School of Aerospace Medicine, Fourth Military Medical University, Xi'an, China.
Department of Ultrasound Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
Ultrasound Med Biol. 2021 Jul;47(7):1725-1736. doi: 10.1016/j.ultrasmedbio.2021.03.004. Epub 2021 Apr 12.
The conventional manual approach to measurement of aortic pulse wave velocity (PWV) by Doppler ultrasonography is time consuming and operator dependent. Here we report a new semi-automated methodology for more efficient and objective measurement of aortic PWV and results of tests of its clinical feasibility and reproducibility. Carotid-femoral pulse wave velocity (cfPWV) was measured in 50 patients with suspected coronary artery disease (aged 59.2 ± 10.0 y, 36 males) by three independent observers, including two experienced sonographers and one cardiologist without ultrasonographic experience. The cfPWV measured by the semi-automatic method (cfPWV) was compared with reference values obtained by averaging measurements by two experienced sonographers using the conventional standard manual method (cfPWV). Measurements of cfPWV were feasible in all 50 patients and exhibited excellent agreement with averaged cfPWV from the two experienced sonographers, with an intraclass correlation coefficient (ICC) of 0.915 (95% confidence interval: 0.876-0.942). The inexperienced observer-measured cfPWV did not differ from the cfPWV measured by the two experienced sonographers (8.04 ± 1.29 vs. 8.14 ± 1.32 m/s, p > 0.05), with a high consistency by ICC of 0.877 (0.793-0.928). Bland-Altman plots further illustrated the good agreement between the two methods and good intra- and inter-observer reproducibility. Time consumption for cfPWV measurement using the new method was significantly less than that for the manual method (122 ± 35 s vs. 455 ± 105 s, p < 0.0001), saving about 73% of the time. This new semi-automatic methodology for aortic PWV measurement not only has an accuracy similar to that of the conventional standard manual method but is also highly feasible and time saving. It may provide a reliable, simple and reproducible approach to arterial stiffness evaluation in clinical settings.
传统的多普勒超声心动图测量主动脉脉搏波速度（PWV）的方法既耗时又依赖于操作人员。在这里，我们报告了一种新的半自动方法，用于更有效地测量主动脉 PWV，并对其临床可行性和可重复性进行测试。50 例疑似冠心病患者（年龄 59.2±10.0 岁，男性 36 例）由 3 名独立观察者进行了颈股脉搏波速度（cfPWV）测量，包括 2 名有经验的超声医师和 1 名没有超声经验的心脏病专家。半自动方法（cfPWV）测量的 cfPWV 与 2 名有经验的超声医师使用传统标准手动方法（cfPWV）平均测量值的参考值进行了比较。所有 50 例患者均可行 cfPWV 测量，与 2 名有经验的超声医师的平均 cfPWV 具有极好的一致性，组内相关系数（ICC）为 0.915（95%置信区间：0.876-0.942）。无经验观察者测量的 cfPWV 与 2 名有经验的超声医师测量的 cfPWV 无差异（8.04±1.29 vs. 8.14±1.32 m/s，p>0.05），ICC 为 0.877（0.793-0.928），一致性较高。Bland-Altman 图进一步说明了两种方法之间的良好一致性和良好的观察者内和观察者间可重复性。使用新方法测量 cfPWV 的时间明显少于手动方法（122±35 s 与 455±105 s，p<0.0001），节省了约 73%的时间。这种新的主动脉 PWV 半自动测量方法不仅具有与传统标准手动方法相似的准确性，而且还具有高度的可行性和节省时间的优点。它可能为临床环境中的动脉僵硬评估提供一种可靠、简单和可重复的方法。
