Patton Daniel M, Li Terry, Hétu Marie-France, Day Andrew G, Preece Erika, Matangi Murray F, Johri Amer M
Division of Cardiology, Cardiovascular Imaging Network at Queen's, Department of Medicine, Queen's University, Kingston, Ontario, Canada.
The Kingston Heart Clinic, Kingston, Ontario, Canada.
J Clin Ultrasound. 2018 Nov;46(9):575-581. doi: 10.1002/jcu.22632. Epub 2018 Aug 13.
Circumferential speckle tracking carotid artery strain is a novel method of quantifying vessel wall stiffness. We hypothesized that carotid wall stiffness would be associated with carotid intimal medial thickening (a medial process associated with risk factors), but not coronary artery disease (an intimal process).
Bilateral carotid artery ultrasound was conducted on outpatients who had previously undergone elective coronary angiography. Mean carotid artery far wall circumferential strain (FWCS) was assessed for correlations with coronary angiographic stenosis, cardiac risk factors, carotid intima-media thickness (CIMT), and carotid plaque.
One hundred and sixty five (165) patients were studied. No significant association was found between the presence of coronary artery disease on angiography and mean FWCS. FWCS was higher in current tobacco smokers. In addition, carotid strain was found to decrease with increased age (r = -0.33, P < 0.001). When adjusted for pulse pressure (PP), FWCS/PP was negatively correlated with mean CIMT (r = -0.29, P = 0.002) and bulb maximum plaque height (r = -0.27, P = 0.004). Hypertension and diabetes were associated with decreased FWCS/PP (increased wall stiffness).
While no clear relationship between carotid strain and coronary artery disease was observed, increased CIMT, carotid plaque, and cardiac risk factors were associated with decreased carotid strain. Further work is required to explore the relationship between carotid strain and cardiovascular events.
圆周散斑追踪颈动脉应变是一种量化血管壁硬度的新方法。我们假设颈动脉壁硬度与颈动脉内膜中层增厚（一种与危险因素相关的中层病变）有关，但与冠状动脉疾病（一种内膜病变）无关。
对先前接受过选择性冠状动脉造影的门诊患者进行双侧颈动脉超声检查。评估平均颈动脉远壁圆周应变（FWCS）与冠状动脉造影狭窄、心脏危险因素、颈动脉内膜中层厚度（CIMT）和颈动脉斑块之间的相关性。
共研究了165例患者。血管造影显示的冠状动脉疾病与平均FWCS之间未发现显著关联。当前吸烟者的FWCS较高。此外，发现颈动脉应变随年龄增长而降低（r = -0.33，P < 0.001）。在调整脉压（PP）后，FWCS/PP与平均CIMT呈负相关（r = -0.29，P = 0.002），与球部最大斑块高度呈负相关（r = -0.27，P = 0.004）。高血压和糖尿病与FWCS/PP降低（血管壁硬度增加）有关。
虽然未观察到颈动脉应变与冠状动脉疾病之间存在明确关系，但CIMT增加、颈动脉斑块和心脏危险因素与颈动脉应变降低有关。需要进一步开展工作来探索颈动脉应变与心血管事件之间的关系。
