Wall shear stress in hypertensive patients is associated with carotid vascular deformation assessed by speckle tracking strain imaging
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Introduction: Wall shear stress (WSS) is critically important in both vascular remodeling and atherosclerosis. Carotid intima-media thickness (IMT) and deformation parameters have been used as relevant indicators of carotid atherosclerosis. This study aimed to investigate the relationships between hemodynamic parameters in the common carotid artery (CCA) and the severity of carotid atherosclerosis in untreated hypertensive patients. Methods: Carotid artery ultrasound was performed in 100 untreated hypertensive patients. Morphologic and hemodynamic parameters of the CCA, including peak and mean WSS, global circumferential strain, peak posterior radial strain assessed by two-dimensional speckle tracking method, and IMT, were measured. Results: In patients with hypertension, there were significant correlations between carotid strain parameters and peak/mean WSS. Stepwise multiple regression analysis for carotid strain parameters after adjustment for age, carotid IMT, and brachial pulse wave velocity showed that peak WSS was an independent determinant of peak posterior radial strain (p = 0.009) and global circumferential strain (p = 0.002). Conclusions: These findings indicate that local shear stress is associated with carotid vascular deformation, which could be an underlying mechanism for the progression of atherosclerosis.
Abstract
Introduction: Wall shear stress (WSS) is critically important in both vascular remodeling and atherosclerosis. Carotid intima-media thickness (IMT) and deformation parameters have been used as relevant indicators of carotid atherosclerosis. This study aimed to investigate the relationships between hemodynamic parameters in the common carotid artery (CCA) and the severity of carotid atherosclerosis in untreated hypertensive patients. Methods: Carotid artery ultrasound was performed in 100 untreated hypertensive patients. Morphologic and hemodynamic parameters of the CCA, including peak and mean WSS, global circumferential strain, peak posterior radial strain assessed by two-dimensional speckle tracking method, and IMT, were measured. Results: In patients with hypertension, there were significant correlations between carotid strain parameters and peak/mean WSS. Stepwise multiple regression analysis for carotid strain parameters after adjustment for age, carotid IMT, and brachial pulse wave velocity showed that peak WSS was an independent determinant of peak posterior radial strain (p = 0.009) and global circumferential strain (p = 0.002). Conclusions: These findings indicate that local shear stress is associated with carotid vascular deformation, which could be an underlying mechanism for the progression of atherosclerosis.
참고문헌 (36)
- Ezzati M, "Comparative risk assessment collaborating group. Selected major risk factors and global and regional burden of disease", Lancet, 360, pp.1347~1360 (2002)
- Fox B, "Distribution of fatty and fibrous plaques in young human coronary arteries", Atherosclerosis, 41, pp.337~347 (1982)
- Asakura T, "Flow patterns and spatial distribution of atherosclerotic lesions in human coronary arteries", Circ Res, 66, pp.1045~1066 (1990)
- Busse R, "Pulsatile stretch and shear stress, physical stimuli determining the production of endothelium-derived relaxing factors", J Vasc Res, 35, pp.73~84 (1998)
- Hoeks AP, "Noninvasive determination of shear-rate distribution across the arterial lumen", Hypertension, 26, pp.26~33 (1995)
- Zarins CK, "Carotid bifurcation atherosclerosis. Quantitative correlation of plaque localization with flow velocity profiles and wall shear stress", Circ Res, 53, pp.502~514 (1983)
- Gnasso A, "In vivo association between low wall shear stress and plaque in subjects with asymmetrical carotid atherosclerosis", Stroke, 28, pp.993~998 (1997)
- Ku DN, "Pulsatile flow and atherosclerosis in the human carotid bifurcation. Positive correlation between plaque location and low oscillating shear stress", Arteriosclerosis, 5, pp.293~302 (1985)
- Van Popele NM, "Association between arterial stiffness and atherosclerosis, the Rotterdam Study", Stroke, 32, pp.454~460 (2001)
- Harloff A, "Combined measurement of carotid stiffness and intima-media thickness improves prediction of complex aortic plaques in patients with ischemic stroke", Stroke, 37, pp.2708~2712 (2006)
- Bots ML, "Increased common carotid intima-media thickness, adaptive response or a reflection of atherosclerosis?, findings from the Rotterdam Study", Stroke, 28, pp.2442~2447 (1997)
- Paini A, "Carotid and aortic stiffness, determinants of discrepancies", Hypertension, 47, pp.371~376 (2006)
- Chobanian AV, "National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee, The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure", the JNC 7 report. JAMA, 289, pp.2560~2572 (2003)
- Vermeersch SJ, "Validation of a new automated IMT measurement algorithm", J Hum Hypertens, 21, pp.976~978 (2007)
- Barth JD, "An update on carotid ultrasound measurement of intima-media thickness", Am J Cardiol, 89, pp.32B~38B (2002)
- Gonzalez-Juanatey C, "Increased prevalence of severe subclinical atherosclerotic findings in long-term treated rheumatoid arthritis patients without clinically evident atherosclerotic disease", Medicine (Baltimore), 82, pp.407~413 (2003)
- Gnasso A, "Association between intima-media thickness and wall shear stress in common carotid arteries in healthy male subjects", Circulation, 94, pp.3257~3262 (1996)
- Lee MY, "Association between wall shear stress and carotid atherosclerosis in patients with never treated essential hypertension", Am J Hypertens, 22, pp.705~710 (2009)
- Samijo SK, "Reproducibility of shear rate and shear stress assessment by means of ultrasound in the common carotid artery of young human males and females", Ultrasound Med Biol, 23, pp.583~590 (1997)
- Lee JH, "Carotid arterial stiffness in patients with rheumatoid arthritis assessed by speckle tracking strain imaging, its association with carotid atherosclerosis", Clin Exp Rheumatol, 30, pp.720~728 (2012)
- Malek AM, "Hemodynamic shear stress and its role in atherosclerosis", 282, pp.2035~2042 (1999), JAMA
- Koller A, "Development of nitric oxide and prostaglandin mediation of shear stress-induced arteriolar dilation with aging and hypertension", Hypertension, 34, pp.1073~1079 (1999)
- Chatzizisis YS, "Role of endothelial shear stress in the natural history of coronary atherosclerosis and vascular remodeling, molecular, cellular, and vascular behavior", J Am Coll Cardiol, 49, pp.2379~2393 (2007)
- Eigenbrodt ML, "Common carotid arterial interadventitial distance (diameter) as an indicator of the damaging effects of age and atherosclerosis, a cross-sectional study of the Atherosclerosis Risk in Community Cohort Limited Access Data (ARICLAD)", Cardiovasc Ultrasound, 1987~1989 (2006)
- Safar ME, "Recent advances on large arteries in hypertension", Hypertension, 32, pp.156~161 (1998)
- Boutouyrie P, "Association between local pulse pressure, mean blood pressure, and large-artery remodeling", Circulation, 100, pp.1387~1393 (1999)
- Chironi G, "Influence of hypertension on early carotid artery remodeling", Arterioscler Thromb Vasc Biol, 23, pp.1460~1464 (2003)
- Jiang YN, "Alteration of carotid circulation in essential hypertensive patients with left ventricular hypertrophy", J Hum Hypertens, 12, pp.173~179 (1998)
- Kohara K, "Effect of reflection of arterial pressure on carotid circulation in essential hypertension", Am J Hypertens, 12(10 Pt 1), pp.1015~1020 (1999)
- Mattace-Raso FU, "Arterial stiffness and risk of coronary heart disease and stroke, the Rotterdam Study", Circulation, 113, pp.657~663 (2006)
- Laurent S, "Arterial stiffness, a new surrogate end point for cardiovascular disease?", J Nephrol, 20(Suppl 12), pp.S45~S50 (2007)
- Traub O, "Laminar shear stress, mechanisms by which endothelial cells transduce an atheroprotective force", Arterioscler Thromb Vasc Biol, 18, pp.677~685 (1998)
- Carallo C, "Wall shear stress is lower in the carotid artery responsible for a unilateral ischemic stroke", Atherosclerosis, 185, pp.108~113 (2006)
- Tuka V, "Diabetes and distal access location are associated with higher wall shear rate in feeding artery of PTFE grafts", Nephrol Dial Transplant, 21, pp.2821~2824 (2006)
- Setty SP, "Noninvasive measurement of shear rate in autologous and prosthetic bypass grafts", Vasc Endovasc Surg, 36, pp.447~455 (2002)
- Paszkowiak JJ, "Arterial wall shear stress, observations from the bench to the bedside", Vasc Endovasc Surg, 37, pp.47~57 (2003)
