Carotid stiffening predicts cardiovascular risk stratification in mid-life: non-invasive quantification with ultrafast ultrasound imaging

Figures

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  Fig. 1.. Flow diagram of study cohort selection. ufPWV, ultrafast pulse wave velocity.

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  Fig. 2.. Protocols for the valid assessment of cIMT using ACAMS and carotid stiffness using ufPWV in a 58-year-old woman. A. 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 83%. B. 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± of ≤1.0 m/s. The abscissa in the color graphs below the images represent time (ms), and the vertical axis represents the anterior CCA wall distance (mm). Red shows movement towards the probe, and blue shows movement away from the probe. The PWV-BS value is 5.48 m/s, and the PWV-ES value is 10.70 m/s. cIMT, carotid intima-media thickness; ACAMS, Aixplorer cIMT automatic measurement system; ufPWV, ultrafast pulse wave velocity; ROI, region of interest; CCA, common carotid artery; LCCA, left common carotid artery; PWVBS, pulse wave velocity-beginning of systole; PWV-ES, pulse wave velocity-end of systole.

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  Fig. 3.. Histograms showing comparisons of measurements of cIMT (A), PWV-BS (B), and PWV-ES (C) between age subgroups, respectively. All comparisons were made with the 40- to 49-year subgroup in both men and women. cIMT, carotid intima-media thickness; PWVBS, pulse wave velocity-beginning of systole; PWV-ES, pulse wave velocity-end of systole. *P<0.05, **P<0.01, ***P<0.001.

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  Fig. 4.. Percent stacked area charts of SCORE risk categories of women (n=344) (A) and men (n=339) (B) in the age subgroups. SCORE, Systematic COronary Risk Evaluation.

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  Fig. 5.. Histograms showing comparisons of measurements of cIMT (A), PWV-BS (B), and PWV-ES (C) between SCORE subgroups. All comparisons were made with the low-risk subgroup (<1%) in both men and women. Of note, there was one woman in the 5%-9% risk subgroup, and no women in the ≥10% risk subgroup. cIMT, carotid intima-media thickness; PWV-BS, pulse wave velocitybeginning of systole; PWV-ES, pulse wave velocity-end of systole; SCORE, Systematic COronary Risk Evaluation. *P<0.05, **P<0.01, ***P<0.001.