Mirault Tristan, Pernot Mathieu, Frank Michael, Couade Mathieu, Niarra Ralph, Azizi Michel, Emmerich Joseph, Jeunemaître Xavier, Fink Mathias, Tanter Mickaël, Messas Emmanuel
aService de Médecine Vasculaire, Hôpital Européen Georges-Pompidou, Pôle Cardiovasculaire bCentre de Référence National Maladies Vasculaires Rares, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris - APHP, Université Paris Descartes, Sorbonne Paris Cité, PARCC cInstitut Langevin Ondes et Images, ESPCI ParisTech, CNRS UMR 7587, Inserm, Paris dSuperSonic Imagine, Aix en Provence eCentre d'Investigation Clinique, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris - APHP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France *Tristan Mirault and Mathieu Pernot contributed equally to the writing of this article.
J Hypertens. 2015 Sep;33(9):1890-6; discussion 1896. doi: 10.1097/HJH.0000000000000617.
Arterial stiffness is related to age and collagen properties of the arterial wall and can be indirectly evaluated by the pulse wave velocity (PWV). Ultrafast ultrasound imaging, a unique ultrahigh frame rate technique (>10, 000 images/s), recently emerged enabling direct measurement of carotid PWV and its variation over the cardiac cycle. Our goal was to characterize the carotid diastolic-systolic arterial stiffening using ultrafast ultrasound imaging in healthy individuals and in vascular Ehlers-Danlos syndrome (vEDS), in which collagen type III is defectuous.
Ultrafast ultrasound imaging was performed on common carotids of 102 healthy individuals and 37 consecutive patients with vEDS. Results are mean ± standard deviation.
Carotid ultrafast ultrasound imaging PWV in healthy individuals was 5.6 ± 1.2 in early systole and 7.3 ± 2.0 m/s in end systole, and correlated with age (r = 0.48; P < 0.0001 and r = 0.68; P < 0.0001, respectively). Difference between early and end-systole PWV increased with age independently of blood pressure (r = 0.54; P < 0.0001). In patients with vEDS, ultrafast ultrasound imaging PWV was 6.0 ± 1.5 in early systole and 6.7 ± 1.5 m/s in end systole. Carotid stiffness change over the cardiac cycle was lower than in healthy people (0.021 vs. 0.057 m/s per mmHg; P = 0.0035).
Ultrafast ultrasound imaging can evaluate carotid PWV and its variation over the cardiac cycle. This allowed to demonstrate the age-induced increase of the arterial diastolic-systolic stiffening in healthy people and a lower stiffening in vEDS, both characterized by arterial complications. We believe that this easy-to-use technique could offer the opportunity to go beyond the diastolic PWV to better characterize arterial stiffness change with age or other collagen alterations.
动脉僵硬度与年龄及动脉壁的胶原特性相关,可通过脉搏波速度(PWV)进行间接评估。超快超声成像作为一种独特的超高帧率技术(>10,000帧/秒),最近开始应用,能够直接测量颈动脉PWV及其在心动周期中的变化。我们的目标是使用超快超声成像对健康个体和血管型埃勒斯-当洛综合征(vEDS,其中III型胶原存在缺陷)患者的颈动脉舒张期-收缩期动脉僵硬度进行特征描述。
对102名健康个体和37例连续的vEDS患者的颈总动脉进行超快超声成像检查。结果以平均值±标准差表示。
健康个体的颈动脉超快超声成像PWV在收缩早期为5.6±1.2,在收缩末期为7.3±2.0米/秒,且与年龄相关(分别为r = 0.48;P < 0.0001和r = 0.68;P < 0.0001)。收缩早期和末期PWV之间的差异随年龄增加,且与血压无关(r = 0.54;P < 0.0001)。在vEDS患者中,超快超声成像PWV在收缩早期为6.0±1.5,在收缩末期为6.7±1.5米/秒。心动周期中颈动脉僵硬度的变化低于健康人(每毫米汞柱0.021对0.057米/秒;P = 0.0035)。
超快超声成像可评估颈动脉PWV及其在心动周期中的变化。这使得能够证明健康人群中年龄导致的动脉舒张期-收缩期僵硬度增加以及vEDS患者中较低的僵硬度增加,两者均以动脉并发症为特征。我们认为,这种易于使用的技术可能提供机会超越舒张期PWV,以更好地描述随年龄或其他胶原改变的动脉僵硬度变化。