基于超声矢量血流成像的2型糖尿病患者颈动脉壁剪切应力特征研究
Study on the characteristics of carotid wall shear stress in type 2 diabetes patients based on ultrasound vector flow imaging.
作者信息
Li Zhaohuan, Luo Anguo, Liu Xuebing, Xie Shenghua, Wang Yulin, Deng Lan, Zhong Shimin, Liu Yaoxia, Cao Xu, Du Yigang, Luo Wen, Deng Yan, Yin Lixue
机构信息
Department of Cardiovascular Ultrasound and Non-invasive Cardiology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cardiovascular Disease, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
出版信息
Front Endocrinol (Lausanne). 2024 Nov 21;15:1409082. doi: 10.3389/fendo.2024.1409082. eCollection 2024.
OBJECTIVES
We aimed to quantitatively analyze wall shear stress (WSS) of the common carotid artery (CCA) and elucidate the relationship between WSS and cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM) using ultrasound vector flow (V-Flow) imaging.
METHODS
A total of 109 T2DM patients were selected as the DM group, while 49 healthy volunteers served as the control group. V-Flow examination of the bilateral CCA was conducted. The maximum wall shear stress (WSS) and mean wall shear stress (WSS) at the bifurcation, proximal bifurcation and middle segment of the bilateral CCA were obtained.
RESULTS
The DM group showed decreased WSS in the middle region and proximal bifurcation of the CCA compared with the control group (p < 0.05). The WSS was further decreased in T2DM patients with CVD compared to those without CVD (middle region: 0.71 ± 0.17 Pa 0.84 ± 0.24 Pa, p < 0.05; proximal bifurcation: 0.62 ± 0.22 Pa 0.80 ± 0.21 Pa, p < 0.05). The receiver operating characteristic curve showed that a model combining with age, body mass index and WSS at the proximal carotid bifurcation had diagnostic value for detecting CVD in T2DM patients (area under the curve: 0.862, p < 0.05).
CONCLUSION
WSS has potential value for evaluation of atherosclerosis, as well as in detecting the occurrence of CVD in T2DM patients. Ultrasound V-Flow imaging may be an effective tool for non-invasive evaluation of WSS in the clinic.
目的
我们旨在使用超声向量流（V-Flow）成像技术，对2型糖尿病（T2DM）患者颈总动脉（CCA）的壁面切应力（WSS）进行定量分析，并阐明WSS与心血管疾病（CVD）之间的关系。
方法
共选取109例T2DM患者作为糖尿病组，49例健康志愿者作为对照组。对双侧CCA进行V-Flow检查。获取双侧CCA分叉处、近端分叉处和中段的最大壁面切应力（WSS）和平均壁面切应力（WSS）。
结果
与对照组相比，糖尿病组CCA中段和近端分叉处的WSS降低（p<0.05）。与无CVD的T2DM患者相比，有CVD的T2DM患者WSS进一步降低（中段：0.71±0.17 Pa对0.84±0.24 Pa，p<0.05；近端分叉处：0.62±0.22 Pa对0.80±0.21 Pa，p<0.05）。受试者工作特征曲线显示，结合年龄、体重指数和颈动脉近端分叉处WSS的模型对检测T2DM患者的CVD具有诊断价值（曲线下面积：0.862，p<0.05）。
结论
WSS在评估动脉粥样硬化以及检测T2DM患者CVD的发生方面具有潜在价值。超声V-Flow成像可能是临床上无创评估WSS的有效工具。
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