Assessment of High Frequency Imaging and Doppler System for the Measurements of the Radial Artery Flow-Mediated Dilation
Methods: We compare two US scanning systems, standard vascular modality working below 12 MHz and high frequency 20 MHz system designed for FMD and SR measurements. Axial resolutions of both systems were compared by imaging of two closely spaced food plastic foils immersed in water and by measuring systolic/diastolic diameter changes in the radial artery. The sensitivities of Doppler modalities were also determined. The diagnostic potential of a high frequency system in measurements of FMD and SR was studied in vivo, in two groups of subjects, 12 healthy volunteers and 14 patients with stable coronary artery disease (CAD).
Results: Over three times better axial resolution was demonstrated for a high frequency system. Also, the sensitivity of the external single transducer 20 MHz pulse Doppler proved to be over 20 dB better (in terms of a signal-to-noise ratio) than the pulse Doppler incorporated into the linear array. Statistically significant differences in FMD and FMD/SR values for healthy volunteers and CAD patients were confirmed, p-values < 0:05. The areas under Receiver Operating Characteristic (ROC) curves for FMD and FMD/SR for the prediction CAD had the values of 0.99 and 0.97, respectively.
Conclusions: These results justify the usefulness of the designed high-frequency scanning system to determine the FMD and SR in the radial artery as predictors of coronary arterial disease.
Cahill P.A., Redmond E.M. (2016), Vascular endothelium – Gatekeeper of vessel health, Atherosclerosis, 248: 97–109, doi: 0.1016/j.atherosclerosis.2016.03.007.
Celermajer D.S. et al. (1992), Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis, Lancet, 40(8828): 1111–1115, doi: 10.1016/0140-6736(92)93147-F.
Deanfield J.E., Halcox J.P., Rabelink T.J. (2007), Endothelial function and dysfunction: testing and clinical relevance, Circulation, 115(10): 1285–1295, doi: 10.1161/CIRCULATIONAHA.106.652859.
Deshko M.S., Snezhitsky V.A., Dolgoshey T.S., Madekina G.A., Stempen T.P. (2011), Flowmediated dilation in patients with paroxysmal atrial fibrillation: initial evaluation, treatment results, pathophysiological correlates, Europace, 13 (supplement 3), https://insights.ovid.com/ep-europace/europ/2011/06/003/flow-mediated-dilation-patients-paroxysmal-atrial/644/00127069.
Gutiérrez E., Flammer, A.J., Lerman, L.O., Elízaga, J., Lerman, A., Fernández-Avilés F. (2013), Endothelial dysfunction over the course of coronary artery disease, European Heart Journal, 34(41): 3175–3181, doi: 10.1093/eurheartj/eht351.
Harris R.A., Nishiyama S.K., Wray D.W., Richardson R.S. (2010), Ultrasound assessment of flow-mediated dilation, Hypertension, 55(5): 1075–1085, doi: 10.1161/HYPERTENSIONAHA.110.150821.
Koeth R.A., Haselden V., Wilson Tang W.H. (2013), Chapter one – myeloperoxidase in cardiovascular disease, Advances in Clinical Chemistry, 62: 1–32, doi: 10.1016/B978-0-12-800096-0.00001-9.
Lehoux S., Jones E.A. (2016), Shear stress, arterial identity and atherosclerosis, Thrombosis and haemostasis, 115(3): 467–73, doi: 10.1160/TH15-10-0791.
Nowicki A. et al. (2018), 20-MHz ultrasound for measurements of flow-mediated dilation and shear rate in the radial artery, Ultrasound in Medicine & Biology, 44(6): 1187–1197, doi: 10.1016/j.ultrasmedbio.2018.02.011.
Padilla J. et al. (2008), Normalization of flowmediated dilation to shear stress area under the curve eliminates the impact of variable hyperemic stimulus, Cardiovascular Ultrasound, 6(1): 44, doi: 10.1186/1476-7120-6-44.
Pyke K.E., Dwyer E.M., Tschakovsky M.E. (2004), Impact of controlling shear rate on flowmediated dilation responses in the brachial artery of humans, Journal of Applied Physiology, 97(2):499–508, doi: 10.1152/japplphysiol.01245.2003.
Pyke K.E., Tschakovsky M.E. (2007), Peak vs. total reactive hyperemia: which determines the magnitude of flow-mediated dilation, Journal of Applied Physiology, 102(4): 1510–1519, doi: 10.1152/japplphysiol.01024.2006.
Roevros J.M.J.G. (1974), Analogue processing of C.W. flowmeter signals to determine average frequency shift momentaneously without the use of a wave analyser, [in:] Reneman R.S. [Ed.], Cardiovascular applications of ultrasound, pp. 43–54, Amsterdam: North-Holland.
Storch A.S., de Mattos J.D., Alves R., dos Santos Galdino I., Rocha H.N.M. (2017), Methods of endothelial function assessment: description and applications, International Journal of Cardiovascular Sciences, 30(3): 262–273, doi: 10.5935/2359-4802.20170034.
Tortoli P., Morganti T., Bambi G., Palombo C., Ramnarine K.V. (2006), Noninvasive simultaneous assessment of wall shear rate and wall distension in carotid arteries, Ultrasound in Medicine & Biology, 32(11): 1661–1670, doi: 10.1016/j.ultrasmedbio.2006.07.023.
Yousuf O. et al. (2013), High-sensitivity C-reactive protein and cardiovascular disease: a resolute belief or an elusive link?, Journal of the American College of Cardiology, 62(5): 397–408, doi: 10.1016/j.jacc.2013.05.016.