Fan Xiao-Juan, Xu Ming-Jun, Zhang Yun, Zhang Mei
Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China.
The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital, Jinan, Shandong, PR China.
J Stroke Cerebrovasc Dis. 2015 Jun;24(6):1351-6. doi: 10.1016/j.jstrokecerebrovasdis.2015.02.011. Epub 2015 Mar 18.
Large-artery atherosclerotic stroke (LAAs) is related to carotid plaque, but the mechanical mechanism is unclear. We aimed to use ultrasonic velocity vector imaging (VVI) technique to study the mechanical difference of carotid plaque in patients with LAAs and controls.
We enrolled 43 LAAs patients and 38 controls but all showing plaque on carotid ultrasonography. Ultrasonic VVI technique was used to analyze radial systolic and diastolic peak velocity (R-vs, R-vd), radial and circumferential peak strain (R-s, C-s) and radial displacement (R-dis) of carotid plaque.
Compared with controls, LAAs patients showed higher pulse pressure (P = .001), pulse pressure index (PPI, P = .006), and greater stress at carotid plaque as manifested by higher absolute value of radial diastolic peak velocity (R-vd, P = .021), radial systolic peak velocity (R-vs, P = .007), radial peak strain (R-s, P = .015), and radial displacement (R-dis, P = .022). PPI was significantly correlated with R-vs (r = -.274, P = .013), R-vd (r = .304, P = .006), and R-dis (r = -.28, P = .011). But there was no correlation between R-s and blood pressure. R-s was screened to be the most predictable parameters for LAAs (odds ratio, 1.118; 95% confidence interval, 1.012∼1.236; P = .029). The area under the curve of R-s was .627.
Radial peak strain (R-s) is a predictable parameter for the occurrence of LAAs. We predict using ultrasonic VVI technique to analyze whether the mechanics of carotid plaque is helpful to screen patients with high risks of LAAs.
大动脉粥样硬化性卒中（LAA）与颈动脉斑块有关，但其力学机制尚不清楚。我们旨在使用超声速度向量成像（VVI）技术研究LAA患者与对照组颈动脉斑块的力学差异。
我们纳入了43例LAA患者和38例对照者，所有患者颈动脉超声均显示有斑块。使用超声VVI技术分析颈动脉斑块的径向收缩期和舒张期峰值速度（R-vs、R-vd）、径向和圆周峰值应变（R-s、C-s）以及径向位移（R-dis）。
与对照组相比，LAA患者的脉压更高（P = 0.001）、脉压指数（PPI，P = 0.006），并且颈动脉斑块处的应力更大，表现为径向舒张期峰值速度（R-vd，P = 0.021）、径向收缩期峰值速度（R-vs，P = 0.007）、径向峰值应变（R-s，P = 0.015）和径向位移（R-dis，P = 0.022）的绝对值更高。PPI与R-vs（r = -0.274，P = 0.013）、R-vd（r = 0.304，P = 0.006）和R-dis（r = -0.28，P = 0.011）显著相关。但R-s与血压之间无相关性。R-s被筛选为LAA最具预测性的参数（比值比，1.118；95%置信区间为1.012～1.236；P = 0.029）。R-s的曲线下面积为0.627。
径向峰值应变（R-s）是LAA发生的一个可预测参数。我们预测使用超声VVI技术分析颈动脉斑块的力学情况是否有助于筛查LAA高危患者。
