Key result
Spontaneous coronary artery dissection was not associated with a significant difference in mean Young's Modulus of the common carotid artery compared to non-dissection controls (difference 2 kPa, p=0.32).
Why the study?
Spontaneous coronary artery dissection is hypothesized to be linked to changes in vessel wall elasticity, but the potential of common carotid artery shear wave elastography in these patients was unknown.
Does ultrasound shear wave elastography imaging detect differences in common carotid artery stiffness in patients with spontaneous coronary artery dissection compared to non-dissection controls?
Case-Control (n=127)
Single-blind
Does ultrasound shear wave elastography imaging detect differences in common carotid artery stiffness in patients with spontaneous coronary artery dissection compared to non-dissection controls?
Mean Difference: 2 (95% CI -11–4)
Absolute Event Rate: 55% vs 57%
p-value: p=0.32
Ultrasound shear wave elastography imaging of the common carotid arteries showed no significant difference in vessel wall stiffness between SCAD patients and non-dissection controls, though clinical utility is limited by high measurement variability.
No association with carotid Young's modulus does not support its use in SCAD evaluation; leaves open arterial stiffness contribution to dissection risk.
BACKGROUND: Shear wave elastography (SWE) is emerging as a valuable clinical tool for a variety of conditions. The aim of this pilot study was to assess the potential of SWE imaging of the common carotid arteries (CCA) in patients with spontaneous coronary artery dissection (SCAD), a rare but potentially life-threatening condition, hypothesized to be linked to changes in vessel wall elasticity. METHODS: Ultrasound shear wave elastography (SWE) estimates of artery wall elasticity were obtained from the left and right CCAs of 89 confirmed SCAD patients and 38 non-dissection controls. SWE images obtained over multiple cardiac cycles were analysed by a blinded observer to estimate elasticity in the form of a Young's Modulus (YM) value, across regions of interest (ROI) located within the anterior and posterior CCA walls. RESULTS: YM estimates ranged from 17 to 133 kPa in SCAD patients compared to 34 to 87 kPa in non-dissection controls. The mean YM of 55 [standard deviation (SD): 21] kPa in SCAD patients was not significantly different to the mean of 57 [SD: 12] kPa in controls, p = 0.32. The difference between groups was 2 kPa [95% Confidence Interval - 11, 4]. CONCLUSIONS: SWE imaging of CCAs in SCAD patients is feasible although the clinical benefit is limited by relatively high variability of YM values which may have contributed to our finding of no significant difference between SCAD patients and non-dissection controls.
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Almutairi et al. (2022) conducted a case-control in Spontaneous Coronary Artery Dissection (SCAD) (n=127). Spontaneous Coronary Artery Dissection (SCAD) vs. Non-dissection controls was evaluated on Mean Young's Modulus (YM) of the common carotid artery (MD 2, 95% CI -11, 4, p=0.32). Spontaneous coronary artery dissection was not associated with a significant difference in mean Young's Modulus of the common carotid artery compared to non-dissection controls (difference 2 kPa, p=0.32).
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