P2.27 LOCAL RADIAL STRAIN OF THE COMMON CAROTID ARTERY WALL
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Background: Rupture of atherosclerotic plaques occurs when mechanical stress exceeds material strength. Increased radial strain (ϵ, measured in the wall tissue) may be indicative for both locally increased mechanical stress as well as locally decreased material strength. The aim of our feasibility study was to analyse the precision and accuracy of ϵ, within the common carotid artery (CCA) wall of patients with and without recent cerebrovascular accident (CVA,<6weeks).
Methods: The left and right CCA of 21 patients (15 with CVA) were measured twice with multiple M-mode ultrasound. ϵ was determined for the intima-media layer (ϵm) and adventitia layer (ϵa), separately, using an RF-based algorithm. Intima-to-intima ((ΔD/D)in) and adventitia-to-adventitia relative distension ((ΔD/D)out) were also obtained, which are strongly related to strain (ϵ ≈−ΔD/D) when wall-inhomogeneities are negligible.
Results: Intra-subject precision was 1.8% for ϵm and 1.0% for ϵa. Averaged over all patients, ϵm=−7.4±2.7% (mean±sd) was higher than ϵa=−3.9±1.7% (p<0.0001). ϵm was significantly correlated with (ΔD/D)in (r2=0.48, p<0.0001), but higher than −(ΔD/D)in (Δ=0.8±2.1%,p=0.02). For the adventitial layer, the correlation between ϵa and (ΔD/D)out was weaker (r2=0.10,p=0.05; Δ=0.7±2.0%,p=0.02). Despite similar blood pressures and stenosis degrees, ϵm, (ΔD/D)out, (ΔD/D)in, but not ϵa, were higher at the ipsilateral side for patients with than for patients without CVA, (p=0.002,p=0.05 and p=0.06, respectively).
Conclusion: Strain can be measured directly within wall tissue with reasonable accuracy and precision and allows discrimination between arterial layers and patient groups. As ΔD/D is not applicable to inhomogeneous walls, strain is a promising tool to evaluate vulnerability of plaques.
| N# | SBP(mmHg) | DBP(mmHg) | stenosis degree(%) | ϵm(%) | ϵa(%) | (ΔD/D)in (%) | (ΔD/D)out (%) | |
|---|---|---|---|---|---|---|---|---|
| ipsilateral | 14 | 136±22 | 77±12 | 38±36 | −8.5±2.5* | −4.3±1.3 | 7.2±2.9 | 5.1±2.0* |
| contralat. | 15 | 28±33 | −7.8±2.6* | −3.8±1.2 | 7.1±2.7 | 4.9±1.6 | ||
| w/o CVA | 10 | 145±18 | 85±10 | 27±29 | −5.3±1.8 | −3.5±2.5 | 5.1±2.1 | 3.6±1.4 |
significant different from patient without (w/o) CVA using Student t-test; number of CCAs (N); systolic blood pressure (SBP); diastolic blood pressure (DBP); contralat, contralateral.
1 ipsilateral CCA of patients with CVA and 2 CCAs in patients without CVA were excluded due to poor image quality.
Radial strain and relative distension between patients with and without CVA
Cite this article
TY - JOUR AU - E. Hermeling AU - F.H. Schreuder AU - W.H. Mess AU - M.E. Kooi AU - A.P.G. Hoeks PY - 2012 DA - 2012/11/17 TI - P2.27 LOCAL RADIAL STRAIN OF THE COMMON CAROTID ARTERY WALL JO - Artery Research SP - 171 EP - 171 VL - 6 IS - 4 SN - 1876-4401 UR - https://doi.org/10.1016/j.artres.2012.09.108 DO - 10.1016/j.artres.2012.09.108 ID - Hermeling2012 ER -