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Objective To assess the carotid elasticity using wave intensity(WI) in subjects with different plasma glucose level.Methods 107 subjects were enrolled in this study,according to their plasma glucose levels,subjects were categorized as normal plasma glucose group (group A),normal plasma glucose in higher level group (group B) and pre-diabetes group (group C).Carotid WI examination was performed and analyzed.The parameters included magnitude of the peak during late systole (W2),negative area during the mid-ejection (NA),and stiffness parameter (β),pressure strain elasticity modulus (Ep),arterial compliance(AC),augmentation index(AI),one point pulse wave velocity(PWVβ).Results Compared to group A,W2,β,Ep,PWVβ increased significantly while AC decreased in group C(P ＜0.05),but there was no obvious difference of NA between two groups.Furthermore,this statistically difference was not found in group B(P ＞0.05).Conclusions Carotid elasticity have been altered in pre-diabetes group which can be evaluated by WI,but no marked change is observed in normal plasma glucose of higher level group.
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Objective To explore the clinical value of wave intensity(WI) in assessing left ventricular systolic function of patients with impaired glucose regulation.Methods 72 people were involved in this study,according to their plasma glucose levels,subjects were categorized as normal plasma glucose group (group A),newly categorized impaired fasting glucose group (group B) and pre-diabetes group (group C).Carotid WI examination was performed and analyzed.The parameters included magnitude of the peak during early systole (W1),amplitude of the peak during late systole (W2),interval between R wave of electrocardiogram and W1 (R-W1),interval between W1 and W2 (W1-W2),stiffness parameter (β),pressure strain elasticity modulus(Ep) and arterial compliance(AC).Echocardiographic indices including left ventricular ejection fraction (LVEF),left ventricular fraction shortening (LVFS) and the peak velocity of mitral annulus at systolic phase(Sm) were determined in each subject.Results Compared to group A,W1,W2,β,Ep increased significantly while AC decreased in group C(P ＜0.05).However,this difference did not persist in group B.Compared to group A,LVEF and LVFS were not observed significantly different in group B and group C.Conclusions WI is a hemodynamic method which not only can evaluate left ventricular systolic function of impaired glucose regulation subjects but also be more sensitive than routine echocardiography.
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Objective To analyze the changes of wave intendy (WI) of the left common carotid artery (LCCA) in coronaryarterydisease (CAD) patients with decreased left ventricular ejection fraction (LVEF). Methods Forty-one CAD patients conitrmed by coronary angiography (CAG) were drnded into group A, LVEF >50%, 23 cases; group B, LVEF
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Objective To evaluate the clinical value of cardiovascular function in patients with type 2 diabetes mellitus by wave intensity and tissue Doppler imaging.Methods According to the course of disease,30 patients with type 2 diabetes mellitus were divided in to two groups:T2DM group 1,the course of disease between 1 year to 5 years; T2DM group 2,the course of disease was longer than 5 years.30healthy volunteers were considered as control group.The parameters of accelerating wave intensity(W1),decelerating wave intensity(W2),negative area(NA),time interval between the R-wave of ECG and the first peak(R-W1),the first and second peaks (W1-W2),elasticity modulus (Ep),stiffness index (β),arterial compliance(AC),pulse wave velocity(PWVβ) and intima media thickness (IMT) were calculated by wave intensity.The left ventricular ejection fraction (LVEF),left ventricular ejection time (LVET),early diastolic peak speed (E),late diastolic peak velocity (A),E / A and isovolumic relaxation time(IVRT) were detected by two dimensional echocardiography.Mitral annular early diastolic peak speeds (Em),late diastolic peak velocity (Am) and Em / Am were detected by tissue Doppler imaging.Then three groups data were recorded and compared.Results Compared with the control group,β,PWVβ,Ep in T2DM group increased significantly(P ＜0.01 or P ＜0.05),while AC decreased(P ＜0.05).IMT in T2DM group 2 was thicker significantly than the control group(P ＜0.01).PWVβ,Ep,IMT in T2DM group 2 were significantly higher than those of T2DM group 1 (P ＜0.05).W2 in T2DM group 2 was significantly higher than those of T2DM group 1 and the control group(P ＜0.01 or P ＜0.05).E/A,Em and Em/Am in T2DM group were significantly lower than those of the control group (P ＜0.05 or P ＜0.01).Compared with T2DM group 1,Em in T2DM group 2 decreased significantly(P ＜0.05).In T2DM group,there were positive correlation between IMT and Ep,β,PWVβ (r =0.48,r =0.385,r =0.478,P ＜0.05 or P ＜0.01),positive correlation between Em and E (r =0.404,P ＜0.05) ;positive correlation between Em/Am and E/Em,E/A (r =0.602,r =0.559,P ＜0.01) ; negative correlation between Em and IVRT (r =-0.653,P ＜0.01);positive correlation between W1 and LVEF (r =0.627,P ＜0.01); positive correlation between W1-W2 and lVET (r =0.847,P ＜ 0.01) ; no correlation between W2 and E/A,E/Em,Em/Am,IVRT(P ＞0.05).Conclusions The elasticity of carotid artery and the diastolic function of left ventricular decreased in T2DM patients,while the systolic function of left ventricular was normal.
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Objective To assess the value of wave intensity (WI) on the discrimination of hypertension with concentric hypertrophy and non-obstructive hypertrophic cardiomyopathy(NOHCM).Methods 36 patients with hypertension with concentric hypertrophy,30 patients with NOHCM and 36 healthy volunteers were randomly selected to perform routine ultrasound examination and carotid arterial WI test.The conventional parameters,inlcuding interventricular septal thickness in diastole (IVSTd),left ventricular posterior wall thickness in diastole(LVPWd),left ventricular diameter in diastole(LVIDd) and WI parameters,including the first peak (W1),the second peak (W2),negative area (NA),the interval between the R wave of the ECG and the peak of W1 (R-1st),the interval between the peaks of W1 and W2 (1st-2nd) were archived and compared among the different groups.Results ① There were statistical significances in IVSTd among the three groups(P ＜0.01).LVPWd of hypertension group was obviously higher than that of normal and NOHCM groups (P ＜0.01),but there were no statistical significances in NOHCM and normal groups(P ＞0.05).There were no statistical significances in LVIDd among different groups(P ＞ 0.05).②Compared with the normal group,W1 in NOHCM group increased significantly,whereas W2 and R-1st was much lower (P ＜0.01);W1 and NA in hypertension group was obviously higher(P ＜0.01).W2 and R-1st in NOHCM group were much smaller than those of hypertension group (P＜0.01).③W2 in 850 mmHg · m · s-3 was an optimal cutoff value to identify NOHCM and hypertension and to yield the sensitivity of 78.9％ and specificity of 72.4％.R-1st in 98.5 ms was a cutoff point to discriminate NOHCM and hypertension and to bring the sensitivity 65.8％ and specificity 72.4％.Conclusions WI analysis can effectively distinguish the difference of NOHCM and hypertension and provide a new viewpoint for the discrimination of hypertension with concentric hypertrophy and non-obstructive hypertrophic cardiomyopathy.
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Objective To explore the value of wave intensity (WI) parameters in evaluating hemodynamic changes of cardiovascular system before and after 131I therapy in hyperthyroid patients.Methods Forty-seven hyperthyroid patients were enrolled as hyperthyroid group,while 47 healthy volunteers were considered as control group.Both of the hyperthyroid and control group took WI examinations,and WI curves of their right common carotid arteries were recorded.WI parameters of WI curve were automatically measured as followed:value of the first positive peak (W1),value of the second positive peak (W2),area of the negative peak (NA),and the square root of NA (A).Twenty-five patients of the hyperthyroid group received 131I therapy were enrolled as treatment group.All these patients were followed up for 3 months.The repeatability of the WI parameters was evaluated in 10 hyperthyroid patients and 10 normal volunteers selected at random from the investigation.Results W1,W2,A in hyperthyroid group increased compared with those in control group,and independent-samples t test showed very significant difference (P=0.000,P=0.000,P=0.000).W1,A decreased after 131I therapy compared with those before treatment,and paired-samples t test showed significant difference (W1:P=0.001;A:P=0.011).A in hyperthyroid group had positive correlation with FT3 (r=0.508,P=0.003);W1 after 131I therapy in treatment group had positive correlation with FT3 and FT4 (r=0.601,P=0.002;r=0.680,P=0.00);W2 after 131I therapy in treatment group had positive correlation with FT3 and FT4 (r=0.549,P=0.005;r=0.570,P=0.004).The repeatability of W1,W2,NA and A were good by consecutive measurement of identical observer.Conclusions WI peak parameters of hyperthyroid patients were higher than those of healthy volunteers,and some sensitive parameters were decreased after 131I therapy,which may provide the basis for assessing the effectiveness of 131I therapy.
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Objective To investigate the feasibility of mean wave intensity (MWI), W1 and W2 in assessing the function of common carotid artery (CCA) before and after cold presser test with wave intensity analysis. Methods Twenty-four healthy subjects were enrolled. The W1, W2, and other parameters of blood flow in resting, before and after cold presser test of CCA, the inner diameter different rate and MWI of blood flow were calculated respectively. The receiver operation characteristic (ROC) curves were drawn, and of the effectiveness of MWI, W1 and W2 was compared. Results The different rate of diameters and W1 decreased significantly when subjects underwent cold presser test (P＜0.05), but MWI and W2 increased significantly (P＜0.05). The area under ROC curves was 0.858, 0.731 and 0.698, corresponding to MWI, W1 and W2 (P＞0.05). Conclusion The function of CCA can be evaluated with MWI calculated from conventional parameters.
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Objective To investigate the clinical application of wave intensity (WI) technique in assessing the short-term effects of cardiac resynchronization therapy(CRT). Methods Sixteen patients with congestive heart failure treated with CRT were chosen. Before the implantation of CRT pacemaker and 1 week, 1 month,3 month after it,the diameters and volumes of left ventricle(LV) in the end-diastole and the end-systole were measured by echocardiography. LV ejection fractions(LVEF) were calculated by Simpson's way,and the variation ratio of left ventricular end-systolic volume(△ESV) was assessed each time after the CRT. The maximal rate of LV pressure rise (LVdP/dtmax) was assessed in the continuous-wave Doppler spectrum of mitral regurgitation. The magnitude of W1, and the length of R-W1 interval as well as W1-W2interval were recorded by WI technique applied on the left carotid artery of each patient. Results Compared to the data before CRT,W1 and W1-W2 interval were significantly higher in different period after CRT (P ＜0. 01). This result was conformed with echocardiographic remodeling data and LV systolic function.Conclusions WI provides a potential usage in conveniently and effectively assessing the CRT effects in short-term.
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Objective To explore the clinical value of wave intensity(WI) curve of the carotid artery in patients with thyroid diseases and its value in evaluating cardiovascular function. Methods All 85 patients with thyroid diseases,including 45 hyperthyroidism and 40 hypothyroidism, were enrolled as case groups,while 270 healthy volunteers were considered as control. All the case groups and control were taken WI test under quiescent condition,and six continuous curves of the carotid artery diameter changes were recorded.Then the parameters of accelerating wave intensity (W1), decelerating wave intensity ( W2), negative area (NA) ,corrected R-W1 and W1-W2,elasticity modulus(Eρ) ,stiffness index(β) ,arterial compliance(AC) and pluse wave velocity(PWV) were calculated. Relationship between those indices and FT3 ,FT4 and TSH were analyzed by Pearson correlative analysis. Results The WI curve appeared differently among different groups,but the vessel elasticity indices did not have statistical significance. Correlation only existed between FT3 and part of the WI parameters. FT3 positively correlated with W1 ( r = 0. 951, P ＜0.01 ), NA( r =0.813, P ＜0.01) and W1-W2' ( r = 0. 887, P ＜0.01 ). And R-W1 ' negatively correlated with FT3( r =-0.878, P ＜0.01 ). Conclusions The WI curve could represent different function status of thyroid,and could be considered as a noninvasive examination for further clinical research,which may help explain the corresponding cardiovascular changes.
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Objective To summarize the characteristics of common carotid arterial wave intensity (WI) in healthy volunteers and offer the normal reference values of WI. Methods Common carotid arteries (CCA) in 525 healthy volunteers were examined using Aloka Prosound α10 equipped with wave intensity software. The volunteers were divided into six group according to age,group A,＜20 years old;group B,20 - 29 years old;group C,30 - 39 years old;group D,40 - 49 years old;group E,50 - 59 years old and group F,≥60 years old. Carotid arterial wave intensity in normal subjects had two positive peaks, the first peak,W1 ,and the second peak, W2. Between the two positive peaks, a negative area (NA), the time interval between the R-wave of ECG and the first peak(R-W1 ) and that between the first and second peaks (W1-W2) were observed. Results ① 1050 common carotid arteries in 525 volunteers were studied. The mean values of W1,W2,NA,R-W1,and W1-W2 were (8332±4796) mmHg · m-1 · s-3,(1853±1143)mmHg · m-1 · s-3,(38 ± 26) mmHg · m-1 · s-2, (102 ± 19)ms and (266 ± 42)ms,respectively. ②These values were no significant between the left and right CCA in same group. W1 and NA were correlated with age ( r = - 0. 204 and r = -0.301, P ＜0. 001). W1 and NA in group A and B were significant increased than those in other groups( P ＜0. 05 or P ＜0. 001 ). ③There were statistical significances in W1 and W1-W2 of CCA between male and female. ④There were no statistical significances in all values in common carotid arteries of both sides (P ＞0. 05). ConclusionsWI technique is useful for evaluating the dynamic behavior of the heart and the vascular system and their interaction. W1 is very sensitive to the changes in the working condition of the cardiovascular system.
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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 observe hemodynamic changes in patients with primary hypertension with wave intensity (WI). Methods Carotid arteries of 36 patients with primary hypertension and 30 age-matched normal controls were examined with imaging technique of WI. The following parameters were measured: the first wave peak in early ejection (W1), the second wave peak in late ejection (W2), the negative area during the mid-ejection (NA), the interval between the R wave of the ECG and the first peak of W1 (R-1st), the interval between the first peak and the second peak (1~(st)-2~(nd)), the ratio of R-1st and a cardiac cycle time R-1_(HR)~(st)) and the ratio of 1~(st)-2~(nd) , as well as one cardiac cycle time (1~(st)-2(_(HR)~(nd)). Results ①W1 in primary hypertension group increased compared with those of normal controls (P＜0.01), while no significant difference of W2, NA, R-1st, 1~(st)-2~(nd), R-1_(HR)~(st), 1~(st)-2_(nd)~(HR) was detected (P＞0.05). ②Both W1 and W2 correlated positively with pulse pressure (PP) and systolic blood pressure (SBP) (r=0.66, 0.55, P＜0.01;r=0.62, 0.44, P＜0.01). W1, W2 and age, DBP were not related significantly (P＞0.05). Conclusion The hemodynamic parameters of WI technology provide a new way to evaluate the dynamics of the heart and vascular system and their interaction.
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Wave intensity (WI) is a hemodynamic index, the method of WI measurement is a real-time system in the basis of the eTRACKING technology, which provides the appearance of haemodynamics ahout heart and blood vascular system and their linear correlation with inner diameter-pressure. The research advantages and the application of WI were reviewed in this article.
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Objective To make certain about the phase of time from the culminated point of instantaneous accelerating wave intensity (W1) to that of instantaneous decelerating wave intensity (W2) wave intensity(WI) technique. Methods The ejection time of the curve of Doppler rate of flow in aortic opens and W1～W2 of common carotid arteries of both sides were detected in 66 healthy adults by Prosound α10 color Doppler ultrasound and the data were contrasted and analyzed. Results There were no statistical significances in the standardized value difference of ejection time of aorta and of time from starting point of W1 to culminated point of W2 in common carotid arteries of both sides (P>0.05). And there were all statistical significances in the standardized value difference of ejection time of aorta and of time in other groups (P<0. 001). Conclusions The ejection time is the time from starting point of W1 to culminated point of W2. The beginning of cardiac ejection should be the starting point of W1 curve,and the culminated point of W2 is the terminal time of ejection.
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lusions WI parameters reflect both cardiac and vascular changes of hyperthyroid patients. Mid-systolic hemodynamic turbulence appears in a portion of hyperthyroid patients.
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Objective To explore the generalization and application of R-W1 through the phase analysis of Wave intensity technique.Methods The phases of R-W1 of 66 healthy adults were detected by Aloka Prosound α10 color Doppler uhrasound.Results There were all statistical significances in the time difference of R-W1 in left and right common carotid arteries and right brachial artery(P＜0.01),in the pressure wave conductive time in left and right common carotid arteries(P＜0.05),in right brachial artery and both sides of common carotid arteries(P＜0.01).There were no statistical significances in the time from the starting point to the culminate point of W1 in left and right common carotid arteries.There were statistical significances in the time from the starting point to the culminate point of W1 in right brachial artery and both sides of common carotid arteries(P＜0.05).Conclusions"R-W1 almost equals to pre-ejection period"as reported by literatures actually involves three phases which respectively are isovolumetric contraction time of left ventricle,pressure wave conductive time and time from the starting point to the culminate point of W1.The factor of pressure wave conductive time should be considered when evaluating diseases in clinic.The pre-ejection time should be the time from the culminate point of R wave in ECG to the starting point of W1 and the time from the starting point to the culminate point of W1 should not be involved in.
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Objective To evalute the clinical application of the new technique of instantaneous wave intensity(WI) through the correlative analysis of instantaneous acceleration wave intensity(W1) and Tei index. Methods The correlation of the intensity of W1 (the apogee of W1) and Tei index of 66 healthy adults were analyzed by Prosound a10 color Doppler ultrasonograph. Results There were positive correlations in pressure and caliber between the common carotid arteries of both sides in 66 cases of healthy adults (P <0.01). There were negative correlations respectively between the pressure of W1 of left and right common carotid arteries and Tei index (P <0.05),and there were the same in caliber (P <0.01), mean pressure (P <0.05) and mean caliber (P <0.01). Conclusions W1 is negatively correlated with Tei index and can be an index in judging the systolic function.
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Objectives: To determine the effect of hot bathing on blood circulation, we analyzed pressure wave using Wave Intensity (WI), which is defined as changes in blood pressure (dP)×changes in blood flow velocity (dV) during hot bathing, as the index for assessment.<br>Methods: Using a combined Doppler and ultrasonic echo-tracking system, we recorded changes in vascular diameter (dD) and dV of the common carotid artery simultaneously in six healthy subjects before (Pre-bathing), during (Bathing), and 10 minutes after bathing (41°C) (Post-bathing). We then measured the product of their changes at fixed intervals as WI and evaluated the positive component of the early systolic phase (FE) (representing the forward-traveling pressure wave), negative components following FE (B) (representing the reflection pressure wave), and the appearance time of (RT). RT was measured as the percentage ratio.<br>Results: 1) The magnitudes of FE and B tended to decrease during 10min of bathing (Bathing) and recover to the level of the pre-bathing stage after 10min of bathing. 2) The value of RT measured after 10min of bathing (Post-bathing) was significantly longer than the level before bathing (Pre-bathing).<br>Conclusion: The effect of the reflection pressure wave (i. e., the after load on the vascular system) decresses during hot bathing. We can thus conjecture that the time phase of appearance of the reflecting pressure wave is delayed when the arrival time of the forwardtraveling pressure wave to the periphery is delayed and the propagation of the reflection pressure wave from the periphery slows down due to the expansion of vessels during hot bathing. Hot bating can therefore be expected to reduce after loads of healthy adult subjects.