Key result
Tissue Doppler Imaging of carotid plaque wall motion yielded highly variable quantitative measures that correlated poorly with stenosis severity, though it provided qualitative biomechanical insights.
Why the study?
Does Tissue Doppler Imaging of Arterial Wall Motion provide clinically useful biomechanical information in normal and diseased carotid arteries?
Observational (n=126)
No
Does Tissue Doppler Imaging of Arterial Wall Motion provide clinically useful biomechanical information in normal and diseased carotid arteries?
Tissue Doppler Imaging of carotid plaque wall motion demonstrates pertinent biomechanical features of arterial disease, though simple quantitative measures are currently limited by high variability.
High variability precludes routine clinical use of quantitative tissue Doppler imaging for carotid plaques; leaves open its role in providing biomechanical insights.
BACKGROUND: Studies suggest the physical and mechanical properties of vessel walls and plaque may be of clinical value in the diagnosis and treatment of cardiovascular atherosclerotic disease. The purpose of this pilot study was to investigate the potential clinical application of ultrasound Tissue Doppler Imaging (TDI) of Arterial Wall Motion (AWM) and to quantify simple wall motion indices in normal and diseased carotid arteries. METHODS: 224 normal and diseased carotid arteries (0-100% stenoses) were imaged in 126 patients (age 25-88 years, mean 68 +/- 11). Longitudinal sections of the carotid bifurcation were imaged using a Philips HDI5000 scanner and L12-5 probe under optimized TDI settings. Temporal and spatial AWMs were analyzed to evaluate the vessel wall displacements and spatial gradients at peak systole averaged over 5 cardiac cycles. RESULTS: AWM data were successfully extracted in 91% of cases. Within the carotid bifurcation/plaque region, the maximum wall dilation at peak systole ranged from -100 to 750 microns, mean 335 +/- 138 microns. Maximum wall dilation spatial gradients ranged 0-0.49, mean 0.14 +/- 0.08. The AWM parameters showed a wide variation and had poor correlation with stenoses severity. Case studies illustrated a variety of pertinent qualitative and quantitative wall motion features related to the biophysics of arterial disease. CONCLUSION: Our clinical experience, using a challenging but realistic imaging protocol, suggests the use of simple quantitative AWM measures may have limitations due to high variability. Despite this, pertinent features of AWM in normal and diseased arteries demonstrate the potential clinical benefit of the biomechanical information provided by TDI.
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Ramnarine et al. (2003) conducted an observational in Carotid artery disease (n=126). Tissue Doppler Imaging of Arterial Wall Motion was evaluated on Maximum wall dilation at peak systole and maximum wall dilation spatial gradients. Tissue Doppler Imaging of carotid plaque wall motion yielded highly variable quantitative measures that correlated poorly with stenosis severity, though it provided qualitative biomechanical insights.
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