Yoon Ji Hyun, Han Donghee, Kim Sujin, Cho In-Jeong, Sung Ji Min, Lee Jinyong, Ryoo Hojin, Shim Chi Young, Hong Geu-Ru, Chang Hyuk-Jae
Cardiology Division, Department of Internal Medicine, Seoul, Korea.
Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Seoul, Korea.
Echocardiography. 2018 Jul;35(7):957-964. doi: 10.1111/echo.13881. Epub 2018 Mar 30.
We aimed to explore the relevance of multidirectional movements of the common carotid artery in atherothrombotic stroke.
We prospectively enrolled 69 patients with atherothrombotic stroke (stroke group) and 69 age-matched and sex-matched controls (control group) who underwent carotid ultrasonography. Based on the speckle tracking technique, circumferential and radial movements of the common carotid artery were analyzed from transverse and longitudinal B-mode images of the common carotid artery. Peak longitudinal and radial displacements, strain, and strain rate were measured. Mean age of the overall population was 64 ± 11 years, and 57% (78 patients) were men. In the transverse image, circumferential strain was significantly lower in the stroke group than in the control group (5.6 ± 1.6 vs 4.2 ± 1.7, P < .001). In multivariate logistic regression analysis, circumferential strain was independently associated with stroke (odds ratio: 0.60, P = .001). Compared with conventional risk factors, as well as carotid intima-media thickness and carotid plaque, the addition of a strain parameter appeared to improve discrimination of a stroke event (area under the receiver operating characteristic curve: 0.65 and 0.75 vs 0.84, respectively; P < .05 for both).
Circumferential strain of the common carotid artery might serve as a novel surrogate marker of atherothrombotic stroke. Multidirectional strain imaging of the common carotid artery may provide more information than conventional carotid ultrasonography and identify clinical risk factors for risk stratification of an acute stroke event.
我们旨在探讨颈总动脉多向运动与动脉粥样硬化性血栓形成性卒中的相关性。
我们前瞻性纳入了69例动脉粥样硬化性血栓形成性卒中患者（卒中组）和69例年龄及性别匹配的对照者（对照组），他们均接受了颈动脉超声检查。基于斑点追踪技术，从颈总动脉的横向和纵向B超图像分析颈总动脉的圆周运动和径向运动。测量纵向和径向峰值位移、应变及应变率。总体人群的平均年龄为64±11岁，57%（78例患者）为男性。在横向图像中，卒中组的圆周应变显著低于对照组（5.6±1.6对4.2±1.7，P<0.001）。在多因素逻辑回归分析中，圆周应变与卒中独立相关（比值比：0.60，P=0.001）。与传统危险因素以及颈动脉内膜中层厚度和颈动脉斑块相比，加入应变参数似乎可改善对卒中事件的判别能力（受试者操作特征曲线下面积分别为0.65和0.75对0.84；两者P均<0.05）。
颈总动脉的圆周应变可能作为动脉粥样硬化性血栓形成性卒中的一种新型替代标志物。颈总动脉的多向应变成像可能比传统颈动脉超声检查提供更多信息，并识别急性卒中事件风险分层的临床危险因素。
