Quantifying carotid stiffness in a pre-hypertensive population with ultrafast ultrasound imaging

Figures

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  Fig. 1.. Flow diagram of the study cohort selection. This study enrolled 1,278 consecutive patients who underwent clinical and laboratory examinations and simultaneous BP, cIMT, and ufPWV measurements. After selecting based on the inclusion and exclusion criteria, the 626 included subjects were divided into three BP groups: normal BP (NBP, n=215), pre-hypertensive (PHT, n=119), and hypertensive (HT, n=292). BP, blood pressure; cIMT, carotid intima-media thickness; ufPWV, ultrafast pulse wave velocity; FBG, fasting blood glucose; SBP, systolic blood pressure; DBP, diastolic blood pressure.

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  Fig. 2.. Protocols for the assessment of cIMT using ACAMS and carotid stiffness using ufPWV A. Measurement of cIMT was performed by using ACAMS. Utilizing ACAMS, a white ROI box was drawn at the posterior wall of the CCA; the intimal and medial lines of the CCA were automatically recorded with two dotted lines, and the mean cIMT of the ROI was obtained with a fit of 98%. B. PWV-BS and PWV-ES were measured by using ufPWV. Using ufPWV imaging, a yellow ROI box covered and a red line automatically tracked the anterior and posterior walls of the CCA. The PWV-BS and PWV-ES values were calculated in the ROI with Δ± ≤2.0 m/s, respectively. cIMT, carotid intima-media thickness; ACAMS, Aixplorer cIMT automatic measuring system; ROI, region of interest; ufPWV, ultrafast pulse wave velocity; CCA, common carotid artery; PWV-BS, pulse wave velocity-beginning of systole; PWV-ES, pulse wave velocityend of systole.

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  Fig. 3.. Correlations between cIMT, PWV-BS, and PWV-ES and age. Pearson’s correlation analysis (n=626) is shown between age and cIMT (r=0.519, P<0.001) (A), PWV-BS (r=0.280, P<0.001) (B), and PWV-ES (r=0.596, P<0.001) (C). cIMT, carotid intima-media thickness; PWV-BS, pulse wave velocity-beginning of systole; PWVES, pulse wave velocity-end of systole.

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  Fig. 4.. Comparison of cIMT among the BP groups. A. Comparisons were made with cIMT among the NBP (n=215), PHT (n=119), and HT (n=292) groups. B. With the cutoff of 0.050 cm by using ACAMS, a comparison of the proportion of thickened cIMT was made among the NBP (n=215), PHT (n=119), and HT (n=292) groups. **P<0.01, ***P<0.001. cIMT, carotid intima-media thickness; BP, blood pressure; NBP, normal blood pressure; PHT, pre-hypertensive; HT, hypertensive; ACAMS, Aixplorer cIMT automatic measuring system.

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  Fig. 5.. Comparison of PWV-BS and PWV-ES among the BP groups and the cIMT subgroups. Comparisons were made with PWV-BS (A) and PWV-ES (B) among the NBP (n=215), PHT (n=119), and HT (n=292) groups in the total population, respectively. Comparisons were made with PWV-BS (C) and PWV-ES (D) among the NBP, PHT, and HT groups in the subpopulations with cIMT <0.050 cm and ≥0.050 cm, respectively. Comparison were made among three BP groups according to cIMT subgroups: ***P<0.001; Comparison between two BP groups with age-adjusted P-values: vs. NBP group with #P<0.05, ##P<0.01, ###P<0.001; vs. PHT group with &P<0.05. PWV-BS, pulse wave velocity-beginning of systole; PWV-ES, pulse wave velocity-end of systole; BP, blood pressure; cIMT, carotid intima-media thickness; NBP, normal blood pressure; PHT, pre-hypertensive; HT, hypertensive.