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二维斑点追踪技术评估动脉僵硬度的可行性:与脉搏波速度及传统动脉粥样硬化超声标志物的比较

Feasibility of two-dimensional speckle tracking in evaluation of arterial stiffness: Comparison with pulse wave velocity and conventional sonographic markers of atherosclerosis.

作者信息

Podgórski Michał, Grzelak Piotr, Kaczmarska Magdalena, Polguj Michał, Łukaszewski Maciej, Stefańczyk Ludomir

机构信息

1 Department of Radiology and Diagnostic Imaging, Medical University of Lodz, Poland.

2 Department of Angiology, Chair of Anatomy, Medical University of Lodz, Poland.

出版信息

Vascular. 2018 Feb;26(1):63-69. doi: 10.1177/1708538117720047. Epub 2017 Jul 20.

Abstract

Objective Arterial stiffening is an early marker of atherosclerosis that has a prognostic value for cardiovascular morbidity and mortality. Although many markers of arterial hardening have been proposed, the search is on for newer, more user-friendly and reliable surrogates. One such potential candidate has emerged from cardiology, the speckle-tracking technique. The aim of this study was to evaluate the feasibility of the two-dimensional speckle tracking for the evaluation of arterial wall stiffness in comparison with standard stiffness parameters. Methods Carotid ultrasound and applanation tonometry were performed in 188 patients with no cardiovascular risk factors. The following parameters were then evaluated: the intima-media complex thickness, distensibility coefficient, β-stiffness index, circumferential strain/strain rate, and pulse wave velocity and augmentation index. These variables were compared with each other and with patient age, and their reliability was assessed with Bland-Altman plots. Results Strain parameters derived from two-dimensional speckle tracking and intima-media complex thickness correlated better with age and pulse wave velocity than standard makers of arterial stiffness. Moreover, the reliability of these measurements was significantly higher than conventional surrogates. Conclusions Two-dimensional speckle tracing is a reliable method for the evaluation of arterial stiffness. Therefore, together with intima-media complex thickness measurement, it offers great potential in clinical practice as an early marker of atherosclerosis.

摘要

目的 动脉僵硬度是动脉粥样硬化的早期标志物,对心血管疾病的发病率和死亡率具有预后价值。尽管已经提出了许多动脉硬化的标志物,但仍在寻找更新的、更便于使用且可靠的替代指标。心脏科出现了一种这样的潜在候选指标,即散斑追踪技术。本研究的目的是评估二维散斑追踪与标准僵硬度参数相比在评估动脉壁僵硬度方面的可行性。方法 对188例无心血管危险因素的患者进行颈动脉超声和压平式眼压测量。然后评估以下参数:内膜 - 中膜复合体厚度、扩张系数、β僵硬度指数、圆周应变/应变率、脉搏波速度和增强指数。将这些变量相互比较,并与患者年龄进行比较,并用布兰德 - 奥特曼图评估其可靠性。结果 二维散斑追踪得出的应变参数以及内膜 - 中膜复合体厚度与年龄和脉搏波速度的相关性比动脉僵硬度的标准指标更好。此外,这些测量的可靠性明显高于传统替代指标。结论 二维散斑追踪是评估动脉僵硬度的可靠方法。因此,与内膜 - 中膜复合体厚度测量一起,它在临床实践中作为动脉粥样硬化的早期标志物具有巨大潜力。

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