Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey.
Department of Endocrinology, Gazi University Faculty of Medicine, Ankara, Turkey.
Diagn Interv Radiol. 2021 Mar;27(2):195-205. doi: 10.5152/dir.2021.20025.
We aimed to evaluate the effectiveness of speckle tracking carotid strain (STCS) technique, which enables measurement of arterial stiffness and strain parameters, in the detection of early atherosclerotic findings in type 1 diabetes mellitus (T1DM).
We prospectively enrolled 30 T1DM patients and 30 age- and sex-matched control participants with no history of cardiovascular disease. All study population underwent carotid ultrasonography. Radial and circumferential movement of the common carotid artery (CCA) in the transverse plane as the well as the radial movement of the CCA in the longitudinal plane were calculated automatically by using the STCS method. In addition, the strain (%), strain rate (per second), and peak circumferential and radial displacements (mm) were calculated. Arterial stiffness parameters, such as elastic modulus, distensibility, arterial compliance, and β-stiffness index, were calculated using the radial measurements. The mean value of the carotid intima media thickness (CIMT) was calculated semi-automatically for each CCA, in the longitudinal plane. We also analyzed the patients' overall body composition.
T1DM and control groups were compared in terms of strain and stiffness parameters and no statistically significant difference was found (p > 0.05). CIMT was higher in diabetic patients than in the control group (p = 0.039). In both groups, age was correlated with all arterial stiffness and strain parameters (p < 0.05). The duration of diabetes was also correlated with β-stiffness index, distensibility, and elastic modulus in the longitudinal plane (p < 0.05). In the diabetic group, abdominal fat ratio, whole body fat ratio, and fat mass were correlated with radial and circumferential displacement and strain parameters in transverse plane, and radial displacement in longitudinal plane (p < 0.05, for each). Diabetic patients were divided into subgroups according to the presence of nephropathy and dyslipidemia. Although no significant difference was found between the groups in terms of CIMT, patients with nephropathy had higher values for transverse and longitudinal elastic modulus, pulse-wave velocity, and longitudinal β-stiffness index, as well as lower values for longitudinal arterial compliance and distensibility, compared with patients without nephropathy (p < 0.05). Also, patients with dyslipidemia had higher longitudinal β-stiffness and elastic modulus values compared with patients without dyslipidemia (p < 0.05).
STCS ultrasonography is an effective, easy, and noninvasive method for evaluating the arterial elasticity. It may provide an early assessment of atherosclerosis in patients with T1DM, especially in the presence of nephropathy and dyslipidemia; thus, together with CIMT measurement, it may be used more frequently to detect subclinical damage and stratify atherosclerosis.
我们旨在评估斑点追踪颈动脉应变（STCS）技术的有效性，该技术可测量动脉僵硬度和应变参数，以检测 1 型糖尿病（T1DM）中的早期动脉粥样硬化发现。
我们前瞻性地招募了 30 名 T1DM 患者和 30 名年龄和性别匹配的无心血管疾病史的对照组参与者。所有研究人群均接受颈动脉超声检查。使用 STCS 方法自动计算颈总动脉（CCA）在横切面上的径向和周向运动以及 CCA 在纵切面上的径向运动。此外，计算了应变（%）、应变速率（每秒）和周向和径向峰值位移（mm）。使用径向测量值计算动脉僵硬度参数，如弹性模量、可扩展性、动脉顺应性和β-僵硬度指数。在纵切面上，半自动计算每个 CCA 的颈动脉内膜中层厚度（CIMT）的平均值。我们还分析了患者的整体身体成分。
比较了 T1DM 组和对照组的应变和僵硬度参数，差异无统计学意义（p > 0.05）。糖尿病患者的 CIMT 高于对照组（p = 0.039）。在两组中，年龄与所有动脉僵硬度和应变参数均相关（p < 0.05）。糖尿病病程也与纵向平面的β-僵硬度指数、可扩展性和弹性模量以及纵向平面的径向位移相关（p < 0.05）。在糖尿病组中，腹部脂肪比、全身脂肪比和脂肪质量与横切面上的径向和周向位移和应变参数以及纵切面上的径向位移相关（p < 0.05，每一个）。根据是否存在肾病和血脂异常，将糖尿病患者分为亚组。尽管 CIMT 组间无显著差异，但与无肾病的患者相比，有肾病的患者的横向和纵向弹性模量、脉搏波速度和纵向β-僵硬度指数较高，而纵向动脉顺应性和可扩展性较低（p < 0.05）。此外，与无血脂异常的患者相比，血脂异常的患者的纵向β-僵硬度和弹性模量值较高（p < 0.05）。
STCS 超声检查是一种有效、简便、无创的评估动脉弹性的方法。它可能为 T1DM 患者的动脉粥样硬化提供早期评估，特别是在存在肾病和血脂异常的情况下；因此，它可能与 CIMT 测量一起更频繁地用于检测亚临床损伤并分层动脉粥样硬化。
