Huang Chengwu, Guo Dong, Lan Feng, Zhang Hongjia, Luo Jianwen
aDepartment of Biomedical Engineering, School of Medicine bCenter for Biomedical Imaging Research, Tsinghua University cDepartment of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University dBeijing Institute of Heart, Lung and Blood Vessel Diseases eBeijing Lab for Cardiovascular Precision Medicine, Beijing, China *Chengwu Huang and Dong Guo contributed equally to this work.
J Hypertens. 2016 Oct;34(10):2026-37. doi: 10.1097/HJH.0000000000001060.
Accurate and noninvasive techniques for measurement of local/regional pulse wave velocity (PWV), instead of global PWV, is desired for quantifying localized arterial stiffness and improving cardiovascular disease assessment. This study aimed at investigating the feasibility of regional PWV measurement in human ascending aorta in vivo using an ultrasound-based technique.
Proximal ascending aortas of 76 healthy patients (23-71 years) were scanned with transthoracic echocardiography in parasternal long-axis view, and ultrasound radiofrequency data were acquired in a high temporal resolution (∼404 Hz). The PWV was derived from the determination of arrival times and identification of travel distances. Both PWVs in early systolic phase (PWVsf; pulse wave velocity measured using the systolic foot as characteristic time point) and late systolic phase (PWVdn; pulse wave velocity measured using the dicrotic notch as characteristic time point) were obtained.
The PWVsf and PWVdn were 4.58 ± 1.38 and 6.51 ± 1.90 m/s, respectively, and both were correlated with age (r = 0.30, P = 0.02 and r = 0.71, P < 0.0001). The measurements were reproducible, and PWVdn showed significant correlation with aortic diameter (r = 0.53, P < 0.0001), relative distension (r = -0.44, P = 0.0002), and local PWV derived from Bramwell-Hill equation (r = 35, P = 0.004). The PWV difference (PWVdn - PWVsf) reflected aortic stiffness change within cardiac cycle from early systole to late systole and was also correlated with age (r = 0.50, P < 0.0001).
The feasibility of ascending aortic PWV measurement using ultrasound imaging was illustrated in vivo, suggesting the potential of the technique in characterization of regional aortic stiffness and assessment of aortic diseases.
为了量化局部动脉僵硬度并改善心血管疾病评估,人们期望采用准确且无创的技术来测量局部/区域脉搏波速度(PWV),而非整体PWV。本研究旨在探讨使用基于超声的技术在人体升主动脉内进行区域PWV测量的可行性。
对76例健康患者(23 - 71岁)的升主动脉近端进行胸骨旁长轴切面的经胸超声心动图扫描,并以高时间分辨率(约404Hz)采集超声射频数据。PWV通过确定到达时间和识别传播距离得出。同时获取了收缩早期阶段的PWV(PWVsf;以收缩期起始点为特征时间点测量的脉搏波速度)和收缩晚期阶段的PWV(PWVdn;以重搏波切迹为特征时间点测量的脉搏波速度)。
PWVsf和PWVdn分别为4.58±1.38和6.51±1.90m/s,且两者均与年龄相关(r = 0.30,P = 0.02;r = 0.71,P < 0.0001)。测量结果具有可重复性,PWVdn与主动脉直径(r = 0.53,P < 0.0001)、相对扩张度(r = -0.44,P = 0.0002)以及根据布拉姆韦尔 - 希尔方程得出的局部PWV(r = 35,P = 0.004)显著相关。PWV差值(PWVdn - PWVsf)反映了心动周期内从收缩早期到收缩晚期主动脉僵硬度的变化,且也与年龄相关(r = 0.50,P < 0.0001)。
在体内证明了使用超声成像测量升主动脉PWV的可行性,表明该技术在表征局部主动脉僵硬度和评估主动脉疾病方面具有潜力。