复合应变成像在非狭窄动脉中的可行性及相关性：心血管疾病患者与健康对照者的比较
Feasibility and relevance of compound strain imaging in non-stenotic arteries: comparison between individuals with cardiovascular diseases and healthy controls.
作者信息
Maessen Martijn F H, Eijsvogels Thijs M H, Grotens Ayla, Hopman Maria T E, Thijssen Dick H J, Hansen Hendrik H G
机构信息
Department of Physiology, Radboud university medical center, Nijmegen, The Netherlands.
Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
出版信息
Cardiovasc Ultrasound. 2017 May 18;15(1):13. doi: 10.1186/s12947-017-0104-9.
BACKGROUND
Compound strain imaging is a novel method to noninvasively evaluate arterial wall deformation which has recently shown to enable differentiation between fibrous and (fibro-)atheromatous plaques in patients with severe stenosis. We tested the hypothesis that compound strain imaging is feasible in non-stenotic arteries and provides incremental discriminative power to traditional measures of vascular health (i.e., distensibility coefficient (DC), central pulse wave velocity [cPWV], and intima-media thickness [IMT]) for differentiating between participants with and without a history of cardiovascular diseases (CVD).
METHODS
Seventy two participants (60 ± 7 years) with non-stenotic arteries (IMT < 1.1 mm) were categorized in healthy participants (CON, n = 36) and CVD patients (n = 36) based on CVD history. Participants underwent standardised ultrasound-based assessment (DC, cPWV, and IMT) and compound strain imaging (radial [RS] and circumferential [CS] strain) in left common carotid artery. Area under receiver operating characteristics (AROC)-curve was used to determine the discriminatory power between CVD and CON of the various measures.
RESULTS
CON had a significantly (P < 0.05) smaller carotid IMT (0.68 [0.58 to 0.76] mm) than CVD patients (0.76 [0.68 to 0.80] mm). DC, cPWV, RS, and CS did not significantly differ between groups (P > 0.05). A higher CS or RS was associated with a higher DC (CS: r = -0.32;p < 0.05 and RS: r = 0.24;p < 0.05) and lower cPWV (CS: r = 0.24;p < 0.05 and RS: r = -0.25;p < 0.05). IMT could identify CVD (AROC: 0.66, 95%-CI: 0.53 to 0.79), whilst the other measurements, alone or in combination, did not significantly increase the discriminatory power compared to IMT.
CONCLUSIONS
In non-stenotic arteries, compound strain imaging is feasible, but does not seem to provide incremental discriminative power to traditional measures of vascular health for differentiation between individuals with and without a history of CVD.
背景
复合应变成像是一种无创评估动脉壁变形的新方法，最近已证明其能够区分严重狭窄患者的纤维斑块和（纤维）动脉粥样硬化斑块。我们检验了以下假设：复合应变成像在无狭窄动脉中是可行的，并且对于区分有和没有心血管疾病（CVD）病史的参与者，它比传统的血管健康测量指标（即扩张系数（DC）、中心脉搏波速度[cPWV]和内膜中层厚度[IMT]）具有更强的鉴别能力。
方法
72名无狭窄动脉（IMT<1.1mm）的参与者（60±7岁）根据CVD病史被分为健康参与者（CON，n = 36）和CVD患者（n = 36）。参与者接受了基于超声的标准化评估（DC、cPWV和IMT）以及左颈总动脉的复合应变成像（径向[RS]和周向[CS]应变）。采用受试者工作特征曲线下面积（AROC）来确定各种测量指标在CVD和CON之间的鉴别能力。
结果
CON组的颈动脉IMT（0.68[0.58至0.76]mm）显著（P<0.05）小于CVD患者（0.76[0.68至0.80]mm）。两组之间的DC、cPWV、RS和CS没有显著差异（P>0.05）。较高的CS或RS与较高的DC相关（CS：r = -0.32；P<0.05，RS：r = 0.24；P<0.05），并且与较低的cPWV相关（CS：r = （此处原文似乎有误，推测可能是0.24）；P<0.05，RS：r = -0.25；P<0.05）。IMT能够识别CVD（AROC：0.66，95%置信区间：0.53至0.79），而其他测量指标单独或联合使用时，与IMT相比，并没有显著提高鉴别能力。
结论
在无狭窄动脉中，复合应变成像是可行的，但对于区分有和没有CVD病史的个体，它似乎并没有比传统的血管健康测量指标提供更强的鉴别能力。
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