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

Bjällmark, Anna; Lind, Britta; Peolsson, Mikael; Shahgaldi, Kambiz; Brodin, Lars‐Åke; Nowak, Jacek

doi:10.1093/ejechocard/jeq033

Cited by 92 publications

(165 citation statements)

References 22 publications

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“…Bjällmark et al reported that the possible heterogeneity of the deformation pattern may be further accentuated by atherosclerotic plaque and plaque calcification 16. In agreement with previous studies,15, 16 CAAS measurement using 2D‐ST echocardiography in the present study demonstrated the heterogeneous motion pattern and local variations in compliance of different segments of the ascending aortic wall (Figure 1B and 1C). According to previous investigators,14, 15 we divided the ascending aortic wall into 6 equally sized segments.…”

Section: Discussionsupporting

confidence: 92%

“…However, validity and reproducibility of these methods are limited because of their dependence on the patient's blood pressure 7, 9. In contrast, strain imaging, using 2D ultrasonography with a speckle tracking technique, is a sensitive and reliable method for the assessment of elastic properties of arteries and offers a valuable tool for early identification of atherosclerosis 16. This method provides 2D data that enable researchers to assess the elastic properties of the arterial wall directly9, 16, 27, 35 and show a high sensitivity and good reproducibility 16, 27.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, strain imaging, using 2D ultrasonography with a speckle tracking technique, is a sensitive and reliable method for the assessment of elastic properties of arteries and offers a valuable tool for early identification of atherosclerosis 16. This method provides 2D data that enable researchers to assess the elastic properties of the arterial wall directly9, 16, 27, 35 and show a high sensitivity and good reproducibility 16, 27. Furthermore, the 2D‐ST method can detect heterogeneous motion pattern and local variations in compliance in different sectors of the vascular wall 16.…”

Section: Discussionmentioning

confidence: 99%

“…This method provides 2D data that enable researchers to assess the elastic properties of the arterial wall directly9, 16, 27, 35 and show a high sensitivity and good reproducibility 16, 27. Furthermore, the 2D‐ST method can detect heterogeneous motion pattern and local variations in compliance in different sectors of the vascular wall 16. In our study, global CAAS obtained by 2D‐ST echocardiography was performed over the entire circumference of the short‐axis section with high feasibility and satisfactory reproducibility.…”

Section: Discussionmentioning

confidence: 99%

“…Circumferential deformation of the descending thoracic aorta,11 abdominal aorta,12, 13 or carotid arteries14 can be measured using 2D speckle tracking (2D‐ST), allowing a simple and accurate determination of aortic stiffness 15. An association between circumferential strain and the progression of vascular stiffness with age has been reported by Bjällmark et al 16. The investigators demonstrated that strain imaging, using the 2D‐ST technique, is a sensitive and reliable method for the assessment of elastic properties in the common carotid artery and offers a valuable tool for early identification of patients with atherosclerotic disease.…”

Section: Introductionmentioning

confidence: 99%

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Ascending Aortic Strain Analysis Using 2‐Dimensional Speckle Tracking Echocardiography Improves the Diagnostics for Coronary Artery Stenosis in Patients With Suspected Stable Angina Pectoris

Fan

et al. 2018

JAHA

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BackgroundArterial stiffening and atherosclerosis tend to coexist. Strain imaging, using a 2‐dimensional speckle tracking (2D‐ST) method, has been used for arterial stiffness assessment and early identification of atherosclerosis. We investigated whether the ascending aortic strain assessed by 2D‐ST echocardiography at rest can predict the presence of coronary artery disease (CAD).Methods and ResultsTwo hundred seventy‐one consecutive patients with suspected stable angina pectoris sequentially underwent exercise treadmill testing, 2‐dimensional echocardiography, M‐mode echocardiography, 2D‐ST echocardiography, and coronary angiography. Circumferential ascending aortic strain (CAAS) and radial ascending aortic strain were assessed by 2D‐ST echocardiography. Ninety‐two patients with coronary lumen area stenosis ≥70% were categorized as having significant CAD. Global CAAS was significantly lower in patients with significant CAD (7.41±2.30% versus 11.54±4.03%; P<0.001) and remained an independent predictor of significant CAD (odds ratio, 0.64 [0.54–0.75]; P<0.001) after multivariate regression. Based on the receiver operating characteristic curve for diagnosing significant CAD, the optimal cut‐off value of global CAAS was ≤9.22% (sensitivity, 86%; specificity, 70%; area under curve=0.82; P<0.001). Global CAAS decreased with increasing severity of CAD and was significantly associated with 3‐vessel disease (odds ratio, 0.58 [0.42–0.79]; P<0.001). Diagnostics for significant CAD were remarkably better for global CAAS combined with exercise treadmill testing than for exercise treadmill testing alone (area under curve=0.88 versus 0.78; P<0.001).ConclusionsGlobal CAAS assessed by 2D‐ST echocardiography at rest was able to predict the presence of significant CAD and identify multivessel disease. In addition, global CAAS combined with exercise treadmill testing remarkably improved the diagnostics for significant CAD.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ascending Aortic Strain Analysis Using 2‐Dimensional Speckle Tracking Echocardiography Improves the Diagnostics for Coronary Artery Stenosis in Patients With Suspected Stable Angina Pectoris

Fan

et al. 2018

JAHA

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Lateral induction limits the impact of cell connectivity on Notch signaling in arterial walls

Ristori

Stassen

Sahlgren

et al. 2020

Numer Methods Biomed Eng

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It is well known that arteries grow and remodel in response to mechanical stimuli. Vascular smooth muscle cells are the main mediators of this process, as they can switch phenotype from contractile to synthetic, and vice-versa, based on the surrounding bio-chemo-mechanical stimuli. A correct regulation of this phenotypic switch is fundamental to obtain and maintain arterial homeostasis. Notch, a mechanosensitive signaling pathway, is one of the main regulators of the vascular smooth muscle cell phenotype. Therefore, understanding Notch dynamics is key to elucidate arterial growth, remodeling, and mechanobiology. We have recently developed a one-dimensional agent-based model to investigate Notch signaling in arteries. However, due to its onedimensional formulation, the model cannot be adopted to study complex nonsymmetrical geometries and, importantly, it cannot capture the realistic "cell connectivity" in arteries, here defined as the number of cell neighbors. Notch functions via direct cell-cell contact; thus, the number of cell neighbors could be an essential feature of Notch dynamics. Here, we extended the agent-based model to a two-dimensional formulation, to investigate the effects of cell connectivity on Notch dynamics and cell phenotypes in arteries. The computational results, supported by a sensitivity analysis, indicate that cell connectivity has marginal effects when Notch dynamics is dominated by the process of lateral induction, which induces all cells to have a uniform phenotype. When lateral induction is weaker, cells exhibit a nonuniform phenotype distribution and the percentage of synthetic cells within an artery depends on the number of neighbors. K E Y W O R D S agent-based model, artery, growth and remodeling, jagged, lateral induction, notch signaling

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Biomarkers of radiation‐induced vascular injury

et al. 2018

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Objective Cancer survivorship has thrown the spotlight on the incidence of nonmalignant chronic diseases in cancer patients. Endothelial injury is increasingly recognized as a consequence of cancer treatment, particularly after radiation therapy (RT). This review is to provide a current understanding on the pathophysiological mechanisms and predictive biomarkers of radiation‐induced vascular injury. Recent findings Radiation directly impacts vasculature by causing endothelial apoptosis and senescence, and alterations in normal homeostasis. This altered milieu at the endothelial surface may contribute to a systemic chronic inflammatory state that is superimposed upon the cascade of normal senescence processes leading to acceleration of age‐related disorders, atherosclerosis, and chronic fibrosis. Vasculature imaging, blood‐based or cell‐component biomarkers, and signatures of genomics, proteomics, metabolomics, and radiomics are potential tools for detection of vascular damage after irradiation. Conclusions Development of a valid prediction model by combining an array of imaging tools, blood‐based biomarkers, coupled with novel predictors like exosomes and metabolic degradation products can serve to identify RT‐induced vascular injury early for subsequent introduction of newer therapeutic approaches to counter radiation morbidity.

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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

Cited by 92 publications

References 22 publications

Ascending Aortic Strain Analysis Using 2‐Dimensional Speckle Tracking Echocardiography Improves the Diagnostics for Coronary Artery Stenosis in Patients With Suspected Stable Angina Pectoris

Ascending Aortic Strain Analysis Using 2‐Dimensional Speckle Tracking Echocardiography Improves the Diagnostics for Coronary Artery Stenosis in Patients With Suspected Stable Angina Pectoris

Lateral induction limits the impact of cell connectivity on Notch signaling in arterial walls

Biomarkers of radiation‐induced vascular injury

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