Assessment of Arterial Stiffness in Hemodialysis Patients, Using Speckle Tracking Carotid Strain Ultrasonography
Abstract
Objective: The newly introduced ultrasonographic based speckle tracking carotid strain (STCS) imaging method is a promising technique that enables cardiovascular risk assessment by measuring arterial stiffness and strain parameters in carotid arteries. The present study evaluates the application of this technique in an endstage renal disease (ESRD) patient group.
Materials and Methods: In total, 100 patients (50 ESRD, 50 controls) were included in this study. Arterial stiffness and strain parameters were measured in the longitudinal and axial planes from both carotid arteries with the STCS technique. The measurements were analyzed between the groups and a multiple regression model was implemented to identify independent predictors of carotid stiffness and strain parameters.
Results: The study found a significant difference between ESRD and the control group in β-stiffness index, arterial distensibility (AD), elastic modulus and pulse wave velocity both in longitudinal and axial plane for stiffness parameters. Strain parameters for radial and circumferential strain parameters for both planes were significantly different between the two groups. In the multivariate linear regression analyse, estimated glomerular filtration rate was positively and independently associated with both axial and longitudinal AD and arterial compliance (all p<0.05).
Conclusion: The study demonstrated the feasibility and clinical value of the STCS method in the assessment of vascular stiffness, and its potential use as a tool in cardiovascular risk assessment in an ESRD patient group.
Keywords
Atherosclerosis cardiovascular disease carotid artery end-stage renal disease speckle tracking carotid strain ultrasonography
References
- 1. Collins AJ, Foley RN, Herzog C, Chavers B, Gilbertson, Ishani A, et al. United States Renal Data System 2008 Annual Data Report. Am J Kidney Dis 2009; 53: S1-374.
- 2. Nair SB, Malik R, Khattar RS. Carotid intima-media thickness: ultrasound measurement, prognostic value and role in clinical practice. Postgrad Med J 2012; 88: 694-9.
- 3. Gamble G, Zorn J, Sanders G, Mac Mahon S, Sharpe N. Estimation of arterial stiffness, compliance, and distensibility from M-mode ultrasound measurements of the common carotid artery. Stroke 1994; 25: 11-6.
- 4. Wada T, Kodaira K, Fujishiro K, Maei K, Tsukiyama E, Fukumoto T, et al. Correlation of ultrasound –measured common carotid artery stiffness with pathological findings. Arterioscler Thromb 1994; 14: 479-82.
- 5. Kim SA, Park SM, Kim MN, Kim HY, Cho DH, Ahn CM, et al. The relationship between mechanical properties of carotid artery and coronary artery disease. Eur Heart J Cardiovasc Imaging 2012; 13: 568-73.
- 6. Cerit MN, Şendur HN, Bolayır B, Cerit ET, Cindil E, Aktürk MY, et al. Evaluation of common carotid artery in type 1 diabetes mellitus patients through speckle tracking carotid strain ultrasonography. Diagn Interv Radiol 2021; 27: 195-205.
- 7. Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006; 27: 2588-605.
- 8. Podgórski M, Grzelak P, Szymczyk K, Szymczyk E, Drozdz J, Stefanczyk L. Peripheral vascular stiffness, assessed with two-dimensional speckle tracking versus the degree of coronary artery calcification, evaluated by tomographic coronary artery calcification index. Arch Med Sci 2015; 11: 122-9.
- 9. Bjallmark A, Lind B, Peolsson M, Shahgaldi K, Brodin LA, Nowak J. Ultrasonographic strain imaging is superior to conventional non-invasive measures of vascular stiffness in the detection of age-dependent differences in the mechanical properties of the common carotid artery. Eur J Echocardiogr 2010; 11: 630-6.
- 10. Catalano M, Lamberti-Castronuovo A, Catalano A, Filocamo D, Zimbalatti C. Two-dimensional speckle-tracking strain imaging in the assessment of mechanical properties of carotid arteries: feasibility and comparison with conventional markers of subclinical atherosclerosis. Eur J Echocardiogr 2011; 12: 528-35.
- 11. Larsson M, Heyde B, Kremer F, Brodin LA, D’hooge J. Ultrasound speckle tracking for radial, longitudinal and circumferential strain estimation of the carotid artery – An in vitro validation via sonomicrometry using clinical and high-frequency ultrasound. Ultrasonics 2015; 56: 399-408.
- 12. Mattace-Raso FU, van der Cammen TJ, Hofman A, van Popele NM, Bos ML, Schalekamp MADH, et al. Arterial stiffness and risk of coronary heart disease and stroke: the Rotterdam Study. Circulation 2006; 113: 657-63.
- 13. Lee SE, Lee J, Yoo TH, Cho IJ, Chang HJ. End-stage renal disease impairs the multidirectional movements of the common carotid artery: assessment using dimensional speckle-tracking carotid strain ultrasonography. J Cardiovasc Imaging 2018; 26: 155-64.
- 14. Zoungas S, Cameron JD, Kerr PG, Wolfe R, BNurs CM, McNeil JJ, et al. Association of carotid intima-medial thickness and indices of arterial stiffness with cardiovascular disease outcomes in CKD. Am J Kidney Dis 2007; 50: 622-30.
- 15. Briet M, Boutouyrie P, Laurent S, London GM. Arterial stiffness and pulse pressure in CKD and ESRD. Kidney Int 2012; 82: 388-400.
- 16. Georgianos PI, Sarafidis PA, Lasaridis AN. Arterial stiffness: a novel cardiovascular risk factor in kidney disease patients. Curr Vasc Pharmacol 2015; 13: 229-38.
Details
| Primary Language | English |
|---|---|
| Subjects | Radiology and Organ Imaging |
| Journal Section | Research Article |
| Authors | |
| Publication Date | September 30, 2022 |
| Published in Issue | Year 2022 Volume: 23 Issue: 3 |