Styczynski Grzegorz, Rdzanek Adam, Pietrasik Arkadiusz, Kochman Janusz, Huczek Zenon, Sobieraj Piotr, Gaciong Zbigniew, Szmigielski Cezary
Department of Internal Medicine, Hypertension and Angiology, Medical University of Warsaw, Warsaw, Poland.
First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
J Am Soc Echocardiogr. 2016 Nov;29(11):1109-1116. doi: 10.1016/j.echo.2016.07.013. Epub 2016 Sep 7.
Aortic pulse-wave velocity (PWV) is a measure of aortic stiffness that has a prognostic role in various diseases and in the general population. A number of methods are used to measure PWV, including Doppler ultrasound. Although echocardiography has been used for PWV measurement, to the authors' knowledge, it has never been tested against an invasive reference method at the same time point. Therefore, the aim of this study was to compare prospectively an echocardiographic PWV measurement, called echo-PWV, with an invasive study.
Forty-five patients (mean age, 66 years; 60% men) underwent simultaneous intra-arterial pressure recording and echocardiographic Doppler flow evaluation during elective cardiac catheterization. Proximal pressure and Doppler waveforms were acquired in the aortic arch. Distal pressure waveforms were registered in the right and distal Doppler waveforms in the left external iliac artery. Transit time was measured as a delay of the foot of pressure or Doppler waveform in the distal relative to the proximal location. Distance was measured on the catheter for invasive PWV and over the surface for echo-PWV. Echo-PWV was calculated as distance divided by transit time.
In the whole group, mean invasive PWV was 9.38 m/sec and mean echo-PWV was 9.51 m/sec (P = .78). The Pearson' correlation coefficient between methods was 0.93 (P < .0001). A Bland-Altman plot revealed a mean difference between invasive PWV and echo-PWV of 0.13 ± 0.79 m/sec.
Echo-PWV, based on Doppler echocardiography, is a reliable method of aortic PWV measurement, with a close correlation with invasive assessment. Wider implementation of the echo-PWV method for the evaluation of aortic wall stiffness can further expand the clinical and scientific utility of echocardiography.
主动脉脉搏波速度（PWV）是衡量主动脉僵硬度的指标，在各种疾病和普通人群中具有预后作用。有多种方法用于测量PWV，包括多普勒超声。尽管超声心动图已用于PWV测量，但据作者所知，它从未在同一时间点与有创参考方法进行过对比测试。因此，本研究的目的是前瞻性地比较一种称为回声PWV的超声心动图PWV测量方法与有创研究。
45例患者（平均年龄66岁；60%为男性）在择期心导管检查期间同时进行动脉内压力记录和超声心动图多普勒血流评估。在主动脉弓采集近端压力和多普勒波形。在右髂外动脉和左髂外动脉的远端记录远端压力波形。通过测量压力或多普勒波形波峰在远端相对于近端位置的延迟来计算传输时间。在导管上测量有创PWV的距离，在体表测量回声PWV的距离。回声PWV通过距离除以传输时间计算得出。
在整个研究组中，平均有创PWV为9.38米/秒，平均回声PWV为9.51米/秒（P = 0.78）。两种方法之间的Pearson相关系数为0.93（P < 0.0001）。Bland-Altman图显示有创PWV与回声PWV之间的平均差异为0.13±0.79米/秒。
基于多普勒超声心动图的回声PWV是一种可靠的主动脉PWV测量方法，与有创评估密切相关。更广泛地应用回声PWV方法评估主动脉壁僵硬度可进一步扩大超声心动图的临床和科学应用价值。
