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应用 B 型超声模式无创评估动脉脉搏波强度及其在心室功能障碍期间的降低。

Non-invasive Assessment by B-Mode Ultrasound of Arterial Pulse Wave Intensity and Its Reduction During Ventricular Dysfunction.

机构信息

Department of Bioengineering, Imperial College London, London, UK.

Department of Bioengineering, Imperial College London, London, UK.

出版信息

Ultrasound Med Biol. 2023 Feb;49(2):473-488. doi: 10.1016/j.ultrasmedbio.2022.09.016. Epub 2022 Nov 2.

Abstract

Arterial pulse waves contain clinically useful information about cardiac performance, arterial stiffness and vessel tone. Here we describe a novel method for non-invasively assessing wave properties, based on measuring changes in blood flow velocity and arterial wall diameter during the cardiac cycle. Velocity and diameter were determined by tracking speckles in successive B-mode images acquired with an ultrafast scanner and plane-wave transmission. Blood speckle was separated from tissue by singular value decomposition and processed to correct biases in ultrasound imaging velocimetry. Results obtained in the rabbit aorta were compared with a conventional analysis based on blood velocity and pressure, employing measurements obtained with a clinical intra-arterial catheter system. This system had a poorer frequency response and greater lags but the pattern of net forward-traveling and backward-traveling waves was consistent between the two methods. Errors in wave speed were also similar in magnitude, and comparable reductions in wave intensity and delays in wave arrival were detected during ventricular dysfunction. The non-invasive method was applied to the carotid artery of a healthy human participant and gave a wave speed and patterns of wave intensity consistent with earlier measurements. The new system may have clinical utility in screening for heart failure.

摘要

动脉脉搏波包含有关心脏功能、动脉僵硬度和血管张力的临床有用信息。在这里,我们描述了一种基于在心动周期中测量血流速度和动脉壁直径变化来无创评估波特性的新方法。速度和直径通过跟踪超快速扫描仪和平面波传输获得的连续 B 模式图像中的散斑来确定。通过奇异值分解分离血液散斑并进行处理以校正超声成像速度测量中的偏差。在兔主动脉中获得的结果与基于血液速度和压力的传统分析进行了比较,该分析使用临床动脉内导管系统获得的测量值。该系统的频率响应较差,滞后较大,但两种方法的正向和反向传播波的模式是一致的。波速误差的大小也相似,在心室功能障碍期间检测到波强度降低和波到达延迟。该非侵入性方法应用于健康人类参与者的颈动脉,给出的波速和波强度模式与早期测量结果一致。该新系统在心力衰竭筛查中可能具有临床应用价值。

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