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The Value of Elastic Modulus Index as a Novel Surrogate Marker for Cardiovascular Risk Stratification by Dimensional Speckle-Tracking Carotid Ultrasonography
Ji hyun Yoon1*, In-Jeong Cho1, Hyuk-Jae Chang1*, Ji min Sung2, Jinyong Lee3, Hojin Ryoo3, Chi Young Shim1, Geu-Ru Hong1, Namsik Chung1
1Yonsei University College of Medicine Cardiology Division
2Yonsei University College of Medicine, Cardiovascular Research Institute
3Infrastructure Technology Lab, Samsung Medison
Corresponding Author: Ji hyun Yoon ,Email: peacy83@yuhs.ac
ABSTRACT
Background:
Carotid intima media thickness (CIMT) and the presence of carotid plaque have been used for risk stratification of cardiovascular disease (CVD). To date, however, the association between multi-directional functional properties of carotid artery and CVD has not been fully elucidated. We sought to explore the multi-directional mechanics of the carotid artery in relation to cardiovascular risk. Method and results: Four hundred one patients who underwent carotid ultrasound (CUS) were enrolled between January 2010 and April 2013. A high risk of CVD was defined as more than 20% of 10-year risk based on the Framingham risk score (FRS). Using a speckle-tracking technique, the longitudinal and radial movements were analyzed in the B-mode images. Peak longitudinal and radial displacements, strain and strain rate were also measured. Beta stiffness and elastic modulus index were calculated from the radial measurements. Of the overall sample, 13% (52) of patients comprised the high-risk group. In multivariate logistic regression, CIMT and elastic modulus index were independently associated with a high-risk of CVD (OR: 2.064 (95% CI 1.475-2.888) and OR: 1.813 (95% CI: 1.157-2.841) ; p<0.001, 0.009 respectively). The combination of CIMT and elastic modulus index correlated with a high-risk of CVD more so than CIMT alone. Conclusions: The elastic modulus index of the carotid artery might serve as a novel surrogate marker of high-risk CVD. Measurement of the multi-directional mechanics of the carotid artery using the speckle tracking technique has potential for providing further information over conventional B-mode ultrasound for stratification of CVD risk.
Keywords: Elastic modulus, Carotid artery, Cardiovascular disease
Volume 25, No 3
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