Regional Upstroke Tracking for Transit Time Detection to Improve the Ultrasound-Based Local PWV Estimation in Carotid Arteries

Yuhan

et al. 2023

Journal of Diabetes

Background Changes in vascular function are closely associated with the development of cardiovascular disease (CVD). Pulse wave velocity (PWV) is a potential indicator of vascular dysfunction; it allows noninvasive assessment of arterial stiffness. Currently, evidence for the effects of different classes of antidiabetic drugs on arterial stiffness remains limited. In this study, a network meta‐analysis (NMA) was performed to explore the associations between changes in arterial stiffness and first‐line antidiabetic drugs by evaluating PWV in patients with different metabolic abnormalities. Methods We systematically searched several electronic databases for randomized controlled trials (RCTs) published from inception until 25 August 2022, without language restrictions. The primary outcome was the change in PWV (ΔPWV) in all included studies; subgroup analysis was performed for patients with abnormal glucose metabolism, including prediabetes and diabetes mellitus. NMA was performed to calculate the mean differences (MDs) with 95% confidence intervals (CIs) as effect sizes to evaluate the ΔPWV. Results Among the 2257 candidate articles identified in the initial search, 18 RCTs were eventually included in the analysis. In all studies, two classes of new antidiabetic drugs, glucagon‐like peptide‐1 receptor (GLP‐1R) agonists and sSodium‐glucose co‐transporter 2 (SGLT‐2) inhibitors, improved arterial stiffness by decreasing PWV compared with placebo (MD = −1.11, 95% CI: −1.94 to 0.28) and (MD = −0.76, 95% CI: −1.45 to −0.08). A conventional antidiabetic drug, metformin, also showed similar efficacy compared with placebo (MD = −0.73, 95% CI: −1.33 to −0.12). Finally, in subgroup studies of patients with abnormal glucose metabolism diseases, GLP‐1R agonists (MD = −1.06, 95% CI: −2.05 to −0.10) significantly decreased PWV compared with placebo. Conclusion Three classes of antidiabetic drugs—GLP‐1R agonists, SGLT‐2 inhibitors, and metformin—have the potential to improve arterial stiffness. Among the six classes of antidiabetic drugs analyzed, GLP‐1R agonists constitute the only class of drugs that improves arterial stiffness in patients with abnormal glucose metabolism diseases.

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of first‐line antidiabetic drugs on the improvement of arterial stiffness: A Bayesian network meta‐analysis

Yuhan

et al. 2023

Journal of Diabetes

“…Due to the ability of gathering information of arterial pulsations and blood flow by penetrating the human tissue, in recent years, ultrasound signals have been widely used to assess local PWV as cost-effective, non-radioactive approaches (compared to CT and MRI), such as the flow-area loop method [ 18 , 19 , 20 ] and the PTT method [ 21 , 22 , 23 ]. The flow-area loop method computes local PWV by simultaneously obtaining the blood flow velocity and arterial cross-sectional area waveforms of a specific artery in a cardiac cycle.…”

Section: Introductionmentioning

confidence: 99%

A Flexible Ultrasound Array for Local Pulse Wave Velocity Monitoring

Pan

et al. 2022

Biosensors

Pulse wave velocity (PWV) measured at a specific artery location is called local PWV, which provides the elastic characteristics of arteries and indicates the degree of arterial stiffness. However, the large and cumbersome ultrasound probes require an appropriate sensor position and pressure maintenance, introducing usability constraints. In this paper, we developed a light (0.5 g) and thin (400 μm) flexible ultrasound array by encapsulating 1–3 composite piezoelectric transducers with a silicone elastomer. It can capture the distension waveforms of four arterial positions with a spacing of 10 mm and calculate the local PWV by multi-point fitting. This is illustrated by in vivo experiments, where the local PWV value of five normal subjects ranged from 3.07 to 4.82 m/s, in agreement with earlier studies. The beat-to-beat coefficient of variation (CV) is 12.0% ± 3.5%, showing high reliability. High reproducibility is shown by the results of two groups of independent measurements of three subjects (the error between the mean values is less than 0.3 m/s). These properties of the developed flexible ultrasound array enable the bandage-like application of local PWV monitoring to skin surfaces.

J of Ultrasound Medicine

“…6 Unlike the global pulse wave velocity, which provides information for the long segment of arteries so that initial changes in arterial stiffness may be concealed, the local pulse wave velocity (LPWV) provides a result close to the site where the illness occurs. 7 Magnetic resonance imaging 8,9 and ultrasound techniques, 4,10,11 are commonly used to noninvasively measure LPWV. Owing to the advantages of reproducibility, comfortability, and affordability, ultrasound techniques such as the flow-area loop method, 12,13 phased-tracking method, 14 and transit time (TT) method 15,16 have been employed to estimate the LPWV.…”

mentioning

confidence: 99%

Optimum Parameters in Ultrasound Coherent Plane Wave Compounding for High LPWV Estimation

Xiong,

Zhang,

et al. 2024

Self Cite

ObjectivesThe aim of this study is to determine the optimum and fine values of the number and transmission angles of tilted plane waves for coherent plane‐wave compounding (CPWC)‐based high local pulse wave velocity (LPWV) estimation.MethodsA Verasonics system incorporating a linear array probe L14‐5/38 with 128 elements and a pulsatile pump, CompuFlow1000, were used to acquire radio frequency data of 3, 5, 7, and 9 tilted plane wave sequences with angle intervals from 0° to 12° with a coarse interval increment step of 1°, and the angle intervals from 0° to 2° with a fine interval increment step of 0.25° from a carotid vessel phantom with the LPWV of 13.42 ± 0.90 m/s. The mean value, standard deviation, and coefficients of variation (CV) of the estimated LPWVs were calculated to quantitatively assess the performance of different configurations for CPWC‐based LPWV estimation. Ten healthy human subjects of two age groups were recruited to assess the in vivo feasibility of the optimum parameter values.ResultsThe CPWC technique with three plane waves (PRF of 12 kHz corresponding to a frame rate of 4000 Hz) with an interval of 0.75° had LPWVs of 13.52 ± 0.08 m/s with the lowest CV of 1.84% on the phantom, and 5.49 ± 1.46 m/s with the lowest CV of 12.35% on 10 subjects.ConclusionsThe optimum parameters determined in this study show the best repeatability of the LPWV measurements with a vessel phantom and 10 healthy subjects, which support further studies on larger datasets for potential applications.