A New Method for Cerebral Arterial Stiffness by Measuring Pulse Wave Velocity Using Transcranial Doppler

Abstract

Xian Fu and Chuming Huang contributed equally to this work Aim: Pulse wave velocity (PWV) has been regarded as the "gold standard" measurement of arterial stiffness (AS), but it is still only used in the assessment of central and peripheral arteries. We constructed a new method to evaluate cerebral AS by measuring PWV using transcranial Doppler (TCD). Methods: In all, 90 healthy subjects who received annual health screening were consecutively enrolled in this study between January 2011 and June 2013. Data on clinical characteristics, brachium-ankle (ba) PWV, and carotid-cerebral (cc) PWV measured with our newly constructed method by two experienced operators were recorded. cc PWV was calculated as the distance between two points in the common carotid artery and proximal part of ipsilateral middle cerebral artery, which was divided by the pulse transit time between these two points where the pulse was measured using TCD. Results: The value of cc PWV was 499.3 78.6 cm/s. Correlation between cc PWV and ba PWV in the assessment of AS was r 0.794 (P 0.001). The concordance between both the above mentioned methods was good. Interobserver and intraobserver reliability using interclass correlation for measuring cc PWV were 0.815 (P 0.001) and 0.939 (P 0.001), respectively. In multivariable analysis, older age ( 4.51, P 0.001) and increased diastolic blood pressure ( 2.39, P 0.001) were independently associated with higher cc PWV. Conclusion: cc PWV measured using TCD may be a promising method for the assessment of human cerebral AS, which is independently associated with age and diastolic blood pressure.

Cerebral Arterial Stiffness as A New Marker of Early Stage Atherosclerosis of The Cerebral Large Artery in Acute Stroke

“…In all studies, ccPWV was obtained after at least 5 min of rest. The validity and reproducibility of the measurement of ccPWV were previously reported elsewhere 26) .…”

“…As described previously 26) , ccPWV was measured with a special two-channel TCD (TCD-2000M; Beijing Chioy Medical Technology Co., Ltd, Beijing, China) by using 2 and 4 MHz ultrasound transducers in the supine position by two experienced operators. The TCD machine used in this study has a built-in program model called arterial pulse wave analysis system, which can store, derive, and process signals obtained from transducers on CCA and MCA sites and simultaneously display these signals with expanded waveforms.…”

“…To detect CCA, the other 4 MHz transducer in the angle fixator of 30° was placed on the ipsilateral pulsation point of CCA beside the thyroid notch in the neck of the patient. The transit time (Δt, ms) of the pulse wave that traveled between the two insonation sites was automatically measured by the arterial pulse wave analysis system on the basis of the waveform analysis of CCA and MCA 26) . The mean transit time (Δmt) was then determined from 10 consecutive cardiac cycles.…”

“…The mean transit time (Δmt) was then determined from 10 consecutive cardiac cycles. The distance (D, cm) traveled by the pulse wave was defined as the body surface distance (D 1 , cm) between the two probes by using a tape measure plus cosine 30° of detecting depth (D 2 , cm) for CCA, namely, D=D 1 + D 2 × cosine 30° 26) . Thus, ccPWVs on each side were calculated as ccPWV=D/Δmt (cm/s).…”

“…Recently, carotid–cerebral PWV (ccPWV) measurement, which can be performed noninvasively and easily, has become available as a means of measuring cerebral arterial stiffness 26) . ccPWV mainly measures the segment (C-M segment) stiffness between th e common carotid artery (CCA) and ipsilat eral middle cerebral artery (MCA).…”