End-Stage Renal Disease Impairs the Multidirectional Movements of the Common Carotid Artery: Assessment Using Dimensional Speckle-Tracking Carotid Strain Ultrasonography
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BACKGROUND: Arterial stiffening is a major contributing factor in the development ofcardiovascular disease in patients with end-stage renal disease (ESRD). However, there isno gold standard for evaluating arterial stiffness. This study aimed to evaluate the newlydeveloped speckle-tracking carotid strain imaging method in assessing arterial stiffness inpatients with ESRD. METHODS: In total, 85 patients with normal renal function (controls) and 36 with ESRD wereenrolled in this single-center study. Carotid B-mode ultrasonography was performed forall patients. Arterial stiffness indices and strain parameters of the common carotid arterieswere analyzed. Values were compared between the groups, and multivariate linear regressionanalysis was performed to assess the impact of ESRD on carotid strain. RESULTS: There were no differences in the intima-media thickness, β stiffness index, andarterial compliance, but arterial distensibility was lower, and the elastic modulus and pulsewave velocity β (PWV) were higher among patients with ESRD (all p < 0.05), whether assessedin the longitudinal or transverse plane. Both longitudinal and transverse strain rates werereduced in patients with ESRD (all p < 0.05). In multivariate analyses, ESRD independentlyreduced both transverse radial strain and strain rate (all p < 0.05), and the transversecircumferential strain and strain rate (p < 0.05). However, all conventional aortic stiffnessindices and longitudinal strain parameters were not associated with ESRD. CONCLUSIONS: Speckle-tracking carotid strain ultrasonography was successfully performedin both normal subjects and patients with ESRD. Multidirectional carotid strain analyses mayprovide more value than conventional aortic stiffness indices for risk stratification in patientswith ESRD.
Abstract
BACKGROUND: Arterial stiffening is a major contributing factor in the development ofcardiovascular disease in patients with end-stage renal disease (ESRD). However, there isno gold standard for evaluating arterial stiffness. This study aimed to evaluate the newlydeveloped speckle-tracking carotid strain imaging method in assessing arterial stiffness inpatients with ESRD. METHODS: In total, 85 patients with normal renal function (controls) and 36 with ESRD wereenrolled in this single-center study. Carotid B-mode ultrasonography was performed forall patients. Arterial stiffness indices and strain parameters of the common carotid arterieswere analyzed. Values were compared between the groups, and multivariate linear regressionanalysis was performed to assess the impact of ESRD on carotid strain. RESULTS: There were no differences in the intima-media thickness, β stiffness index, andarterial compliance, but arterial distensibility was lower, and the elastic modulus and pulsewave velocity β (PWV) were higher among patients with ESRD (all p < 0.05), whether assessedin the longitudinal or transverse plane. Both longitudinal and transverse strain rates werereduced in patients with ESRD (all p < 0.05). In multivariate analyses, ESRD independentlyreduced both transverse radial strain and strain rate (all p < 0.05), and the transversecircumferential strain and strain rate (p < 0.05). However, all conventional aortic stiffnessindices and longitudinal strain parameters were not associated with ESRD. CONCLUSIONS: Speckle-tracking carotid strain ultrasonography was successfully performedin both normal subjects and patients with ESRD. Multidirectional carotid strain analyses mayprovide more value than conventional aortic stiffness indices for risk stratification in patientswith ESRD.
참고문헌 (19)
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