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. 2010 Apr;23(4):393-8.
doi: 10.1038/ajh.2009.272. Epub 2010 Jan 21.

Pulse wave imaging for noninvasive and quantitative measurement of arterial stiffness in vivo

Jonathan Vappou  1 , Jianwen Luo, Elisa E Konofagou
Affiliations

Pulse wave imaging for noninvasive and quantitative measurement of arterial stiffness in vivo

Jonathan Vappou et al. Am J Hypertens. 2010 Apr.

Abstract

Background: Arterial stiffening is recognized to be associated with increased cardiovascular mortality and to be a major cause of several cardiovascular complications. Pulse wave velocity (PWV) has been widely accepted to be a reliable and robust measure of arterial stiffness. In this article, the novel ultrasound-based pulse wave imaging (PWI) method is hereby proposed for visualization of the pulse wave during its propagation and for calculation of the PWV.

Methods: The PWV is estimated by measuring the spatiotemporal variation of the pulse wave-induced displacement of the arterial wall within the imaged segment. The method is compared to mechanical testing on aortic phantoms in order to evaluate its reliability and accuracy, and in vivo results are presented on normal abdominal aortas (N = 11).

Results: Good agreement was found with mechanical testing on phantoms (r(2) = 0.92), showing the reliability of the method. In vivo average PWV and Young's modulus were found to be equal to 4.4 +/- 0.6 m/s and 108 +/- 27 kPa, respectively.

Conclusions: Reliability and in vivo feasibility of the proposed PWI method were demonstrated in this study. Its simplicity of use and its capability of providing regional PWV render PWI a valuable tool for quantitative assessment of arterial stiffness. The utility of the method in a clinical setting has yet to be established and is part of an ongoing clinical study.

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Figures

Figure 1.
Figure 1.. Schematic of the experimental protocol used for phantom experiments. The pulsatile flow is generated by a peristaltic pump, and the aortic phantom is imaged in a water bath.
Figure 2.
Figure 2.. Successive PWI images (overlaid onto underlying B-mode image), showing the propagation of the pulse wave from left to right. White arrows depict the approximate location of foot of the wave on both upper (corresponding to anterior) and lower (corresponding to posterior) walls. PWI, pulse wave imaging.
Figure 3.
Figure 3.. Comparison between PWI and mechanical testing. (a) Young's modulus of the five phantoms measured by the two methods and (b) corresponding correlation plot.
Figure 4.
Figure 4.. In vivo results. (a) Aortic wall displacement at four different frames (delay between two successive frames is 7.7ms) overlaid onto B-mode image, showing clearly the propagation of the wavefront (black arrow) from right to left. For clarity, the displacement is also represented on the surrounding tissue (b) profile of the wall displacement vs. time and distance from inlet, and (c) determination of the pulse wave velocity from the fit of this profile at the foot of the wave. PWV, pulse wave velocity.
See this image and copyright information in PMC

Comment in

  • Potentials and pitfalls of local PWV measurements.
    Hermeling E, Reesink KD, Hoeks AP, Reneman RS. Hermeling E, et al. Am J Hypertens. 2010 Sep;23(9):934; author reply 935. doi: 10.1038/ajh.2010.123. Am J Hypertens. 2010. PMID: 20733569 No abstract available.

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