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Segmental analysis of carotid arterial strain using speckle-tracking.

ABSTRACT: BACKGROUND:Increased arterial stiffness has been shown to be associated with aging and cardiovascular risk factors. Speckle-tracking algorithms are being used to measure myocardial strain. The aims of this study were to evaluate whether speckle-tracking could be used to measure carotid arterial strain (CAS) reproducibly in healthy volunteers and to determine if CAS was lesser in individuals with diabetes. METHODS:Bilateral electrocardiographically gated ultrasound scans of the distal common carotid arteries (three cardiac cycles; 14-MHz linear probe; mean frame rate, 78.7 ± 8.9 frames/sec) were performed twice (2-4 days apart) on 10 healthy volunteers to test repeatability. Differences in CAS between healthy subjects (n = 20) and patients with diabetes (n = 21) were examined. Peak CAS was measured in each of six equal segments, and averages of all segments (i.e., the global average), of the three segments nearest the probe, and of the three segments farthest from the probe (i.e., the far wall average) were obtained. RESULTS:Global CAS (intraclass correlation coefficient = 0.40) and far wall average (intraclass correlation coefficient = 0.63) had the greatest test-retest reliability. Global and far wall averaged CAS values were lower in patients with diabetes (4.29% [SE, 0.27%] and 4.30% [SE, 0.44%], respectively) than in controls (5.48% [SE, 0.29%], P = .001, and 5.58% [SE, 0.44%], P = .003, respectively). This difference persisted after adjustment for age, gender, race, and hemodynamic parameters. CONCLUSIONS:Speckle-tracking to measure CAS is feasible and modestly reliable. Patients with diabetes had lower CAS obtained with speckle-tracking compared with healthy controls.

SUBMITTER: Yang EY

PROVIDER: S-EPMC3200442 | biostudies-literature | 2011 Nov

REPOSITORIES: biostudies-literature

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Segmental analysis of carotid arterial strain using speckle-tracking.

Yang Eric Y EY Dokainish Hisham H Virani Salim S SS Misra Arunima A Pritchett Allison M AM Lakkis Nasser N Brunner Gerd G Bobek Jaromir J McCulloch Marti L ML Hartley Craig J CJ Ballantyne Christie M CM Nagueh Sherif F SF Nambi Vijay V

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 20110909 11

<h4>Background</h4>Increased arterial stiffness has been shown to be associated with aging and cardiovascular risk factors. Speckle-tracking algorithms are being used to measure myocardial strain. The aims of this study were to evaluate whether speckle-tracking could be used to measure carotid arterial strain (CAS) reproducibly in healthy volunteers and to determine if CAS was lesser in individuals with diabetes.<h4>Methods</h4>Bilateral electrocardiographically gated ultrasound scans of the dis ...[more]

PMID: 21907541

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Project description:BackgroundWe investigated longitudinal right ventricular (RV) function assessed using speckle-tracking strain echocardiography in patient with myocardial infarction (MI), and identified the contributing factors for RV dysfunction.MethodsWe retrospectively studied 71 patients with old MI (the OMI group) and 45 normal subjects (the Control group) who underwent a transthoracic echocardiography. Global and free wall RV peak systolic strains (PSSs) in the longitudinal direction were measured by using speckle-tracking strain echocardiography. Left ventricular (LV) PSSs were measured in the longitudinal, radial and circumferential directions. Cardiac hemodynamics including peak systolic pulmonary artery pressure was also assessed non-invasively. Plasma brain natriuretic peptide (BNP) levels were measured in all patients.ResultsIn the OMI group, 73% of the patients had a normal estimated peak systolic pulmonary artery pressure of less than 35 mmHg. Global and free wall RV PSS were impaired in the OMI group compared with the Control group, and these RV systolic indices were significantly associated with heart rate, logarithmic transformed plasma BNP, greater than 1 year after onset of MI, Doppler-derived estimated pulmonary vascular resistance, LV systolic indices, LV mass index, infarcted segments within a territory of the left circumflex artery and residual total occlusion in the culprit right coronary artery. Multivariable linear regression analysis indicated that reduced longitudinal LV PSS in the 4-chamber view and BNP levels ≥500 pg/ml were independently associated with reduced global and free wall RV PSS. Moreover, when patients were divided into 3 groups according to plasma BNP levels (BNP <100 pg/ml; n = 31, 100 ≤BNP <500 pg/ml; n = 24, and BNP ≥500 pg/ml; n = 16), only patients with BNP ≥500 pg/ml had a strong correlation between RV PSS and longitudinal LV PSS in the 4-chamber view (r = 0.78 for global RV PSS and r = 0.71 for free wall RV PSS, p <0.05).ConclusionLongitudinal RV systolic strain depends significantly on longitudinal LV systolic strain especially in patients with high plasma BNP levels, but not on estimated peak systolic pulmonary artery pressure. These results indicate that process of RV myocardial dysfunction following MI may be governed by neurohormonal activation which causing ventricular remodeling rather than increased RV afterload.

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Segmental analysis of carotid arterial strain using speckle-tracking.

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Segmental analysis of carotid arterial strain using speckle-tracking.

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