Université de Lyon, CREATIS, CNRS UMR 5220, INSERM U1044, INSA, Lyon, France.
Ultrasound Med Biol. 2012 Oct;38(10):1705-15. doi: 10.1016/j.ultrasmedbio.2012.05.004. Epub 2012 Aug 21.
The recently discovered longitudinal displacement of the common carotid arterial wall (i.e., the motion along the same plane as the blood flow), may be associated with incident cardiovascular events and represents a novel and relevant clinical information. At present, there have only been a few studies that have been conducted to investigate this longitudinal movement. We propose here a method to assess noninvasively the wall bi-dimensional (two-dimensional [2-D], cross-sectional and longitudinal) motion and present an original approach that combines a robust speckle tracking scheme to guidance by minimal path contours segmentation. Our method is well suited to large clinical population studies as it does not necessitate strong imaging prerequisites. The aim of this study is to describe the association between the longitudinal displacement of the carotid arterial wall and cardiovascular risk factors, among which periodontal disease. Some 126 Indigenous Australians with periodontal disease, an emerging risk factor, and 27 healthy age- and sex-matched non-indigenous control subjects had high-resolution ultrasound scans of the common carotid artery. Carotid intima-media thickness and arterial wall 2-D motion were then assessed using our method in ultrasound B-mode sequences. Carotid longitudinal displacement was markedly lower in the periodontal disease group than the control group (geometric mean (IQR): 0.15 mm (0.13) vs. 0.42 mm (0.30), respectively; p < 0.0001), independent of cardiovascular risk factors, cross-sectional distensibility and carotid intima-media thickness (p < 0.0001). A multivariable model indicated that the strongest correlates of carotid longitudinal displacement in adults with periodontal disease were age (β-coefficient = -.235, p = .03), waist (β-coefficient = -.357, p = 0.001), and pulse pressure (β-coefficient = .175, p = 0.07), independent of other cardiovascular risk factors, cross-sectional distensibility and pulse wave velocity. Carotid longitudinal displacement, estimated with our approach, is impaired in the periodontal disease group, independent of established cardiovascular risk factors and other noninvasive measures of arterial stiffness, and may represent an important marker of cardiovascular risk.
最近发现的颈总动脉壁的纵向移位（即与血流方向相同的平面上的运动）可能与心血管事件的发生有关，代表了一种新的、相关的临床信息。目前，只有少数研究调查了这种纵向运动。我们在这里提出了一种无创评估管壁二维（二维，横截面和纵向）运动的方法，并提出了一种原始方法，该方法将稳健的斑点跟踪方案与最小路径轮廓分割相结合。我们的方法非常适合于大型临床人群研究，因为它不需要强烈的成像前提条件。本研究的目的是描述颈总动脉壁的纵向位移与心血管危险因素之间的关系，其中包括牙周病。一些患有牙周病（新兴危险因素）的 126 名澳大利亚土着人和 27 名年龄和性别匹配的健康非土着对照组进行了颈总动脉的高分辨率超声扫描。然后使用我们的方法在超声 B 模式序列中评估颈动脉内-中膜厚度和动脉壁 2-D 运动。牙周病组的颈动脉纵向位移明显低于对照组（几何平均值（IQR）：0.15 毫米（0.13）比 0.42 毫米（0.30）；p <0.0001），独立于心血管危险因素、横截面可扩展性和颈动脉内-中膜厚度（p <0.0001）。多变量模型表明，牙周病成人颈动脉纵向位移的最强相关因素是年龄（β系数=-0.235，p=0.03）、腰围（β系数=-0.357，p=0.001）和脉压（β系数=0.175，p=0.07），独立于其他心血管危险因素、横截面可扩展性和脉搏波速度。使用我们的方法估计的颈动脉纵向位移在牙周病组受损，与已确立的心血管危险因素和其他动脉僵硬的无创测量无关，可能是心血管风险的一个重要标志物。
