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Ultrasonographic strain imaging is superior to conventional non-invasive measures of vascular stiffness in the detection of age-dependent differences in the mechanical properties of the common carotid artery
KTH, School of Technology and Health (STH), Medical Engineering.
KTH, School of Technology and Health (STH), Medical Engineering.
KTH, School of Technology and Health (STH), Medical Engineering.
KTH, School of Technology and Health (STH).
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2010 (English)In: European Journal of Echocardiography, ISSN 1525-2167, E-ISSN 1532-2114, Vol. 11, no 7, 630-636 p.Article in journal (Refereed) Published
Abstract [en]

Aims: Elastic properties of large arteries have been shown to deteriorate with age and in the presence of atherosclerotic vascular disease. In this study, the performance of ultrasonographic strain measurements was compared to conventional measures of vascular stiffness in the detection of age-dependent differences in the elastic properties of the common carotid artery.

Methods and results: In 10 younger (25-28 years, 4 women) and 10 older (50-59 years, 4 women) healthy individuals, global and regional circumferential and radial strain variables were measured in the short-axis view of the right common carotid artery using ultrasonographic two-dimensional (2D) strain imaging with recently introduced speckle tracking technique. Conventional elasticity variables, elastic modulus (Ep) and β stiffness index, were calculated using M-mode sonography and non-invasive blood pressure measurements. Global and regional circumferential systolic strain and strain rate values were significantly higher (p < 0.001, p < 0.01 for regional late systolic strain rate) in the younger individuals, whereas the values of conventional elasticity variables in the same group were lower (p < 0.05). Among all strain and conventional elasticity variables, principal component analysis and its regression extension identified only circumferential systolic strain variables as contributing significantly to the observed discrimination between the younger and older age groups.

Conclusion: Ultrasonographic 2D-strain imaging is a sensitive method for the assessment of elastic properties in the common carotid artery, being in this respect superior to conventional measures of vascular elasticity. The method has potential to become a valuable non-invasive tool in the detection of early atherosclerotic vascular changes.

Place, publisher, year, edition, pages
2010. Vol. 11, no 7, 630-636 p.
National Category
Medical Laboratory and Measurements Technologies
Identifiers
URN: urn:nbn:se:kth:diva-11757DOI: 10.1093/ejechocard/jeq033ISI: 000280704100016Scopus ID: 2-s2.0-77955443516OAI: oai:DiVA.org:kth-11757DiVA: diva2:280832
Note

QC 20101208

Available from: 2009-12-11 Created: 2009-12-11 Last updated: 2017-12-12Bibliographically approved
In thesis
1. New ultrasonographic approaches to monitoring cardiac and vascular function
Open this publication in new window or tab >>New ultrasonographic approaches to monitoring cardiac and vascular function
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Atherosclerotic cardiovascular disease is the leading cause of death worldwide. To decrease mortality and morbidity in cardiovascular disease, the development of accurate, non-invasive methods for early diagnosis of atherosclerotic cardiac and vascular engagement is of considerable clinical interest. Cardiovascular ultrasound imaging is today the cornerstone in the routine evaluation of cardiovascular function and recent development has resulted in two new techniques, tissue velocity imaging (TVI) and speckle tracking, which allow objective quantification of cardiovascular function. TVI and speckle tracking are the basis for three new approaches to cardiac and vascular monitoring presented in this thesis: wave intensity wall analysis (WIWA), two-dimensional strain imaging in the common carotid artery, and the state diagram of the heart.

 

WIWA uses longitudinal and radial strain rate as input for calculations of wave intensity in the arterial wall. In this thesis, WIWA was validated against a commercially available wave intensity system, showing that speckle tracking-derived strain variables can be useful in wave intensity analysis. WIWA was further tested in patients with end stage renal disease and documented high mortality in cardiovascular disease. The latter study evaluated the effects of a single session of hemodialysis using WIWA and TVI variables and showed improved systolic function after hemodialysis. The results also indicated that preload-adjusted early systolic wave intensity obtained by the WIWA system may contribute in the assessment of left ventricular contractility in this patient category. Two-dimensional strain imaging in the common carotid artery is a new approach showing great potential to detect age-dependent differences in mechanical properties of the common carotid artery. Among the measured strain variables, global circumferential strain had the best discriminating performance and appeared to be superior to conventional measures of arterial stiffness such as elastic modulus and β stiffness index. The state diagram is a visualisation tool that provides a quantitative overview of the temporal interrelationship of mechanical events in the left and right ventricles. Case examples and a small clinical study showed that state diagrams clearly visualize cardiac function and can be useful in the detection of non ST-elevation myocardial infarction (NSTEMI).

 

Even though WIWA, two-dimensional strain imaging in the common carotid artery and the state diagram show potential to be useful in the evaluation of cardiovascular function, there still remains a considerable amount of work to be done before they can be used in the daily clinical practice.

Place, publisher, year, edition, pages
Stockholm: KTH, 2009. xiv, 47 p.
Series
Trita-STH : report, ISSN 1653-3836 ; 2009:7
National Category
Biomedical Laboratory Science/Technology
Identifiers
urn:nbn:se:kth:diva-11760 (URN)978-91-7415-525-9 (ISBN)
Public defence
2010-01-22, 3-221, Alfred nobels alle 10, Huddinge, 13:00 (Swedish)
Opponent
Supervisors
Note
QC 20100705Available from: 2009-12-14 Created: 2009-12-11 Last updated: 2010-07-05Bibliographically approved

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