stratification. Currently, the reference device for noninvasive cfPWV is SphygmoCor but its cost and technically challenging use limit its diffusion in clinical practice. AIM To validate a new device for noninvasive assessment of cfPWV, ATHOS (Arterial sTiffness faitHful tOol aSsessment), designed in collaboration with the Politecnico di Torino, against the reference noninvasive method represented by SphygmoCor. METHODS Ninety healthy volunteers were recruited. In each volunteer, we assessed cfPWV, using SphygmoCor (PWVSphygmoCor) and ATHOS (PWVATHOS) devices in an alternate fashion, following the ARTERY Society guidelines. The accuracy was assessed by Bland--Altman plot, and reproducibility was assessed by interoperator correlation coefficient (ICC). RESULTS Mean PWVATHOS and mean PWVSphygmoCor were 7.88 ± 1.96 and 7.72 ± 1.95 m/s, respectively. Mean difference between devices was 0.15 ± 0.56 m/s, with a high correlation between measurements (r = 0.959, P < 0.001). Considering only PWV values at least 8 m/s (n = 30), mean difference was 0.1 ± 0.63 m/s. The ICC was 97.7% with ATHOS. CONCLUSION ATHOS showed an excellent level of agreement with SphygmoCor, even at high PWV values, with a good reproducibility. Its simplicity of use could help increase clinical application of PWV assessment, improving patients' cardiovascular risk stratification.
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Affiliation(s)
- Dario Leone
- Department of Medical Sciences, Division of Internal Medicine, Hypertension Unit, AO Città della Salute e della Scienza di Torino, University of Torino
| | - Irene Buraioli
- Department of Electronics and Telecomunications, Politecnico di Torino, Turin
| | - Giulia Mingrone
- Department of Medical Sciences, Division of Internal Medicine, Hypertension Unit, AO Città della Salute e della Scienza di Torino, University of Torino
| | | | | | - Fabrizio Vallelonga
- Department of Medical Sciences, Division of Internal Medicine, Hypertension Unit, AO Città della Salute e della Scienza di Torino, University of Torino
| | - Francesco Tosello
- Department of Medical Sciences, Division of Internal Medicine, Hypertension Unit, AO Città della Salute e della Scienza di Torino, University of Torino
| | - Eleonora Avenatti
- Department of Medical Sciences, Division of Internal Medicine, Hypertension Unit, AO Città della Salute e della Scienza di Torino, University of Torino
| | - Marco Cesareo
- Department of Medical Sciences, Division of Internal Medicine, Hypertension Unit, AO Città della Salute e della Scienza di Torino, University of Torino
| | - Anna Astarita
- Department of Medical Sciences, Division of Internal Medicine, Hypertension Unit, AO Città della Salute e della Scienza di Torino, University of Torino
| | - Lorenzo Airale
- Department of Medical Sciences, Division of Internal Medicine, Hypertension Unit, AO Città della Salute e della Scienza di Torino, University of Torino
| | - Luca Sabia
- Department of Medical Sciences, Division of Internal Medicine, Hypertension Unit, AO Città della Salute e della Scienza di Torino, University of Torino
| | - Franco Veglio
- Department of Medical Sciences, Division of Internal Medicine, Hypertension Unit, AO Città della Salute e della Scienza di Torino, University of Torino
| | - Danilo Demarchi
- Department of Electronics and Telecomunications, Politecnico di Torino, Turin
| | - Alberto Milan
- Department of Medical Sciences, Division of Internal Medicine, Hypertension Unit, AO Città della Salute e della Scienza di Torino, University of Torino
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Validation of a new device for photoplethysmographic measurement of multi-site arterial pulse wave velocity. Biocybern Biomed Eng 2021. [DOI: 10.1016/j.bbe.2021.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Shin S, Mousavi A, Lyle S, Jang E, Yousefian P, Mukkamala R, Jang DG, Kwon UK, Kim YH, Hahn JO. Posture-Dependent Variability in Wrist Ballistocardiogram-Photoplethysmogram Pulse Transit Time: Implication to Cuff-Less Blood Pressure Tracking. IEEE Trans Biomed Eng 2021; 69:347-355. [PMID: 34197317 DOI: 10.1109/tbme.2021.3094200] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Toward the ultimate goal of robust cuff-less blood pressure (BP) tracking with wrist wearables against postural changes, the goal of this work was to investigate posture-dependent variability in pulse transit time (PTT) measured with ballistocardiogram (BCG) and photoplethysmogram (PPG) signal pair at the wrist. METHODS BCG and PPG signals were acquired from 25 subjects under the combination of 3 body (standing, sitting, and supine) and 3 arm (vertical in head-to-foot direction, placed on the chest, and holding a shoulder) postures. PTT was computed as the time interval between the BCG J wave and the PPG foot, and the impact of the 9 postures on PTT was analyzed by invoking an array of possible physical mechanisms. RESULTS Our work suggests that (i) wrist BCG-PPG PTT is consistent under standing and sitting postures with vertically held arms; and (ii) changes in wrist orientation and height as well as restrictions in body and arm movement may alter wrist BCG-PPG PTT via distortions in the wrist BCG and PPG waveforms. The results indicate that wrist BCG-PPG PTT varies with respect to postures even when BP remains constant. CONCLUSION The potential of cuff-less BP tracking via wrist BCG-PPG PTT demonstrated under standing posture with arms vertically down in the head-to-foot direction may not generalize to other body and arm postures. SIGNIFICANCE Understanding the physical mechanisms responsible for posture-induced BCG-PPG PTT variability may increase the versatility of the wrist BCG for cuff-less BP tracking.
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Wang Z, Wang D, Han M, Ai Y, Zhang X, Yuan L, Duan Y, Gao F, Yang Y. A Novel Methodology for Semi-automatic Measurement of Arterial Stiffness by Doppler Ultrasound: Clinical Feasibility and Reproducibility. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:1725-1736. [PMID: 33858722 DOI: 10.1016/j.ultrasmedbio.2021.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 02/25/2021] [Accepted: 03/06/2021] [Indexed: 06/12/2023]
Abstract
The conventional manual approach to measurement of aortic pulse wave velocity (PWV) by Doppler ultrasonography is time consuming and operator dependent. Here we report a new semi-automated methodology for more efficient and objective measurement of aortic PWV and results of tests of its clinical feasibility and reproducibility. Carotid-femoral pulse wave velocity (cfPWV) was measured in 50 patients with suspected coronary artery disease (aged 59.2 ± 10.0 y, 36 males) by three independent observers, including two experienced sonographers and one cardiologist without ultrasonographic experience. The cfPWV measured by the semi-automatic method (cfPWVA) was compared with reference values obtained by averaging measurements by two experienced sonographers using the conventional standard manual method (cfPWVM). Measurements of cfPWVA were feasible in all 50 patients and exhibited excellent agreement with averaged cfPWVM from the two experienced sonographers, with an intraclass correlation coefficient (ICC) of 0.915 (95% confidence interval: 0.876-0.942). The inexperienced observer-measured cfPWVA did not differ from the cfPWVM measured by the two experienced sonographers (8.04 ± 1.29 vs. 8.14 ± 1.32 m/s, p > 0.05), with a high consistency by ICC of 0.877 (0.793-0.928). Bland-Altman plots further illustrated the good agreement between the two methods and good intra- and inter-observer reproducibility. Time consumption for cfPWV measurement using the new method was significantly less than that for the manual method (122 ± 35 s vs. 455 ± 105 s, p < 0.0001), saving about 73% of the time. This new semi-automatic methodology for aortic PWV measurement not only has an accuracy similar to that of the conventional standard manual method but is also highly feasible and time saving. It may provide a reliable, simple and reproducible approach to arterial stiffness evaluation in clinical settings.
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Affiliation(s)
- Zhen Wang
- School of Aerospace Medicine, Fourth Military Medical University, Xi'an, China
| | - Dingyi Wang
- Department of Ultrasound Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Mengyao Han
- Department of Ultrasound Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Yongfei Ai
- Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Xing Zhang
- School of Aerospace Medicine, Fourth Military Medical University, Xi'an, China
| | - Lijun Yuan
- Department of Ultrasound Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Yunyou Duan
- Department of Ultrasound Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Feng Gao
- School of Aerospace Medicine, Fourth Military Medical University, Xi'an, China
| | - Yong Yang
- Department of Ultrasound Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
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Fiori G, Fuiano F, Scorza A, Conforto S, Sciuto SA. Non-Invasive Methods for PWV Measurement in Blood Vessel Stiffness Assessment. IEEE Rev Biomed Eng 2021; 15:169-183. [PMID: 34166202 DOI: 10.1109/rbme.2021.3092208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
In recent years, statistical studies highlighted an increasing incidence of cardiovascular diseases (CVD) which reflected on additional costs on the healthcare systems worldwide. Pulse wave velocity (PWV) measurement is commonly considered a CVD predictor factor as well as a marker of Arterial Stiffness (AS), since it is closely related to the mechanical characteristics of the arterial wall. An increase in PWV is due to a more rigid arterial system. Because of the prevalence of the elastic component, in young people the PWV is lower than in the elderly. Nowadays, invasive and non-invasive methods for PWV assessment are employed: there is an increasing attention in the development of non-invasive devices which mostly perform a regional PWV measurement (over a long arterial portion) rather than local (over a short arterial portion). The accepted gold-standard for non-invasive AS measurement is the carotid-femoral PWV used to evaluate the arterial damage, the corresponding cardiovascular risk and to adapt the proper therapy. This review article considers the main commercially available devices underlining their operating principles in terms of sensors, execution mode, pulse waveform acquired, site of measurement, distance and time estimation methods, as well as their main limitations in clinical practice.
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Beutel F, Van Hoof C, Rottenberg X, Reesink K, Hermeling E. Pulse Arrival Time Segmentation Into Cardiac and Vascular Intervals - Implications for Pulse Wave Velocity and Blood Pressure Estimation. IEEE Trans Biomed Eng 2021; 68:2810-2820. [PMID: 33513094 DOI: 10.1109/tbme.2021.3055154] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study demonstrates a novel method for pulse arrival time (PAT) segmentation into cardiac isovolumic contraction (IVC) and vascular pulse transit time to approximate central pulse wave velocity (PWV). METHODS 10 subjects (38 ± 10 years, 121 ± 12 mmHg SBP) ranging from normotension to hypertension were repeatedly measured at rest and with induced changes in blood pressure (BP), and thus PWV. ECG was recorded simultaneously with ultrasound-based carotid distension waveforms, a photoplethysmography-based peripheral waveform, noninvasive continuous and intermittent cuff BP. Central PAT was segmented into cardiac and vascular time intervals using a fiducial point in the carotid distension waveform that reflects the IVC onset. Central and peripheral PWVs were computed from (segmented) intervals and estimated arterial path lengths. Correlations with Bramwell-Hill PWV, systolic and diastolic BP (SBP/DBP) were analyzed by linear regression. RESULTS Central PWV explained more than twice the variability (R2) in Bramwell-Hill PWV compared to peripheral PWV (0.56 vs. 0.27). SBP estimated from central PWV undercuts the IEEE mean absolute deviation threshold of 5 mmHg, significantly lower than peripheral PWV or PAT (4.2 vs. 7.1 vs. 10.1 mmHg). CONCLUSION Cardiac IVC onset signaled in carotid distension waveforms enables PAT segmentation to obtain unbiased vascular pulse transit time. Corresponding PWV estimates provide the basis for single-site assessment of central arterial stiffness, confirmed by significant correlations with Bramwell-Hill PWV and SBP. SIGNIFICANCE In a small-scale cohort, we present proof-of-concept for a novel method to estimate central PWV and BP, bearing potential to improve the practicality of cardiovascular risk assessment in clinical routines.
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Abstract
OBJECTIVE Carotid-femoral pulse wave velocity (PWV) is considered the gold standard for arterial stiffness assessment in clinical practice. A large number of devices to measure PWV have been developed and validated. We reviewed different validation studies of PWV estimation techniques and assessed their conformity to the Artery Society Guidelines and the American Heart Association recommendations. METHODS Pubmed and Medline (1995-2017) were searched to identify PWV validation studies. Of the 96 article retrieved, 26 met the inclusion criteria. RESULTS Several devices had been developed and validated to noninvasively measure arterial stiffness, using applanation tonometry (SphygmoCor, PulsePen), piezoelectric mechanotransducers (Complior), cuff-based oscillometry (Arteriograph, Vicorder and Mobil-O-Graph), photodiode sensors (pOpmètre) and devices assessing brachial-ankle pulse wave velocity and cardiac-ankle PWV. Ultrasound technique and MRI remain confined to clinical research. Good agreement was found with the Artery Society Guidelines. Two studies (Complior, SphygmoCor Xcel) showed best adherence with the guidelines. In Arteriograph, MRI, ultrasound and SphygmoCor Xcel validation studies sample size was smaller than the minimum suggested by the guidelines. High discrepancies between devices were shown in distance estimation: in two studies (Arteriograph, Complior) path length was estimated in conformity to the guidelines. Transit time was calculated using the intersecting tangent method, but in two studies (Vicorder, pOpmètre) best agreement was found using the maximum of the second derivative. Six studies reached the accuracy level 'excellent' defined in the Artery guidelines. CONCLUSION Method to assess transit time and path length need validation in larger populations. Further studies are required in different risk population to implement clinical applicability of every device.
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Wang Z, Fu Z, Yang Y, Xing W, Zhang X, Wang J, Li Y, Yuan L, Gao F. A novel methodology for rat aortic pulse wave velocity assessment by Doppler ultrasound: validation against invasive measurements. Am J Physiol Heart Circ Physiol 2019; 317:H1376-H1387. [PMID: 31702970 DOI: 10.1152/ajpheart.00382.2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
There is still lack of a simple, accurate, and noninvasive method for rat aortic pulse wave velocity (PWV) measurement, especially the transit distance cannot be accurately measured. Thus, we aimed to derive an equation for aortic transit distance as a function of the nose-to-rump length (L) and to test the hypothesis that aortic PWV measured by new equation combined with Doppler ultrasound (the "equation method") may have stronger correlation with invasive measurements than traditional "body surface method." Two-hundred male Sprague-Dawley (SD) rats (age ranged 5-24 wk) were included in protocol 1, and the aortic transit distances were measured postmortem. In protocol 2, heart-femoral PWV and carotid-femoral PWV were measured by equation method (hfPWVE, cfPWVE) and also by traditional body surface method (hfPWVS, cfPWVS) in another 30 young and 28 old rats. These measurements were then validated against invasively measured hfPWVI and cfPWVI from the same animal. Protocol 1 showed that the heart-femoral transit distance could be calculated by 0.6086 × L - 1.6523, and the carotid-femoral transit distance by 0.4614 × L + 1.8335. In protocol 2, in young rats, the Pearson r between hfPWVE, cfPWVE, hfPWVS, and cfPWVS and their corresponding invasive measurement were 0.8962, 0.8509, 0.8387, and 0.7828, respectively (all P < 0.0001). In the old group, the results were 0.8718, 0.7999, 0.8330, and 0.7112, respectively (all P < 0.0001). The hfPWVE and cfPWVE showed better agreement with hfPWVI and cfPWVI and lower intra- and interobserver variability compared with hfPWVS and cfPWVS in both groups. These findings demonstrate that this novel methodology provides a simple and reliable method for rat noninvasive aortic PWV measurement.NEW & NOTEWORTHY First, when measuring aortic PWV in SD rat models, the heart-femoral transit distance can be estimated by 0.6086 × L - 1.6523, and the carotid-femoral distance transit distance can be estimated by 0.4614 × L + 1.8335, where L (in mm) is nose-to-rump length. Second, this novel methodology for aortic PWV measurement was validated with a closer correlation with the invasive measurements than traditional approach in young and old rats. Third, this study provides a simple and reliable method for rat noninvasive aortic PWV measurement.
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Affiliation(s)
- Zhen Wang
- School of Aerospace Medicine, Fourth Military Medical University, Xi'an, China
| | - Zihao Fu
- School of Aerospace Medicine, Fourth Military Medical University, Xi'an, China
| | - Yong Yang
- Department of Ultrasound Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Wenjuan Xing
- School of Aerospace Medicine, Fourth Military Medical University, Xi'an, China
| | - Xing Zhang
- School of Aerospace Medicine, Fourth Military Medical University, Xi'an, China
| | - Jiaping Wang
- State Key Laboratory of Space Medicine, China Astronaut Research and Training Center, Beijing, China
| | - Yongzhi Li
- State Key Laboratory of Space Medicine, China Astronaut Research and Training Center, Beijing, China
| | - Lijun Yuan
- Department of Ultrasound Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Feng Gao
- School of Aerospace Medicine, Fourth Military Medical University, Xi'an, China
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Yang Y, Wang Z, Fu Z, Yang R, Wang J, Yuan L, Gao F, Duan Y. Stiffening of aorta is more preferentially associated with rheumatoid arthritis than peripheral arteries. Rheumatol Int 2019; 39:1711-1721. [DOI: 10.1007/s00296-019-04405-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 07/29/2019] [Indexed: 12/11/2022]
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Nabeel PM, Kiran VR, Joseph J, Abhidev VV, Sivaprakasam M. Local Pulse Wave Velocity: Theory, Methods, Advancements, and Clinical Applications. IEEE Rev Biomed Eng 2019; 13:74-112. [PMID: 31369386 DOI: 10.1109/rbme.2019.2931587] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Local pulse wave velocity (PWV) is evolving as one of the important determinants of arterial hemodynamics, localized vessel stiffening associated with several pathologies, and a host of other cardiovascular events. Although PWV was introduced over a century ago, only in recent decades, due to various technological advancements, has emphasis been directed toward its measurement from a single arterial section or from piecewise segments of a target arterial section. This emerging worldwide trend in the exploration of instrumental solutions for local PWV measurement has produced several invasive and noninvasive methods. As of yet, however, a univocal opinion on the ideal measurement method has not emerged. Neither have there been extensive comparative studies on the accuracy of the available methods. Recognizing this reality, makes apparent the need to establish guideline-recommended standards for the measurement methods and reference values, without which clinical application cannot be pursued. This paper enumerates all major local PWV measurement methods while pinpointing their salient methodological considerations and emphasizing the necessity of global standardization. Further, a summary of the advancements in measuring modalities and clinical applications is provided. Additionally, a detailed discussion on the minimally explored concept of incremental local PWV is presented along with suggestions of future research questions.
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Arathy R, Nabeel PM, Joseph J, Sivaprakasam M. Accelerometric patch probe for cuffless blood pressure evaluation from carotid local pulse wave velocity: design, development, and
in vivo
experimental study. Biomed Phys Eng Express 2019. [DOI: 10.1088/2057-1976/ab1a82] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Simultaneous multi-site measurement system for the assessment of pulse wave delays. Biocybern Biomed Eng 2019. [DOI: 10.1016/j.bbe.2019.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Deng L, Zhang Y, Zhao Z, Zhang K, Hu X, Gao L, Liang H, Zhang J. Ultrasound simulation model incorporating incident and reflected wave propagations along a common carotid artery. Comput Biol Med 2018; 104:267-277. [PMID: 30551000 DOI: 10.1016/j.compbiomed.2018.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/25/2018] [Accepted: 11/12/2018] [Indexed: 11/28/2022]
Abstract
An ultrasound simulation model incorporating incident and reflected wave propagations is proposed to provide a realistic data source for validation of transit time (TT)-based local pulse wave velocity (PWV) estimation algorithms. First, the incident wave (IW) and reflected wave (RW) at a certain position over a common carotid artery (CCA) are estimated. Then, the propagating pulse waves (PWs) along the CCA are modelled with the synthesizations of the estimated IWs and RWs, whose occurrences are delayed in opposite sequences according to a preset PWV. In ultrasound simulation, a geometric model of a CCA is built, and the dynamic scatterer models are constructed by moving the scatterer positions according to the synthesized PWs. The RF signals are generated using Field II. To characterize the PW propagations of different arterial stiffnesses consistent with clinical ones in the model, 30 healthy subjects from young, middle-aged, and elderly groups are recruited for extractions of IWs and RWs. To quantitatively verify the effectiveness of the simulation model, the normalized root-mean-squared errors (NRMSEs) are used to compare the estimated and preset PWs, time delays (TDs), and PWVs. Results show that for the three age groups, the estimated PWs, TDs, and PWVs conform to the preset ones with the mean NRMSEs of 0.92%, 18.47%, and 8.55%, respectively. Moreover, the model can characterize the effect of the wave reflection on the local PW propagation as its clinical manifestation. Therefore, the proposed model can be effective as a data source for the validation of TT-based local PWV estimation algorithms, particularly the effects of RWs on the estimation performance.
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Affiliation(s)
- Li Deng
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Yufeng Zhang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China.
| | - Zhengpeng Zhao
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Kexin Zhang
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650031, China
| | - Xiao Hu
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Lian Gao
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Hong Liang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Junhua Zhang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
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In Vitro Validation of 4D Flow MRI for Local Pulse Wave Velocity Estimation. Cardiovasc Eng Technol 2018; 9:674-687. [PMID: 30218205 DOI: 10.1007/s13239-018-00377-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 09/04/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE Arterial stiffness has predictive value for cardiovascular disease (CVD). Local artery stiffness can provide insight on CVD pathology and may be useful for diagnosis and prognosis. However, current methods are invasive, require real-time expertise for measurement, or are limited by arterial region. 4D Flow MRI can non-invasively measure local stiffness by estimating local pulse wave velocity (PWV). This technique can be applied to vascular regions, previously accessible only by invasive stiffness measurement methods. MRI PWV data can also be analyzed post-exam. However, 4D Flow MRI requires validation before it is used in vivo to measure local PWV. METHODS PWV, calculated from 4D Flow MRI and a benchtop experiment, was compared with petersons elastic modulus (PEM) of in vitro models. PEM was calculated using high-speed camera images and pressure transducers. Three transit-time algorithms were analyzed for PWV measurement accuracy and precision. RESULTS PWV from 4D Flow MRI and reference benchtop experiments show strong correlation with PEM (R2 = 0.99). The cross correlation transit-time algorithm showed the lowest percent difference between 4D Flow MRI and benchtop experiments (4-7%), and the point to point of 50% upstroke algorithm had the highest transit-time vs. distance data average R2 (0.845). CONCLUSION 4D Flow MRI is a feasible method for estimating local PWV in simple in vitro models and is a viable tool for clinical analysis. In addition, choice in transit-time algorithm depends on flow waveform shape and arterial region. This study strengthens the validity of 4D Flow MRI local PWV measurement in simple models. However, this technique requires validation in more complex models before it is used in vivo.
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Sun Y, Dong Y, Gao R, Chu Y, Zhang M, Qian X, Wang X. Wearable Pulse Wave Monitoring System Based on MEMS Sensors. MICROMACHINES 2018; 9:mi9020090. [PMID: 30393366 PMCID: PMC6187337 DOI: 10.3390/mi9020090] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 02/10/2018] [Accepted: 02/21/2018] [Indexed: 11/16/2022]
Abstract
Pulse wave monitoring is critical for the evaluation of human health. In this paper, a wearable multi-sensor pulse wave monitoring system is proposed and demonstrated. The monitoring system consists of a measuring unit and an analog circuit processing unit. The main part of the measuring unit is a flexible printed circuit board (PCB) with a thickness of 0.15 mm, which includes three micro-electromechanical system (MEMS) pressure sensors softly packaged by polydimethylsiloxane (PDMS), a blood oxygen detector and a MEMS three-axis accelerometer. The MEMS pressure sensors,the blood oxygen detector and the accelerometer are fixed on the expected locations of the flexible PCB. The analog circuit processing unit includes a power supply module, a filter and an amplifier. The pulse waves of two volunteers are detected by the monitoring system in this study. The output signals of the analog circuit processing module are processed and analyzed. In the preliminary test, the time delay of the three pressure pulse waves has been detected and the calculated pulse wave velocities (PWVs) are 12.50 and 11.36 m/s, respectively. The K value, related to the area of the pulse wave, can be obtained. Both the PWV and K value meet the health parameter standards.
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Affiliation(s)
- Yu Sun
- Graduate School at Shenzhen, Tsinghua University, University Town of Shenzhen, Shenzhen 518055, China.
| | - Ying Dong
- Graduate School at Shenzhen, Tsinghua University, University Town of Shenzhen, Shenzhen 518055, China.
| | - Ruyi Gao
- Graduate School at Shenzhen, Tsinghua University, University Town of Shenzhen, Shenzhen 518055, China.
| | - Yao Chu
- Tsinghua-Berkeley Shenzhen Institute, University Town of Shenzhen, Shenzhen 518055, China.
| | - Min Zhang
- Graduate School at Shenzhen, Tsinghua University, University Town of Shenzhen, Shenzhen 518055, China.
| | - Xiang Qian
- Graduate School at Shenzhen, Tsinghua University, University Town of Shenzhen, Shenzhen 518055, China.
| | - Xiaohao Wang
- Graduate School at Shenzhen, Tsinghua University, University Town of Shenzhen, Shenzhen 518055, China.
- Tsinghua-Berkeley Shenzhen Institute, University Town of Shenzhen, Shenzhen 518055, China.
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Nabeel PM, Jayaraj J, Mohanasankar S. Single-source PPG-based local pulse wave velocity measurement: a potential cuffless blood pressure estimation technique. Physiol Meas 2017; 38:2122-2140. [DOI: 10.1088/1361-6579/aa9550] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Zardi EM, Di Geso L, Afeltra A, Zardi DM, Giorgi C, Salaffi F, Carotti M, Gutierrez M, Filippucci E, Grassi W. An ultrasound automated method for non-invasive assessment of carotid artery pulse wave velocity. J Investig Med 2017; 66:973-979. [PMID: 28866633 DOI: 10.1136/jim-2017-000430] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2017] [Indexed: 12/29/2022]
Abstract
To validate the clinical applicability and feasibility of an automated ultrasound (US) method in measuring the arterial stiffness of patients with chronic inflammatory rheumatic diseases, comparing automated measurements performed by a rheumatologist without experience in vascular sonography with those obtained by a sonographer experienced in vascular US, using a standardized manual method. Twenty subjects affected by different chronic inflammatory rheumatic disorders were consecutively recruited. For each patient, the arterial stiffness of both common carotids was manually calculated. Subsequently, the measure of the pulse wave velocity (PWV) was obtained using an US device called Radio Frequency - Quality Arterial Stiffness (RF-QAS), provided by the same US system (ie, My Lab 70 XVG, Esaote SpA, Genoa, Italy) equipped with a 4-13 MHz linear probe. The reliability comparison between the two US methods was calculated using the intraclass correlation coefficient (ICC). ICC between the values obtained with the two methods for calculating the arterial stiffness resulted 0.789. A significant positive correlation between the two methods was also established with Pearson's (r=0.62, p<0.0001) and Spearman's analysis (r=0.66, p=0.001). A significant performance comparison was seen using Bland-Altman plot. The acquisition of the arterial stiffness parameter with the automated method required about 2 min for each patient. Clinical applicability of this US automated method to assess PWV at common carotid level by a rheumatologist is reliable and feasible in comparison with a conventional manual method.
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Affiliation(s)
- Enrico Maria Zardi
- Department of Immunorheumatology, Università "Campus Bio-Medico", Roma, Italy
| | - Luca Di Geso
- Department of Rheumatology, Polytechnic University of the Marche, Jesi - Ancona, Italy
| | - Antonella Afeltra
- Department of Immunorheumatology, Università "Campus Bio-Medico", Roma, Italy
| | - Domenico Maria Zardi
- Division of Cardiology, Faculty of Medicine and Psychology, University of Rome "Sapienza", Sant'Andrea Hospital, Rome, Italy
| | - Chiara Giorgi
- Department of Radiology, S. Maria della Misericordia Hospital, Urbino, Italy
| | - Fausto Salaffi
- Department of Rheumatology, Polytechnic University of the Marche, Jesi - Ancona, Italy
| | - Marina Carotti
- Istituto di Radiologia, Università Politecnica delle Marche, Ancona, Italy
| | - Marwin Gutierrez
- Division of Musculoskeletal and Rheumatic Diseases, Instituto Nacional de Rehabilitacion, Mexico City, Mexico
| | - Emilio Filippucci
- Department of Rheumatology, Polytechnic University of the Marche, Jesi - Ancona, Italy
| | - Walter Grassi
- Department of Rheumatology, Polytechnic University of the Marche, Jesi - Ancona, Italy
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Evaluation of local carotid stiffness and inflammatory biomarkers in stable angina pectoris. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2017; 13:122-129. [PMID: 28798782 PMCID: PMC5545659 DOI: 10.5114/pwki.2017.68046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 02/07/2017] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Arterial stiffness (AS) is a well-accepted and reliable predictor of atherosclerotic diseases. Inflammation plays an important role in the development of AS. AIM To evaluate local carotid stiffness (CS) together with fibrinogen and high-sensitivity C-reactive protein (hsCRP) levels in stable angina pectoris (SAP) patients. MATERIAL AND METHODS The study consisted of 353 consecutive patients with SAP. All underwent coronary angiography (CAG) after the evaluation of local CS parameters and carotid intima-media thickness (IMT) from both common carotid arteries by a real-time echo-tracking system. Baseline inflammatory biomarkers, serum hsCRP and fibrinogen levels were measured. Based on CAG findings, the patients were classified into 4 groups: control subjects with normal coronary arteries (group 1, n = 86), single-vessel disease (group 2, n = 104), double-vessel disease (group 3, n = 95) and triple-vessel disease (group 4, n = 68). RESULTS The mean carotid pulse wave velocity (PWV) in patients with angiographically confirmed coronary artery disease (CAD) was significantly higher than that in patients with normal coronary arteries (7.82 ±1.76 vs. 6.51 ±0.85 cm/s, p = 0.001). The mean carotid IMT was detected to be significantly higher in group 4 patients compared to those in group 1 (p < 0.001) and group 2 (p = 0.001). Significant correlations were observed between both inflammatory biomarkers and the number of diseased vessels and carotid PWV. Using multi-variate analysis, carotid stiffness, carotid IMT, hsCRP and fibrinogen were independently associated with the presence and extent of CAD. CONCLUSIONS Local CS, carotid IMT, hsCRP and fibrinogen levels are significant predictors of atherosclerotic burden and they may facilitate the identification of high-risk patients for the early diagnosis and prompt treatment of CAD.
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Echocardiographic Assessment of Aortic Pulse-Wave Velocity: Validation against Invasive Pressure Measurements. J Am Soc Echocardiogr 2016; 29:1109-1116. [DOI: 10.1016/j.echo.2016.07.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Indexed: 12/16/2022]
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Campo A, Heuten H, Goovaerts I, Ennekens G, Vrints C, Dirckx J. A non-contact approach for PWV detection: application in a clinical setting. Physiol Meas 2016; 37:990-1003. [PMID: 27244585 DOI: 10.1088/0967-3334/37/7/990] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A need for screening methods for arteriosclerosis led to the development of several approaches to measure pulse wave velocity (PWV) being indicative of arterial stiffness. Carotid-femoral PWV (cfPWV) can be measured between common carotid artery (CCA) and femoral artery (FA) displaying the physiologically important stiffness of the conduit arteries. However, this measurement approach has several disadvantages, and a local PWV-measurement of CCA-stiffness has been proposed as an alternative in the past. In the presented pilot study, laser Doppler vibrometry (LDV) is used to measure PWV locally in the CCA (PWVLDV) in 48 patients aged between 48 and 70, with known atherosclerotic arterial disease: stabilized coronary artery disease (CAD), cerebro-vascular disease (CVD) or peripheral artery disease (PAD). Additionally, cfPWV, CCA distensibility coefficient (DC), CCA intima-media thickness (IMT), blood pressure (BP) and age were evaluated. LDV is a valid method for local PWV-measurement. The method is potentially easy to use, and causes no discomfort to the patient. PWVLDV correlates with age (R = 0.432; p = 0.002) as reported in related studies using other techniques, and measured values lay between 2.5 and 5.8 m s(-1), which is well in line with literature measures of local PWV in the CCA. In conclusion, PWVLDV potentially is a marker for arterial health, but more research in a larger and more homogeneous patient population is mandatory. In future studies, blood velocity measurements should be incorporated, as well as a reference method such as pulse wave imaging (PWI) or magnetic resonance imaging (MRI).
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Affiliation(s)
- Adriaan Campo
- Laboratory of Biomedical Physics, Faculty of Science, University of Antwerp, Groenenborgerlaan 171 B-2020 Antwerp, Belgium. Ultrasound Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, 630 West 168th Street, NY 10032, USA
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Huang C, Su Y, Zhang H, Qian LX, Luo J. Comparison of Different Pulse Waveforms for Local Pulse Wave Velocity Measurement in Healthy and Hypertensive Common Carotid Arteries in Vivo. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:1111-1123. [PMID: 26924694 DOI: 10.1016/j.ultrasmedbio.2015.12.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 12/12/2015] [Accepted: 12/28/2015] [Indexed: 06/05/2023]
Abstract
Pulse wave velocity (PWV), a measurement of arterial stiffness, can be estimated locally by determining the time delay of the pulse waveforms for a known distance as measured in an ultrasound image. Our aim was to compare three ultrasound-based methods for estimation of local PWV based on the measurement of diameter distension waveforms, displacement waveforms of the anterior wall and displacement waveforms of the posterior wall, respectively, in human common carotid arteries in vivo. The local PWVs at both systolic foot (PWVsf) and dicrotic notch (PWVdn) were estimated from ultrasound radiofrequency data of 25 healthy and 24 hypertensive patients for each method. PWV estimation using the distension waveform method was found to have the highest precision in both groups. Both PWVsf and PWVdn were significantly higher in the hypertensive group compared with the healthy group using the distension waveform method (PWVsf: 6.08 ± 1.70 m/s vs. 4.75 ± 0.92 m/s, p = 0.000014; PWVdn: 7.83 ± 2.26 m/s vs. 5.21 ± 0.95 m/s, p < 0.000001), whereas there was no significant difference at a significance level of 0.01 between the two groups when the anterior or posterior wall waveform method was used. Thus, the difference in arterial stiffness between the two groups could be discriminated well by the distension waveform method. The local PWV estimated using distension waveforms might be a promising index for arterial stiffness characterization and hypertension management.
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Affiliation(s)
- Chengwu Huang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China; Center for Biomedical Imaging Research, Tsinghua University, Beijing, China
| | - Yuan Su
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hong Zhang
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Lin-Xue Qian
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jianwen Luo
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China; Center for Biomedical Imaging Research, Tsinghua University, Beijing, China.
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Li F, He Q, Huang C, Liu K, Shao J, Luo J. High frame rate and high line density ultrasound imaging for local pulse wave velocity estimation using motion matching: A feasibility study on vessel phantoms. ULTRASONICS 2016; 67:41-54. [PMID: 26773791 DOI: 10.1016/j.ultras.2015.12.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 11/20/2015] [Accepted: 12/28/2015] [Indexed: 06/05/2023]
Abstract
Pulse wave imaging (PWI) is an ultrasound-based method to visualize the propagation of pulse wave and to quantitatively estimate regional pulse wave velocity (PWV) of the arteries within the imaging field of view (FOV). To guarantee the reliability of PWV measurement, high frame rate imaging is required, which can be achieved by reducing the line density of ultrasound imaging or transmitting plane wave at the expense of spatial resolution and/or signal-to-noise ratio (SNR). In this study, a composite, full-view imaging method using motion matching was proposed with both high temporal and spatial resolution. Ultrasound radiofrequency (RF) data of 4 sub-sectors, each with 34 beams, including a common beam, were acquired successively to achieve a frame rate of ∼507 Hz at an imaging depth of 35 mm. The acceleration profiles of the vessel wall estimated from the common beam were used to reconstruct the full-view (38-mm width, 128-beam) image sequence. The feasibility of mapping local PWV variation along the artery using PWI technique was preliminarily validated on both homogeneous and inhomogeneous polyvinyl alcohol (PVA) cryogel vessel phantoms. Regional PWVs for the three homogeneous phantoms measured by the proposed method were in accordance with the sparse imaging method (38-mm width, 32-beam) and plane wave imaging method. Local PWV was estimated using the above-mentioned three methods on 3 inhomogeneous phantoms, and good agreement was obtained in both the softer (1.91±0.24 m/s, 1.97±0.27 m/s and 1.78±0.28 m/s) and the stiffer region (4.17±0.46 m/s, 3.99±0.53 m/s and 4.27±0.49 m/s) of the phantoms. In addition to the improved spatial resolution, higher precision of local PWV estimation in low SNR circumstances was also obtained by the proposed method as compared with the sparse imaging method. The proposed method might be helpful in disease detections through mapping the local PWV of the vascular wall.
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Affiliation(s)
- Fubing Li
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China; Center for Biomedical Imaging Research, Tsinghua University, Beijing 100084, China
| | - Qiong He
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China; Center for Biomedical Imaging Research, Tsinghua University, Beijing 100084, China
| | - Chengwu Huang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China; Center for Biomedical Imaging Research, Tsinghua University, Beijing 100084, China
| | - Ke Liu
- Division of Electronics and Information Technology, National Institute of Metrology, Beijing 100013, China
| | - Jinhua Shao
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Jianwen Luo
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China; Center for Biomedical Imaging Research, Tsinghua University, Beijing 100084, China.
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Teixeira R, Vieira MJ, Gonçalves A, Cardim N, Gonçalves L. Ultrasonographic vascular mechanics to assess arterial stiffness: a review. Eur Heart J Cardiovasc Imaging 2015; 17:233-46. [DOI: 10.1093/ehjci/jev287] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 10/04/2015] [Indexed: 12/21/2022] Open
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Mukkamala R, Hahn JO, Inan OT, Mestha LK, Kim CS, Töreyin H, Kyal S. Toward Ubiquitous Blood Pressure Monitoring via Pulse Transit Time: Theory and Practice. IEEE Trans Biomed Eng 2015; 62:1879-901. [PMID: 26057530 PMCID: PMC4515215 DOI: 10.1109/tbme.2015.2441951] [Citation(s) in RCA: 400] [Impact Index Per Article: 44.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Ubiquitous blood pressure (BP) monitoring is needed to improve hypertension detection and control and is becoming feasible due to recent technological advances such as in wearable sensing. Pulse transit time (PTT) represents a well-known potential approach for ubiquitous BP monitoring. The goal of this review is to facilitate the achievement of reliable ubiquitous BP monitoring via PTT. We explain the conventional BP measurement methods and their limitations; present models to summarize the theory of the PTT-BP relationship; outline the approach while pinpointing the key challenges; overview the previous work toward putting the theory to practice; make suggestions for best practice and future research; and discuss realistic expectations for the approach.
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Affiliation(s)
- Ramakrishna Mukkamala
- Department of Electrical and Computer Engineering, Michigan State University, East Lansing, MI, USA (phone: 517-353-3120; fax: 517-353-1980; )
| | - Jin-Oh Hahn
- Department of Mechanical Engineering, University of Maryland, College Park, MD, USA,
| | - Omer T. Inan
- The School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, 30308, USA,
| | - Lalit K. Mestha
- Palo Alto Research Center East (a Xerox Company), Webster, NY, 14580, USA,
| | - Chang-Sei Kim
- Department of Mechanical Engineering, University of Maryland, College Park, MD, USA,
| | - Hakan Töreyin
- The School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, 30308, USA,
| | - Survi Kyal
- Palo Alto Research Center East (a Xerox Company), Webster, NY, 14580, USA,
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Li RX, Qaqish W, Konofagou EE. Performance assessment of Pulse Wave Imaging using conventional ultrasound in canine aortas ex vivo and normal human arteries in vivo. Artery Res 2015; 11:19-28. [PMID: 26640603 DOI: 10.1016/j.artres.2015.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The propagation behavior of the arterial pulse wave may provide valuable diagnostic information for cardiovascular pathology. Pulse Wave Imaging (PWI) is a noninvasive, ultrasound imaging-based technique capable of mapping multiple wall motion waveforms along a short arterial segment over a single cardiac cycle, allowing for the regional pulse wave velocity (PWV) and propagation uniformity to be evaluated. The purpose of this study was to improve the clinical utility of PWI using a conventional ultrasound system. The tradeoff between PWI spatial and temporal resolution was evaluated using an ex vivo canine aorta (n = 2) setup to assess the effects of varying image acquisition and signal processing parameters on the measurement of the PWV and the pulse wave propagation uniformity r2. PWI was also performed on the carotid arteries and abdominal aortas of 10 healthy volunteers (24.8 ± 3.3 y.o.) to determine the waveform tracking feature that would yield the most precise PWV measurements and highest r2 values in vivo. The ex vivo results indicated that the highest precision for measuring PWVs ~ 2.5 - 3.5 m/s was achieved using 24-48 scan lines within a 38 mm image plane width (i.e. 0.63 - 1.26 lines/mm). The in vivo results indicated that tracking the 50% upstroke of the waveform would consistently yield the most precise PWV measurements and minimize the error in the propagation uniformity measurement. Such findings may help establish the optimal image acquisition and signal processing parameters that may improve the reliability of PWI as a clinical measurement tool.
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Affiliation(s)
- Ronny X Li
- Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - William Qaqish
- Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Elisa E Konofagou
- Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY, USA ; Department of Radiology, Columbia University, New York, NY, USA
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Validation of new and existing decision rules for the estimation of beat-to-beat pulse transit time. BIOMED RESEARCH INTERNATIONAL 2015; 2015:306934. [PMID: 25821794 PMCID: PMC4363553 DOI: 10.1155/2015/306934] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 01/28/2015] [Accepted: 01/28/2015] [Indexed: 11/17/2022]
Abstract
Pulse transit time (PTT) is a pivotal marker of vascular stiffness. Because the actual PTT duration in vivo is unknown and the complicated variation in waveform may occur, the robust determination of characteristic point is still a very difficult task in the PTT estimation. Our objective is to devise a method for real-time estimation of PTT duration in pulse wave. It has an ability to reduce the interference caused by both high- and low-frequency noise. The reproducibility and performance of these methods are assessed on both artificial and clinical pulse data. Artificial data are generated to investigate the reproducibility with various signal-to-noise ratios. For all artificial data, the mean biases obtained from all methods are less than 1 ms; collectively, this newly proposed method has minimum standard deviation (SD, <1 ms). A set of data from 33 participants together with the synchronously recorded continuous blood pressure data are used to investigate the correlation coefficient (CC). The statistical analysis shows that our method has maximum values of mean CC (0.5231), sum of CCs (17.26), and median CC (0.5695) and has the minimum SD of CCs (0.1943). Overall, the test results in this study indicate that the newly developed method has advantages over traditional decision rules for the PTT measurement.
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Wang Z, Yang Y, Yuan LJ, Liu J, Duan YY, Cao TS. Noninvasive method for measuring local pulse wave velocity by dual pulse wave Doppler: in vitro and in vivo studies. PLoS One 2015; 10:e0120482. [PMID: 25786124 PMCID: PMC4364771 DOI: 10.1371/journal.pone.0120482] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 01/22/2015] [Indexed: 11/29/2022] Open
Abstract
Objectives To evaluate the validity and reproducibility of a noninvasive dual pulse wave Doppler (DPWD) method, which involves simultaneous recording of flow velocity of two independent sample volumes with a measurable distance, for measuring the local arterial pulse wave velocity (PWV) through in vitro and in vivo studies. Methods The DPWD mode of Hitachi HI Vision Preirus ultrasound system with a 5–13MHz transducer was used. An in vitro model was designed to compare the PWV of a homogeneous rubber tubing with the local PWV of its middle part measured by DPWD method. In the in vivo study, local PWV of 45 hypertensive patients (25 male, 49.8±3.1 years) and 45 matched healthy subjects (25 male, 49.3±3.0 years) were investigated at the left common carotid artery (LCCA) by DPWD method. Results In the in vitro study, the local PWV measured by DPWP method and the PWV of the homogeneous rubber tubing did not show statistical difference (5.16 ± 0.28 m/s vs 5.03 ± 0.15 m/s, p = 0.075). The coefficient of variation (CV) of the intra- and inter- measurements for local PWV were 3.46% and 4.96%, for the PWV of the homogeneous rubber tubing were 0.99% and 1.98%. In the in vivo study, a significantly higher local PWV of LCCA was found in the hypertensive patients as compared to that in healthy subjects (6.29±1.04m/s vs. 5.31±0.72m/s, P = 0.019). The CV of the intra- and inter- measurements in hypertensive patients were 2.22% and 3.94%, in healthy subjects were 2.07% and 4.14%. Conclusions This study demonstrated the feasibility of the noninvasive DPWD method to determine the local PWV, which was accurate and reproducible not only in vitro but also in vivo studies. This noninvasive echocardiographic method may be illuminating to clinical use.
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Affiliation(s)
- Zhen Wang
- Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi’an, China
| | - Yong Yang
- Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi’an, China
| | - Li-jun Yuan
- Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi’an, China
- * E-mail: (LY); (TC)
| | - Jie Liu
- Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi’an, China
| | - Yun-you Duan
- Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi’an, China
| | - Tie-sheng Cao
- Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi’an, China
- * E-mail: (LY); (TC)
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Larsson M, Heyde B, Kremer F, Brodin LÅ, D'hooge J. Ultrasound speckle tracking for radial, longitudinal and circumferential strain estimation of the carotid artery--an in vitro validation via sonomicrometry using clinical and high-frequency ultrasound. ULTRASONICS 2015; 56:399-408. [PMID: 25262347 DOI: 10.1016/j.ultras.2014.09.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 08/14/2014] [Accepted: 09/09/2014] [Indexed: 06/03/2023]
Abstract
Ultrasound speckle tracking for carotid strain assessment has in the past decade gained interest in studies of arterial stiffness and cardiovascular diseases. The aim of this study was to validate and directly contrast carotid strain assessment by speckle tracking applied on clinical and high-frequency ultrasound images in vitro. Four polyvinyl alcohol phantoms mimicking the carotid artery were constructed with different mechanical properties and connected to a pump generating carotid flow profiles. Gray-scale ultrasound long- and short-axis images of the phantoms were obtained using a standard clinical ultrasound system, Vivid 7 (GE Healthcare, Horten, Norway) and a high-frequency ultrasound system, Vevo 2100 (FUJIFILM, VisualSonics, Toronto, Canada) with linear-array transducers (12L/MS250). Radial, longitudinal and circumferential strains were estimated using an in-house speckle tracking algorithm and compared with reference strain acquired by sonomicrometry. Overall, the estimated strain corresponded well with the reference strain. The correlation between estimated peak strain in clinical ultrasound images and reference strain was 0.91 (p<0.001) for radial strain, 0.73 (p<0.001) for longitudinal strain and 0.90 (p<0.001) for circumferential strain and for high-frequency ultrasound images 0.95 (p<0.001) for radial strain, 0.93 (p<0.001) for longitudinal strain and 0.90 (p<0.001) for circumferential strain. A significant larger bias and root mean square error was found for circumferential strain estimation on clinical ultrasound images compared to high frequency ultrasound images, but no significant difference in bias and root mean square error was found for radial and longitudinal strain when comparing estimation on clinical and high-frequency ultrasound images. The agreement between sonomicrometry and speckle tracking demonstrates that carotid strain assessment by ultrasound speckle tracking is feasible.
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Affiliation(s)
- Matilda Larsson
- Department of Medical Engineering, School of Technology and Health, KTH Royal Institute of Technology, Stockholm, Alfred Nobels Allé 10, 141 52 Huddinge, Sweden; Lab on Cardiovascular Imaging & Dynamics, KU Leuven, Campus Gasthuisberg O&N1, Herestraat 49 box 911, 3000 Leuven, Belgium.
| | - Brecht Heyde
- Lab on Cardiovascular Imaging & Dynamics, KU Leuven, Campus Gasthuisberg O&N1, Herestraat 49 box 911, 3000 Leuven, Belgium
| | - Florence Kremer
- Lab on Cardiovascular Imaging & Dynamics, KU Leuven, Campus Gasthuisberg O&N1, Herestraat 49 box 911, 3000 Leuven, Belgium
| | - Lars-Åke Brodin
- Department of Medical Engineering, School of Technology and Health, KTH Royal Institute of Technology, Stockholm, Alfred Nobels Allé 10, 141 52 Huddinge, Sweden
| | - Jan D'hooge
- Lab on Cardiovascular Imaging & Dynamics, KU Leuven, Campus Gasthuisberg O&N1, Herestraat 49 box 911, 3000 Leuven, Belgium
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40
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Larsson M, Verbrugghe P, Smoljkić M, Verhoeven J, Heyde B, Famaey N, Herijgers P, D’hooge J. Strain assessment in the carotid artery wall using ultrasound speckle tracking: validation in a sheep model. Phys Med Biol 2015; 60:1107-23. [DOI: 10.1088/0031-9155/60/3/1107] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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41
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Morales MS, Cuffaro PE, Barochiner J, Rada MA, Alfie J, Aparicio L, Marin M, Galarza CR, Waisman GD. Validation of a new piezo-electronic device for non-invasive measurement of arterial pulse wave velocity according to the artery society guidelines. Artery Res 2015. [DOI: 10.1016/j.artres.2015.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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42
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Darwich MA, Langevin F, Darwich K. Local Pulse Wave Velocity Estimation in the Carotids Using Dynamic MR Sequences. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/jbise.2015.84022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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43
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Huang C, Ren TL, Luo J. Effects of parameters on the accuracy and precision of ultrasound-based local pulse wave velocity measurement: a simulation study. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2014; 61:2001-2018. [PMID: 25474776 DOI: 10.1109/tuffc.2014.006597] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Quantification of arterial stiffness, such as pulse wave velocity (PWV), is increasingly used in the risk assessment of cardiovascular disease. Pulse wave imaging (PWI) is an emerging ultrasound-based technique to noninvasively measure the local PWV instead of the global PWV, as in conventional methods. In PWI, several key parameters, including the frame rate of ultrasound imaging, motion estimation rate (MER), number of scan lines, image width, PWV value, and sonographic signal-to-noise ratio (SNRs), play an important but still unclear role in the accuracy and precision of PWV measurement. In this study, computer simulations were performed to investigate the fundamental effects of these parameters on the PWV measurement. The pulse waveform was estimated by speckle tracking on ultrasound RF signals acquired at a frame rate of 2083 Hz from a location on the common carotid artery of a healthy subject. By applying different time delays on the estimated waveform based on specific PWI parameters, the pulse waveforms at others locations were simulated. Ultrasound RF signals of the artery during the pulse wave propagation were generated from a 2-D convolutional image formation model. The PWI technique was applied to estimate the PWV at different values of frame rate, MER, number of scan lines, image width, PWV, and SNRs. The performance of the PWV estimation was evaluated by measuring the relative error, coefficient of variation (CV) and coefficient of determination (R(2)). The results showed that PWVs could be correctly measured when the frame rate was higher than a certain value (i.e., minimum frame rate), below which the estimated error increased rapidly. The minimum frame rate required for PWV estimation was found to increase with the value of PWV. An optimal MER was found (i.e., about 200 Hz) and allowed better performance of PWV measurement. The CV of PWV estimation decreased and R(2) increased with number of scan lines and image width, indicating that the performance of the PWV estimation could be improved with a larger number of scan lines and image width. For a given sufficiently high frame rate, a higher PWV value was found to deteriorate the PWV estimation, as indicated by an increasing CV and decreasing R(2). The simulation results were in good agreement with the theoretical analysis. Finally, high-quality PWV estimation could be obtained as long as the SNRs was higher than about 30 dB. The quantitative effects of the key parameters obtained from this study might provide important guidelines for parameter optimization in ultrasound-based local PWV measurement in vivo.
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Kruizinga P, Mastik F, van den Oord SCH, Schinkel AFL, Bosch JG, de Jong N, van Soest G, van der Steen AFW. High-definition imaging of carotid artery wall dynamics. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:2392-403. [PMID: 25088760 DOI: 10.1016/j.ultrasmedbio.2014.03.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 02/12/2014] [Accepted: 03/10/2014] [Indexed: 05/10/2023]
Abstract
The carotid artery (CA) is central to cardiovascular research, because of the clinical relevance of CA plaques as culprits of stroke and the accessibility of the CA for cardiovascular screening. The viscoelastic state of this artery, essential for clinical evaluation, can be assessed by observing arterial deformation in response to the pressure changes throughout the cardiac cycle. Ultrasound imaging has proven to be an excellent tool to monitor these dynamic deformation processes. We describe how a new technique called high-frame-rate ultrasound imaging captures the tissue deformation dynamics throughout the cardiac cycle in unprecedented detail. Local tissue motion exhibits distinct features of sub-micrometer displacements on a sub-millisecond time scale. We present a high-definition motion analysis technique based on plane wave ultrasound imaging able to capture these features. We validated this method by screening a group of healthy volunteers and compared the results with those for two patients known to have atherosclerosis to illustrate the potential utility of this technique.
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Affiliation(s)
- Pieter Kruizinga
- Department of Biomedical Engineering, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
| | - Frits Mastik
- Department of Biomedical Engineering, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
| | - Stijn C H van den Oord
- Department of Biomedical Engineering, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands; Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
| | - Arend F L Schinkel
- Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
| | - Johannes G Bosch
- Department of Biomedical Engineering, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
| | - Nico de Jong
- Department of Biomedical Engineering, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands; Interuniversity Cardiology Institute, Utrecht, The Netherlands; Delft University of Technology, Delft, The Netherlands
| | - Gijs van Soest
- Department of Biomedical Engineering, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
| | - Anton F W van der Steen
- Department of Biomedical Engineering, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands; Interuniversity Cardiology Institute, Utrecht, The Netherlands; Delft University of Technology, Delft, The Netherlands; Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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45
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Gao M, Zhang G, Olivier NB, Mukkamala R. Improved pulse wave velocity estimation using an arterial tube-load model. IEEE Trans Biomed Eng 2014; 61:848-58. [PMID: 24263016 PMCID: PMC4527045 DOI: 10.1109/tbme.2013.2291385] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Pulse wave velocity (PWV) is the most important index of arterial stiffness. It is conventionally estimated by noninvasively measuring central and peripheral blood pressure (BP) and/or velocity (BV) waveforms and then detecting the foot-to-foot time delay between the waveforms wherein wave reflection is presumed absent. We developed techniques for improved estimation of PWV from the same waveforms. The techniques effectively estimate PWV from the entire waveforms, rather than just their feet, by mathematically eliminating the reflected wave via an arterial tube-load model. In this way, the techniques may be more robust to artifact while revealing the true PWV in absence of wave reflection. We applied the techniques to estimate aortic PWV from simultaneously and sequentially measured central and peripheral BP waveforms and simultaneously measured central BV and peripheral BP waveforms from 17 anesthetized animals during diverse interventions that perturbed BP widely. Since BP is the major acute determinant of aortic PWV, especially under anesthesia wherein vasomotor tone changes are minimal, we evaluated the techniques in terms of the ability of their PWV estimates to track the acute BP changes in each subject. Overall, the PWV estimates of the techniques tracked the BP changes better than those of the conventional technique (e.g., diastolic BP root-mean-squared errors of 3.4 versus 5.2 mmHg for the simultaneous BP waveforms and 7.0 versus 12.2 mmHg for the BV and BP waveforms (p <; 0.02)). With further testing, the arterial tube-load model-based PWV estimation techniques may afford more accurate arterial stiffness monitoring in hypertensive and other patients.
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Affiliation(s)
- Mingwu Gao
- Department of Electrical and Computer Engineering, Michigan State University, East Lansing, MI 48824 USA
| | - Guanqun Zhang
- Department of Electrical and Computer Engineering, Michigan State University, East Lansing, MI 48824 USA. He is now with Sotera Wireless, San Diego, CA 92121 USA
| | - N. Bari Olivier
- Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, MI 48824 USA
| | - Ramakrishna Mukkamala
- Department of Electrical and Computer Engineering, Michigan State University, East Lansing, MI 48824 USA (phone: 517-353-3120; fax: 517-353-1980;)
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46
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Huang C, Ren T, Luo J. Effects of key parameters on the accuracy and precision of local pulse wave velocity measurement by ultrasound imaging. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2014; 2014:2877-2880. [PMID: 25570592 DOI: 10.1109/embc.2014.6944224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Quantification of arterial stiffness, such as pulse wave velocity (PWV), is increasingly used in the risk assessment of cardiovascular disease. Pulse wave imaging (PWI) is an emerging ultrasound-based technique to noninvasively measure the local PWV, instead of the global PWV as in conventional methods. In PWI, several key parameters, including the frame rate, number of scan lines, image width and PWV, play an important but still unclear role in the accuracy and precision of PWV measurement. In this study, computer simulations were performed to investigate the fundamental effects of these parameters on the PWV estimation. By applying different time delays on the pre-obtained pulse waveform based on specific PWI parameters, the pulse wave propagation along the artery was simulated and the ultrasound RF signals were generated from a convolutional image formation model. The PWI technique was applied to calculate the PWV at different values of key parameters. The performance is evaluated by measuring the bias, standard deviation (SD) and coefficient of determination (R(2)) of the estimated PWVs. The results show that PWVs can be correctly measured when the frame rate is higher than a certain value, below which the estimated PWVs become inaccurate. The SD decreases while R(2) increases with number of scan lines and image width, indicating a better performance of the PWV estimation with a larger number of scan lines and image width. A higher value of PWV is found to deteriorate the PWV estimation. The quantitative effects of the key parameters obtained from this study may provide important guidelines for optimization of PWI parameters in vivo.
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47
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Struijk PC, Migchels H, Mathews JV, Stewart PA, Clark EB, de Korte CL, Lotgering FK. Fetal aortic distensibility, compliance and pulse pressure assessment during the second half of pregnancy. ULTRASOUND IN MEDICINE & BIOLOGY 2013; 39:1966-1975. [PMID: 23988265 DOI: 10.1016/j.ultrasmedbio.2013.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Revised: 05/21/2013] [Accepted: 06/06/2013] [Indexed: 06/02/2023]
Abstract
The objective of the study was to measure fetal aortic pulse wave velocity and lumen diameter waveforms and subsequently calculate local distensibility, compliance and pulse pressure. A dedicated algorithm for optimizing lumen diameter assessment from radiofrequency ultrasound data is described. Biplane raw data were obtained from a matrix array transducer. We evaluated 83 confirmed, normally developing pregnancies at 22-38 wk. Fetal aortic pulse wave velocity (PWV, m/s) = 0.047 × gestational age (wk) + 1.241, and the distensibility coefficient (1/kPa) = 1/(1.04 × PWV(2)). The logarithm of the local compliance index (mm(2)/kPa) and the pulse pressure (kPa) were both linearly related to gestational age as 0.022 × GA (wk) - 0.343 and 0.012 × GA (wk) + 0.931, respectively. In conclusion, fetal aortic elastic properties can be derived from phase-sensitive radiofrequency data and multiline diameter assessment. Future studies may shed further light on the developmental origins of vascular health and disease.
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Affiliation(s)
- Pieter C Struijk
- Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Li RX, Qaqish WW, Shahmirzadi D, Konofagou EE. Performance assessment and optimization of Pulse Wave Imaging (PWI) in ex vivo canine aortas and in vivo normal human arteries. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2012:3179-82. [PMID: 23366601 DOI: 10.1109/embc.2012.6346640] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The amplitude, velocity, and morphology of the arterial pulse wave may all provide valuable diagnostic information for cardiovascular pathology. Pulse Wave Imaging (PWI) is an ultrasound-based method developed by our group to noninvasively visualize and map the spatio-temporal variations of the pulse wave-induced vessel wall motion. Because PWI is capable of acquiring multiple wall motion waveforms successively along an imaged arterial segment over a single cardiac cycle in vivo, the regional morphological changes, amplitudes, and velocity (i.e. pulse wave velocity, or PWV) of the pulse wave can all be evaluated. In this study, an ex vivo setup was used to assess the effects of varying PWI image acquisition variables (beam density/frame rate and scanning orientation) and signal processing methods (beam sweep compensation scheme and waveform feature tracking) on the PWV estimation in order to validate the optimal parameters. PWI was also performed on the carotid arteries and abdominal aortas of six healthy volunteers for identification of several salient features of the waveforms over the entire cardiac cycle that may aid in assessing the morphological changes of the pulse wave. The ex vivo results suggest that the PWI temporal resolution is more important for PWV estimation than the PWI spatial resolution, and also that the reverse scanning orientation (i.e. beam sweeping direction opposite the direction of fluid flow) is advantageous due to higher precision and less dependence on the frame rate. In the in vivo waveforms, the highest precision PWV measurements were obtained by tracking the 50% upstroke of the waveforms. Finally, the dicrotic notch, reflected wave, and several inflection points were qualitatively identified in the carotid and aortic anterior wall motion waveforms and shown in one representative subject.
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49
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Shahmirzadi D, Narayanan P, Li RX, Qaqish WW, Konofagou EE. Mapping the longitudinal wall stiffness heterogeneities within intact canine aortas using Pulse Wave Imaging (PWI) ex vivo. J Biomech 2013; 46:1866-74. [PMID: 23764176 DOI: 10.1016/j.jbiomech.2013.04.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 01/25/2013] [Accepted: 04/26/2013] [Indexed: 12/22/2022]
Abstract
The aortic stiffness has been found to be a useful independent indicator of several cardiovascular diseases such as hypertension and aneurysms. Existing methods to estimate the aortic stiffness are either invasive, e.g. catheterization, or yield average global measurements which could be inaccurate, e.g., tonometry. Alternatively, the aortic pulse wave velocity (PWV) has been shown to be a reliable marker for estimating the wall stiffness based on the Moens-Korteweg (M-K) formulation. Pulse Wave Imaging (PWI) is a relatively new, ultrasound-based imaging method for noninvasive and regional estimation of PWV. The present study aims at showing the application of PWI in obtaining localized wall mechanical properties by making PWV measurements on several adjacent locations along the ascending thoracic to the suprarenal abdominal aortic trunk in its intact vessel form. The PWV estimates were used to calculate the regional wall modulus based on the M-K relationship and were compared against conventional mechanical testing. The findings indicated that for the anisotropic aortic wall, the PWI estimates of the modulus are smaller than the circumferential modulus by an average of -32.22% and larger than the longitudinal modulus by an average of 25.83%. Ongoing work is focused on the in vivo applications of PWI in normal and pathological aortas with future implications in the clinical applications of the technique.
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Affiliation(s)
- Danial Shahmirzadi
- Department of Biomedical Engineering, Columbia University, New York, NY 10027, USA
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50
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Vardoulis O, Papaioannou TG, Stergiopulos N. Validation of a novel and existing algorithms for the estimation of pulse transit time: advancing the accuracy in pulse wave velocity measurement. Am J Physiol Heart Circ Physiol 2013; 304:H1558-67. [PMID: 23604712 DOI: 10.1152/ajpheart.00963.2012] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The method used for pulse transit time (PTT) estimation critically affects the accuracy and precision of regional pulse wave velocity (PWV) measurements. Several methods of PTT estimation exist, often yielding substantially different PWV values. Since there is no analytic way to determine PTT in vivo, these methods cannot be validated except by using in silico or in vitro models of known PWV and PTT values. We aimed to validate and compare the most commonly used "foot-to-foot" algorithms, namely, the " diastole-minimum," "tangential," "maximum first derivative," and "maximum second derivative" methods. Also, we propose a new "diastole-patching" method aiming to increase the accuracy and precision in PWV measurements. We simulated 2,000 cases under different hemodynamic conditions using an accurate, validated, distributed, one-dimensional arterial model. The new algorithm detects and "matches" a specific region of the pressure wave foot between the proximal and distal waveforms instead of determining characteristic points. The diastole-minimum and diastole-patching methods showed excellent agreement compared with "real" PWV values of the model, as indicated by high values of the intraclass correlation coefficient (>0.86). The diastole-patching method resulted in low bias (absolute mean difference: 0.26 m/s). In contrast, PWV estimated by the maximum first derivative, maximum second derivative, and tangentia methods presented low to moderate agreement and poor accuracy (intraclass correlation coefficient: <0.79 and bias: >0.9 m/s). The diastole-patching method yielded PWV measurements with the highest agreement, accuracy, and precision and lowest variability.
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Affiliation(s)
- Orestis Vardoulis
- Laboratory of Hemodynamics and Cardiovascular Technology, Institute of Bioengineering, Swiss Federal Institute of Technology, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
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