Journal of Cardiovascular Imaging

Korean Society of Echocardiography (한국심초음파학회)
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End-Stage Renal Disease Impairs the Multidirectional Movements of the Common Carotid Artery: Assessment Using Dimensional Speckle-Tracking Carotid Strain Ultrasonography

  • Lee, Sang-Eun (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System) ;
  • Lee, Jinyong (Medical Imaging Research Group, Samsung Medison) ;
  • Yoo, Tae-Hyun (Department of Internal Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Yonsei University Health System) ;
  • Cho, In-Jeong (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System) ;
  • Chang, Hyuk-Jae (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System)
  • Received : 2018.07.23
  • Accepted : 2018.09.04
  • Published : 2018.09.27
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Abstract

BACKGROUND: Arterial stiffening is a major contributing factor in the development of cardiovascular disease in patients with end-stage renal disease (ESRD). However, there is no gold standard for evaluating arterial stiffness. This study aimed to evaluate the newly developed speckle-tracking carotid strain imaging method in assessing arterial stiffness in patients with ESRD. METHODS: In total, 85 patients with normal renal function (controls) and 36 with ESRD were enrolled in this single-center study. Carotid B-mode ultrasonography was performed for all patients. Arterial stiffness indices and strain parameters of the common carotid arteries were analyzed. Values were compared between the groups, and multivariate linear regression analysis was performed to assess the impact of ESRD on carotid strain. RESULTS: There were no differences in the intima-media thickness, ${\beta}$ stiffness index, and arterial compliance, but arterial distensibility was lower, and the elastic modulus and pulse wave velocity ${\beta}$ (PWV) were higher among patients with ESRD (all p < 0.05), whether assessed in the longitudinal or transverse plane. Both longitudinal and transverse strain rates were reduced in patients with ESRD (all p < 0.05). In multivariate analyses, ESRD independently reduced both transverse radial strain and strain rate (all p < 0.05), and the transverse circumferential strain and strain rate (p < 0.05). However, all conventional aortic stiffness indices and longitudinal strain parameters were not associated with ESRD. CONCLUSIONS: Speckle-tracking carotid strain ultrasonography was successfully performed in both normal subjects and patients with ESRD. Multidirectional carotid strain analyses may provide more value than conventional aortic stiffness indices for risk stratification in patients with ESRD.

Keywords

Acknowledgement

Grant : Development of ultrafast cardiovascular diagnostic system based on the multifunctional 3D ultrasound imaging

Supported by : Ministry of Trade, Industry and Energy (MOTIE)

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