Feasibility and Relevance of Compound Strain Imaging in Non-stenotic Arteries: Comparison Between Individuals with Cardiovascular Diseases and Healthy Controls

Overview

Journal Cardiovasc Ultrasound

Publisher Biomed Central

Specialties Cardiology & Vascular Diseases
Radiology

Date 2017 May 20

PMID 28521772

Authors

Martijn F H Maessen

Thijs M H Eijsvogels

Ayla Grotens

Maria T E Hopman

Dick H J Thijssen

Hendrik H G Hansen

Affiliations

Soon will be listed here.

Abstract

Background: Compound strain imaging is a novel method to noninvasively evaluate arterial wall deformation which has recently shown to enable differentiation between fibrous and (fibro-)atheromatous plaques in patients with severe stenosis. We tested the hypothesis that compound strain imaging is feasible in non-stenotic arteries and provides incremental discriminative power to traditional measures of vascular health (i.e., distensibility coefficient (DC), central pulse wave velocity [cPWV], and intima-media thickness [IMT]) for differentiating between participants with and without a history of cardiovascular diseases (CVD).

Methods: Seventy two participants (60 ± 7 years) with non-stenotic arteries (IMT < 1.1 mm) were categorized in healthy participants (CON, n = 36) and CVD patients (n = 36) based on CVD history. Participants underwent standardised ultrasound-based assessment (DC, cPWV, and IMT) and compound strain imaging (radial [RS] and circumferential [CS] strain) in left common carotid artery. Area under receiver operating characteristics (AROC)-curve was used to determine the discriminatory power between CVD and CON of the various measures.

Results: CON had a significantly (P < 0.05) smaller carotid IMT (0.68 [0.58 to 0.76] mm) than CVD patients (0.76 [0.68 to 0.80] mm). DC, cPWV, RS, and CS did not significantly differ between groups (P > 0.05). A higher CS or RS was associated with a higher DC (CS: r = -0.32;p < 0.05 and RS: r = 0.24;p < 0.05) and lower cPWV (CS: r = 0.24;p < 0.05 and RS: r = -0.25;p < 0.05). IMT could identify CVD (AROC: 0.66, 95%-CI: 0.53 to 0.79), whilst the other measurements, alone or in combination, did not significantly increase the discriminatory power compared to IMT.

Conclusions: In non-stenotic arteries, compound strain imaging is feasible, but does not seem to provide incremental discriminative power to traditional measures of vascular health for differentiation between individuals with and without a history of CVD.

References

Thijssen D, Black M, Pyke K, Padilla J, Atkinson G, Harris R . Assessment of flow-mediated dilation in humans: a methodological and physiological guideline. Am J Physiol Heart Circ Physiol. 2010; 300(1):H2-12. PMC: 3023245. DOI: 10.1152/ajpheart.00471.2010. View

Polak J, Pencina M, Meisner A, Pencina K, Brown L, Wolf P . Associations of carotid artery intima-media thickness (IMT) with risk factors and prevalent cardiovascular disease: comparison of mean common carotid artery IMT with maximum internal carotid artery IMT. J Ultrasound Med. 2010; 29(12):1759-68. PMC: 3186063. DOI: 10.7863/jum.2010.29.12.1759. View

Thijssen D, De Groot P, van den Bogerd A, Veltmeijer M, Cable N, Green D . Time course of arterial remodelling in diameter and wall thickness above and below the lesion after a spinal cord injury. Eur J Appl Physiol. 2012; 112(12):4103-9. PMC: 3496545. DOI: 10.1007/s00421-012-2400-2. View

Liu F, Yong Q, Zhang Q, Liu P, Yang Y . Real-time tissue elastography for the detection of vulnerable carotid plaques in patients undergoing endarterectomy: a pilot study. Ultrasound Med Biol. 2015; 41(3):705-12. DOI: 10.1016/j.ultrasmedbio.2014.10.007. View

Tomlinson L, Wilkinson I . Does it matter where we measure blood pressure?. Br J Clin Pharmacol. 2012; 74(2):241-5. PMC: 3630744. DOI: 10.1111/j.1365-2125.2012.04203.x. View

Maurice R, Ohayon J, Fretigny Y, Bertrand M, Soulez G, Cloutier G . Noninvasive vascular elastography: theoretical framework. IEEE Trans Med Imaging. 2004; 23(2):164-80. DOI: 10.1109/TMI.2003.823066. View

Hansen H, Lopata R, Idzenga T, de Korte C . Full 2D displacement vector and strain tensor estimation for superficial tissue using beam-steered ultrasound imaging. Phys Med Biol. 2010; 55(11):3201-18. DOI: 10.1088/0031-9155/55/11/014. View

Weber T, Ammer M, Rammer M, Adji A, ORourke M, Wassertheurer S . Noninvasive determination of carotid-femoral pulse wave velocity depends critically on assessment of travel distance: a comparison with invasive measurement. J Hypertens. 2009; 27(8):1624-30. DOI: 10.1097/HJH.0b013e32832cb04e. View

Lopata R, Hansen H, Nillesen M, Thijssen J, de Korte C . Comparison of one-dimensional and two-dimensional least-squares strain estimators for phased array displacement data. Ultrason Imaging. 2009; 31(1):1-16. DOI: 10.1177/016173460903100101. View

10.

Leung K, Bosch J . Automated border detection in three-dimensional echocardiography: principles and promises. Eur J Echocardiogr. 2010; 11(2):97-108. DOI: 10.1093/ejechocard/jeq005. View

11.

Potter K, Reed C, Green D, Hankey G, Arnolda L . Ultrasound settings significantly alter arterial lumen and wall thickness measurements. Cardiovasc Ultrasound. 2008; 6:6. PMC: 2254584. DOI: 10.1186/1476-7120-6-6. View

12.

Polak J, Pencina M, Pencina K, ODonnell C, Wolf P, DAgostino Sr R . Carotid-wall intima-media thickness and cardiovascular events. N Engl J Med. 2011; 365(3):213-21. PMC: 3153949. DOI: 10.1056/NEJMoa1012592. View

13.

Huang C, Pan X, He Q, Huang M, Huang L, Zhao X . Ultrasound-Based Carotid Elastography for Detection of Vulnerable Atherosclerotic Plaques Validated by Magnetic Resonance Imaging. Ultrasound Med Biol. 2015; 42(2):365-77. DOI: 10.1016/j.ultrasmedbio.2015.09.023. View

14.

Lopata R, Nillesen M, Hansen H, Gerrits I, Thijssen J, de Korte C . Performance evaluation of methods for two-dimensional displacement and strain estimation using ultrasound radio frequency data. Ultrasound Med Biol. 2009; 35(5):796-812. DOI: 10.1016/j.ultrasmedbio.2008.11.002. View

15.

Laurent S, Cockcroft J, van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D . Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006; 27(21):2588-605. DOI: 10.1093/eurheartj/ehl254. View

16.

Bjallmark A, Lind B, Peolsson M, Shahgaldi K, Brodin L, Nowak J . 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. Eur J Echocardiogr. 2010; 11(7):630-6. DOI: 10.1093/ejechocard/jeq033. View

17.

Catalano M, Lamberti-Castronuovo A, Catalano A, Filocamo D, Zimbalatti C . Two-dimensional speckle-tracking strain imaging in the assessment of mechanical properties of carotid arteries: feasibility and comparison with conventional markers of subclinical atherosclerosis. Eur J Echocardiogr. 2011; 12(7):528-35. DOI: 10.1093/ejechocard/jer078. View

18.

Ashor A, Lara J, Siervo M, Celis-Morales C, Oggioni C, Jakovljevic D . Exercise modalities and endothelial function: a systematic review and dose-response meta-analysis of randomized controlled trials. Sports Med. 2014; 45(2):279-96. DOI: 10.1007/s40279-014-0272-9. View

19.

Linhart A, Dostalova G, Belohlavek J, Vitek L, Karetova D, Ingrischova M . Carotid intima-media thickness in young survivors of acute myocardial infarction. Exp Clin Cardiol. 2013; 17(4):215-20. PMC: 3627278. View

20.

Poree J, Garcia D, Chayer B, Ohayon J, Cloutier G . Noninvasive Vascular Elastography With Plane Strain Incompressibility Assumption Using Ultrafast Coherent Compound Plane Wave Imaging. IEEE Trans Med Imaging. 2015; 34(12):2618-31. DOI: 10.1109/TMI.2015.2450992. View