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Purpose To explore the application of vascular echo tracking technology in early stage vascular lesions of type 2 diabetes mellitus combined with proteinuria with normal intima and medial membrane of femoral artery,in order to provide evidence for early clinical intervention and to reduce complications of diabetes patients.Materials and Methods Fifty-two patients with type 2 diabetes mellitus diagnosed in Longgang Central Hospital from March 2015 to July 2016 were selected,20in proteinuria group and 32 in group without proteinuria.30 patients at the same stage with normal physical examination results were selected as control group.Vascular echo-tracking technology was used to check femoral arterial elasticity on both sides of the examinee,including stiffness parameter (β),pressure-strain elasticity modulus (Ep),arterial compliance (AC),augmentation index (AI) and one-point pulse wave velocity (PWVβ).Results ① Ep,β and PWVβ of femoral artery in diabetes patients were higher than those in control group,and AC was lower than that in control group.The differences was of statistical significance (P＜0.05).There was no statistical difference in AI between the two groups (P＞0.05).② Ep,β and PWVβ of femoral artery for patients in proteinuria group were higher than those in group without proteinuria and AC was also lower.The difference was of statistical significance (P＜0.05).There was no statistical difference in AI between the two groups (P＞0.05).③ After judgment and analysis,AC and diastolic blood pressure were of statistical significance for judgment,and sensitivity was 92.3％ and specificity 100.0％ when adopting its function to diagnose diabetes femoral arterial elasticity.Conclusion Vascular echo-tracking technology can accurately assess femoral elasticity for diabetes patients and is of great significance in early preventive treatment of diseases.The appearance ofproteinuria indicates that vascular elasticity function decreases dramatically.
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Objective · To explore whether stiffness parameter β could help carotid intima-media thickness (IMT) to predict ischemic stroke.Methods · Ninety-nine patients with acute ischemic stroke and transient ischemic attacks were retrospectively evaluated by routine ultrasound and divided into increased IMT group and normal IMT group. The normal IMT group cases were further divided into 30~ 39 years, 40 ~ 49 years, 50 ~ 59 years and ≥ 60 years groups, and were compared with healthy crowd respectively. Results · ① The common carotid artery wall β of both increased IMT group and normal IMT group were significantly higher than healthy crowd (each P=0.000). ② Further analysis showed that β of ≥ 60 years group were significantly higher than healthy crowd (left side P=0.047, right side P=0.007); while the difference was not found across younger age groups (30 ~ 39 years,40 ~ 49 years and 50 ~ 59 years). Conclusion · Stiffness parameter β may help carotid intima-media IMT to predict ischemic stroke in high risk subjects≥ 60 years old without morphology changes.
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Objective To observe the changes of artery elasticity in patients with High-Normal Blood Pressure(HNBP) by ET, and search bound values in diagnosis by ROC. Methods Comparative analysis of artery IMT and β, Ep, AC, PWVβ with HNBP and normal group, which were analyzed by ROC. Results Compared with the normal group, β, Ep, PWVβ were increased in HNBP group, AC was lower significantly. Conclusion The peripheral artery elasticity have reduced before the artery IMT didn′t appear morphological change.
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Objective To study the correlation between single point pulse wave velocity (PWVβ)of different peripheral arteries and coronary artery stenosis quantity obtained by coronary arteriongraphy so as to explore the diagnostic value of PWVβin coronary heart disease.Methods We made a retrospective analysis of 183 patients receiving coronary arteriongraphy in our hospital from October 2013 to May 2014.Based on stenosis quantity of coronary artery,the patients were divided into one-vessel lesion group,double-vessel lesion group,multi-vessel lesion group,and nonstenosis as control group.Clinical data of all the patients were collected before coronary arteriongraphy.Different peripheral artery PWVβwas measured with vascular echo tracking (ET)technology for statistical analysis.Results As the lesion vessel number increased,PWVβandβvalues in three peripheral arteries presented a rising tendency.Correlation analysis indicated that PWVβvalues in the three peripheral arteries showed a positive correlation with coronary artery involvement degree.The correlation between PWVβvalue of the common carotid artery and coronary artery involvement degree was most obvious,followed by the femoral artery and the popliteal artery.The sensitivity,specificity,positive predictive value,negative predictive value and Youden index of the common carotid artery PWVβvalue to diagnose coronary heart disease were 91.2%,84.5%,92.7%,81.7 and 0.76,respectively.Non-conditional multi-factor Logistic regression analysis was implemented by choosing age, sex,smoking history,hypertension history,diabetes history,hyperlipemia,BMI,HDL-C,LDL-C,TC,TG,GLU,SBP,DBP,UA,Cr,and PWVβ value as independent variables,and the degree of coronary artery disease as dependent variable.The results revealed that age,hypertension history,diabetes history,and PWVβ value were independent risk factors for coronary heart disease.Conclusion PWVβ value can be regarded as one index for observing artherosclerosis lesion degree and predicting early lesion.PWVβvalue of the common carotid artery can be an important index for dynamically observing the occurrence and development of artherosclerosis.
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Objective To investigate the carotid arterial stiffness in patients with coronary slow flow ( CSF) .Methods forty-five patients with CSF and Forty -five persons having normal coronary arteries ( NCA) detected by coronary angiography with a similar distri-bution of risk factors were recruited .Stiffness parameter (β), pressure-strain elastic modulus (Ep), arterial compliance (AC) and lo-cal pulse-wave velocity (PWV) were obtained at the level of bilateral carotid artery by a real time echo -tracking system.Serum levels of high-sensitivity C-reactive protein ( hs-CRP) were measured in two groups of subjects .Linear regression analysis were performed to evaluate the correlation between hs -CRP and the parameters of the carotid artery stiffness .Results We found that stiffness parameter (β), Ep and PWV were significantly higher in CSF group those that of control group (β:11.80 ±3.19 vs 9.70 ±3.76,P<0.01;Ep:149.90 ±44.47 vs 130.10 ±41.56,P<0.05;PWV:7.40 ±0.84 vs 7.00 ±1.08,P<0.05), AC was lower than that of control group (0.640 ±0.180 vs 0.760 ±0.192 ,P<0.01).The levels of high-sensitivity C-reactive protein (hs-CRP) was significantly higher in CSF group than that of control group (13.90 ±10.66 vs 9.30 ±6.33,P<0.05).The levels of hs-CRP was positively correlated with theβ(r=0.272,P=0.005), Ep(r=0.411,P=0.003), and PWV(r=0.452,P=0.001), but negatively correlated with AC (r=-0.293,P=0.025).Conclusion Echo-tracking technology is a simple practical method to evaluate carotid artery stiffness in patients with CSF and correlation well with coronary slow flow and artery stiffness .
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Objective To evaluate the effects of different dialysis treatment on femoral artery elasticity in uremia patients by Echo-tracking technique. Methods 81 cases of uremia patients (42 peritoneal dialysis patients and 39 hemodialysis patients) and 31 cases of normal adults as control were recruited in this study. The Intima-media thickness (IMT), Internal systolic diameter (Ds), Internal diastolic diameter (Dd), Value difference between Dd and Ds (△D), Arterial stiffness (β), Pressure strain elastic modulus (Ep), Arterial compliance (AC), Pulse wave conducting velocity (PWVβ) and Augmentation index(AI) parameters were analyzed for evaluation the right femoral arterial elasticity. Results The parameters ofβ, Ep, PWVβin dialysis patients significantly increased (P<0.05) and their AC significantly decreased (P<0.05) compared with normal group. Theβand Ep in hemodialysis patients is higher that those patients not receiving dialysis (P<0.05). Theβand Ep in peritoneal dialysis patients is lower that those patients not receiving dialysis (P<0.05). Theβ, Ep and PWVβin hemodialysis patients are higher than those in peritoneal patients (P<0.05). And AC is lower than control group (P<0.05). In uremia patients, Vascular stiffness was positively correlated with age, duration of dialysis, IMT, pulse pressure, Dd, and negatively correlated with△D(P<0.05). Conclusions Femoral artery endothelial function in uremia patients was damaged earlier than morphological changes. Vascular intimal injury resulting from hemodialysis is more serious, and vascular elasticity decrease is correlated with age, dialysis duration and pulse pressure. Echo-tracking technique could provide quantification evidences for early diagnosis of the femoral artery endothelial dysfunction in uremia patients. The echo-tracking technique has certain significance in early intervention and improvement the prognosis, however, the influence factor of the accuracy of measurement should be consider during the procedure.
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Objective To investigate the clinical value of echo-tracking(ET) technique in evaluating the carotid elasticity in patients with hyperuricemia and hyperuricemia combined with hyperlipidemia.Methods One hundred and twenty patients with hyperuricemia were divided into two group:group of hyperuricemia (group A) and group of hyperuricemia combined with hyperlipidemia (group B).Sixty normal persons were served as the control group.ET was used to measure the carotid artery elastic modulus including stiffness parameters (β),pressure-strain elastic modulus (Ep),arterial compliance (AC),augmentation index (AI) and pulse wave conducting velocity (PWVβ).Then the statistical data were analyzed to observe the changes of each parameter.Results In the comparison of three groups,elastic function index β,Ep,PWVβ and AI in group A and group B were higher than those of control group (P ＜0.05) ;however,AC was lower than that of control group (P ＜ 0.05).Compared with group A,elastic function index β,Ep,PWVβ,AI was higher in group B,while the AC was lower than that of group B (P ＜0.05).Conclusions ET may be helpful to prevent atherosclerotic changes and to provide the basis for the clinical diagonosis and treatment atherosclerotic changes.
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Objective To investigate the elasticity and hemodynamics of femoral artery in patients with type 2 diabetes mellitus (T2DM).Methods Subjects recruited in this study were divided into three groups,healthy control ( n =30),T2DM patients with femoral arterial intima-media thickness(IMT) ＜1.0mm ( n =32) and IMT≥1.0 mm( n =22).The IMT and diameter were measured by two-dimensional ultrasound.The blood velocity in early and late systolic stages and early diastolic reverse blood velocity,resistance index and pulsatile index were measured by pulse Doppler.The stiffness parameter,pressurestrain elasticity modulus,arterial compliance,argumentation index and one-point pulse wave velocity were measured by echo-tracking technique.Results The early diastolic reverse blood velocity,resistance index,pulsatile index,stiffness parameter,pressure-strain elasticity modulus and one-point pulse wave velocity were significantly elevated in T2DM patients compared with healthy control (P ＜ 0.05),the arterial compliance was significantly lower in T2DM subjects.Stiffness parameter,pressure-strain elasticity modulus and one-point pulse wave velocity were more pronounced in the patients with IMT≥1.0 mm than those with IMT ＜ 1.0 mm ( P ＜0.05).Conclusions There is atherosclerosis in femoral arteries in patients with T2DM.A decrease in arterial elasticity occurs prior to the morphological changes in vascular atherosclerosis,the arterial elasticity abnormality causes insufficient blood supply to peripheral tissues.
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Objective To explore the clinical value of early diagnosis of atherosclerosis in patients with systemic lupus erythematosus (SLE) using vascular echo-tracking technique and to detect changes of elastieity of carotid artery quantitatively in SLE patients.Methods Fifry patients with SLE were divided into SLE1 group(duration≤1 year),and SLE2 group(duration>1 year)based on different course.An ultrasonic echo-tracking method was used to measure patients'pressure strain elastic modulus (Ep),the stiffness constant(β),arterial compliance(AC),augmentation index(AI),pulse wave velocity (PWVβ) and intimamedia thickness(IMT)of the common carotid arteries in 50 patients with SLE and in 25 healthy control subjects.Results Among carotid artery elasticity indicators of three groups,there was no significant difference in AI(P>0.05).Ep,β,PWVβ parameters of SLE1 group and SLE2 group were statistically higher than that of the control group[Ep of SLE1 group,SLE2 group,control group was (69±20),(103±40),(48±18)kPa respectively;β was 5.2±1.9,8.0±3.1,4.2±1.3 respectively;PWVβ was 5.2±0.7,6.3±1.1,4.5±0.7]respectively,but AC(AC of SLE1 group,SLE2 group,control group was(1.1±0.3),(0.8±0.3),(1.2±0.6)mm2/k respectively]lower than the controls(P<0.01).Ep,β,PWVβ in SLE2 group was significantly increased compared with SLE1 group,but AC was decreased (P<0.01).Conclusion The application of echo-tracking technology can be used to diagnose early atherosclerosis.Complications of cardiovascular disease in SLE have high clinical value.
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This study examined the wave intensity (WI) of the carotid artery in patients with hyperthyroid in order to assess the hemodynamic changes of hyperthyroid patients. A total of 86 hyperthyroid patients without cardiac morphological changes and arrhythmia, and 80 healthy control subjects were enrolled in the study. Right common carotid artery (RCCA) was selected for ultrasonic imaging to obtain WI indices, including amplitude of the peak during early systole (W1), amplitude of the peak during late systole (W2), area of the negative wave during mid-systole (NA), interval between R wave of electrocardiogram and W1 (R-1 st), interval between W1 and W2 (1 st-2nd). The levels of serum thyroid hormones, consisting of free triiodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH), were measured in hyperthyroid patients. Echocardiographic indices including left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were determined in each subject. The results showed that the WI, W2, NA, and (lst-2nd×HR) in hyperthyroid patients were significantly higher than those in healthy controls. There was no significant difference in LVEF and LVFS between the two groups. FT3 was correlated with WI, W2, NA,(lst-2nd×HR), pulse pressure (PP) and heart rate (HR) in hyperthyroid patients. Several abnormal waves on WI curves were present in 19 hyperthyroid patients during mid-systole. It was concluded that WI technique may prove a real-time, noninvasive, sensitive and convenient tool for assessing the cardiac function and hemodynamic alterations in hyperthyroid patients.
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Objective To study the elastic features of common femoral artery by echo-tracking(ET)technique in type 2 diabetic(T2DM)patients.Method 60 eases of T2DM and 60 cases in control group,were separated into groups with age,ET technique was used to evaluate the common femoral artery modulus,including pressure strain elastic modulus(Ep),stiffness parameter(β),arterial compliance (AC),augment index(AI).Results Compared with the normal group ,in the T2DM group,β and Ep of common femoral artery were significantly higher(P＜0.01,P＜0.05),and AC was significantly lower(P＜0.05),and the difference in AI was not obvious (P＞0.05).The indexes were most obviouse in 40 to 59-year-old.The correlation parameter of age with β,Ep,AC,AI was 0.74,0.76 (P＜0.001)and 0.62,0.51 (P＞0.05).Conclusion The elasticity declination of common femoral artery in T2DM patients occur in the early stages,the change in 40-59 years old is obvious.β,Ep are apparently age-related indexes,and AC,AI are not.
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Objective To assess the value of echo tracking(ET) technique on atherosclerosis in the rabbit models, and to probe the pathological foundation of its indexes changes and the usefulness in evaluating arterial elasticity. Methods Thirty New Zealand rabbits were divided into 3 groups randomly: group A was the control group;group B,C were fed with high lipid feedstuffs for 8 weeks and 12 weeks, respectively. The ET examination of abdominal aorta was performed in group A and group B at the end of 8 weeks,it was performed in group A and group C at the end of 12 weeks. The parameters of elasticity were measured including pressure-strain elastic modulus (Ep), stiffness parameters(β), pulse wave velocity (PWVβ), augmentation index (AI), arterial compliance (AC), etc. Two dimensional ultrasound and pathological examination of abdominal aorta were performed at the same time. Results No obvious plaque and arterial wall thickness were seen in the abdominal aorta. Ep,β,PWVβ of group C were higher than that of group A and B, while AC of group C was lower than that of group A and B, and the difference had statistical significance (P<0.05). AI had no significant difference in all groups (P>0.05). Pathological examinations indicated that foam cell formation was seen in the abdominal aorta intima, the elastic fiber layer and smooth muscle layer were kept well in B group. Lots of cholesterol crystal formation was seen in the abdominal aorta intima and the two layer were obvious destroyed in group C. Conclusions ET can detect the atherosclerosis earlier than two-dimensional ultrasound. ET can detect the elasticity changes only when the elastic fiber layer and smooth muscle layer were destroyed . So it can be concluded that the destroy of elastic fiber layer and smooth muscle layer may be the pathological foundation of ET elasticity parameters changes.
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Objective To investigate the interferences of the variations in the blood pressure and vasoreactivity to the parameters of arterial elasticity via cold pressor test(CPT) in healthy young men. Methods The wave intensities(WI) of the right common carotid artery(RCCA) in twenty-two healthy young men during CPT were measured by echo-tracking technique. The parameters of arterial elasticity, including stiffness parameter (β),pressure-strain etastic modulus(Ep), arlerial compliance(AC),augument index(AI) , pulse wave veloctiy-β (PWVβ),and pulse wave velocity_WI(PWV_WI) from WI analysis during CPT were recorded and statistically compared with the baseline data. Results During CPT, the heart rates increased slightly ( P <0. 05) and the mean arterial pressures increased obviously ( P <0. 05); As to the parameters of arterial elasticity, the Ep,AI, PWVβ,and PWV_WI increased obviously ( P <0. 05), AC decreased ( P <0. 05), while the (3 didn't change. Conclusions The β is affected little by the blood pressure and vasoreactivity, and can reflect the actual arterial elasticity; while the Ep, AC, AI, PWVβ, and PWV_WI are affected much by blood pressure and vasoreactivity. When the latter parameters are used to evaluate the arterial elasticity, the interferences of variations in blood pressure and vasoreactivity must be excluded.
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Objective To investigate the feasibility, accuracy and senaitivety of echo tracking (ET) technology on carotid elasticity in rabbits. Methods Thirty-nine healthy New Zealand rabbits were divided into 4 groups,which group 1,2,3 were experimental groups and group 4 was control group. Experimental groups were fed with high cholesterol diet,control group were fed with basic diet. The parameters of elasticity of carotid were measured with ET technology, including pressure-strain elasticity modulus(Ep), stiffness parameter(β), arterial complianee(AC), pulse wave velocity( PWV), augmentation index (AI) at the interval of 0,4,8,12 weeks of the experiment respectively. Blood-fat level of all rabbits were checked and the common carotid artery was examined pathologically,which were compared and analyzed then. Results With the prolong of the experiment time,the Ep and β raised, but the AC reduced. There were significant difference between experimental group 1 (4 weeks) and basement,which were same between experimental group 2 (8 weeks) and experimental group 1, between experimental group 3(12 weeks) and experimental group 2( P<0.05). PWV increased comparing with basement in the end of 8 weeks,which increased obviously in the end of 12 weeks,meanwhile was higher than in the end of 8 weeks,which there were significant differences ( P<0.01 ). AI had no change all the time. Conclusions ET technology is accurate and reliable in detecting early atherosclerosis. Probe maintenance tool can keep the steady of checking progress, sensitive of result and repeatability.