Feasibility and relevance of compound strain imaging in non-stenotic arteries: comparison between individuals with cardiovascular diseases and healthy controls

Abstract

BackgroundCompound strain imaging is a novel method to noninvasively evaluate arterial wall deformation which has recently shown to enable differentiation between fibrous and (fibro-)atheromatous plaques in patients with severe stenosis. We tested the hypothesis that compound strain imaging is feasible in non-stenotic arteries and provides incremental discriminative power to traditional measures of vascular health (i.e., distensibility coefficient (DC), central pulse wave velocity [cPWV], and intima-media thickness [IMT]) for differentiating between participants with and without a history of cardiovascular diseases (CVD).MethodsSeventy two participants (60 ± 7 years) with non-stenotic arteries (IMT < 1.1 mm) were categorized in healthy participants (CON, n = 36) and CVD patients (n = 36) based on CVD history. Participants underwent standardised ultrasound-based assessment (DC, cPWV, and IMT) and compound strain imaging (radial [RS] and circumferential [CS] strain) in left common carotid artery. Area under receiver operating characteristics (AROC)-curve was used to determine the discriminatory power between CVD and CON of the various measures.ResultsCON had a significantly (P < 0.05) smaller carotid IMT (0.68 [0.58 to 0.76] mm) than CVD patients (0.76 [0.68 to 0.80] mm). DC, cPWV, RS, and CS did not significantly differ between groups (P > 0.05). A higher CS or RS was associated with a higher DC (CS: r = −0.32;p < 0.05 and RS: r = 0.24;p < 0.05) and lower cPWV (CS: r = 0.24;p < 0.05 and RS: r = −0.25;p < 0.05). IMT could identify CVD (AROC: 0.66, 95%-CI: 0.53 to 0.79), whilst the other measurements, alone or in combination, did not significantly increase the discriminatory power compared to IMT.ConclusionsIn non-stenotic arteries, compound strain imaging is feasible, but does not seem to provide incremental discriminative power to traditional measures of vascular health for differentiation between individuals with and without a history of CVD.

3-D Strain Imaging of the Carotid Bifurcation: Methods and in-Human Feasibility

“…The circumferential strain measured in the common CA using the accumulative length of the segments between the nodes placed along the inner, middle and outer vessel wall yielded in-plane circumferential strains that were in the range of strains reported in the literature (Cinthio et al 2018;Godia et al 2007;Maessen et al 2017;Yang et al 2013). Assuming the CA closely resembles an isotropic homogeneous cylindrical structure, the strains measured at the inside should exceed the strains measured at the outside (with an increased radius), which is the case for all patients and corroborates reliable global displacement and strain estimations similarly as reported before (de Korte et al 1997).…”

Acute Effects of Dietary Nitrate on Exercise Tolerance, Muscle Oxygenation, and Cardiovascular Function in Patients With Peripheral Arterial Disease

“…For peripheral PWV, measures were taken at the right femoral and posterior tibial artery. Both measures were calculated as: distance (in meters)/pulse wave transit time (in seconds) as previously described (Maessen et al, 2017). At least five cardiac cycles were recorded for the analysis.…”