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向量血流图技术在高血压患者颈动脉壁剪切应力定量评估中的应用:一项初步研究。

Utility of vector flow mapping technology in quantitative assessment of carotid wall shear stress in hypertensive patients: A preliminary study.

作者信息

He Lan, Cai Yundan, Feng Yuhong, Wang Wenwen, Feng Tienan, Shen E, Yang Shaoling

机构信息

Department of Ultrasound Medicine, Shanghai Eighth People's Hospital, Shanghai, China.

Department of Ultrasound Medicine, Shanghai Sixth People's Hospital, Shanghai, China.

出版信息

Front Cardiovasc Med. 2022 Oct 28;9:967763. doi: 10.3389/fcvm.2022.967763. eCollection 2022.

Abstract

BACKGROUND

Blood flowing in the arterial lumen acts on the surface of the vessel wall to form wall shear stress (WSS). To date, there has been limited research on the utility of non-invasive technology in the accurate quantification of carotid WSS in patients with hypertension (HP).

OBJECTIVE

The present study aimed to explore the usage of vascular vector flow mapping (VFM) in the quantitative assessment of carotid WSS in hypertensive patients at an early stage and to validate its clinical utility.

METHODS

A total of 50 individuals confirmed without carotid plaques were grouped into a HP group ( = 25) and a control (CON) group ( = 25) according to blood pressure. An ALOKA LISENDO 880 Color Doppler Ultrasound with a L441 3-15 MHZ probe was used to obtain a longitudinal section scan to determine the regions of interests (ROIs) of the common carotid artery. VFM-based WSS measurements were obtained by selecting the ROI with optimal image quality from three full cardiac cycles. WSS-derived measurements, including WSS, WSS, and WSS, were analyzed and compared between the HP and CON groups. In addition, the correlations between WSS-derived measurements and the carotid artery intima-media thickness (IMT) were also analyzed.

RESULTS

There were significant statistical differences in WSS and WSS between patients in the HP and CON groups. Specifically, the HP group had significantly decreased WSS and WSS compared to the CON group (WSS: 1.781 ± 0.305 Pa vs. 2.286 ± 0.257 Pa; WSS: 1.276 ± 0.333 Pa vs. 1.599 ± 0.293 Pa, both < 0.001). However, there was no statistical difference in WSS between the groups (0.79 ± 0.36 vs. 0.99 ± 0.42, = 0.080). Additionally, Spearman's correlation analysis indicated that the WSS-derived parameters were negatively correlated with the IMT ( < 0.001).

CONCLUSION

Vascular VFM technology shows promising results in the quantitative assessment of difference in hemodynamics of the vascular flow field between patients with HP and normal controls. Difference in WSS may serve as a potential predictor for the development of arteriosclerosis risks.

摘要

背景

动脉管腔内流动的血液作用于血管壁表面,形成壁面剪应力(WSS)。迄今为止,关于非侵入性技术在准确量化高血压(HP)患者颈动脉WSS方面的应用研究有限。

目的

本研究旨在探讨血管矢量血流成像(VFM)在高血压患者早期颈动脉WSS定量评估中的应用,并验证其临床实用性。

方法

将50例确诊无颈动脉斑块的个体根据血压分为HP组(n = 25)和对照组(CON组,n = 25)。使用配备L441 3 - 15 MHz探头的ALOKA LISENDO 880彩色多普勒超声进行纵向扫描,以确定颈总动脉的感兴趣区域(ROI)。通过从三个完整心动周期中选择图像质量最佳的ROI来获得基于VFM的WSS测量值。分析并比较HP组和CON组之间WSS衍生测量值,包括WSS、WSS和WSS。此外,还分析了WSS衍生测量值与颈动脉内膜中层厚度(IMT)之间的相关性。

结果

HP组和CON组患者之间的WSS和WSS存在显著统计学差异。具体而言,与CON组相比,HP组的WSS和WSS显著降低(WSS:1.781±0.305 Pa对2.286±0.257 Pa;WSS:1.276±0.333 Pa对1.599±0.293 Pa,均P < 0.001)。然而,两组之间的WSS无统计学差异(0.79±0.36对0.99±0.42,P = 0.080)。此外,Spearman相关性分析表明,WSS衍生参数与IMT呈负相关(P < 0.001)。

结论

血管VFM技术在定量评估HP患者与正常对照者血管流场血流动力学差异方面显示出有前景的结果。WSS差异可能作为动脉硬化风险发展的潜在预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b707/9649775/3f21b14eb478/fcvm-09-967763-g001.jpg

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