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. 2022 Aug 8:13:976254.
doi: 10.3389/fphys.2022.976254. eCollection 2022.

Associations between electrocardiogram and carotid ultrasound parameters: a healthy chinese group study

Lingwei Shi  1 , Dongsheng Bi  1 , Jingchun Luo  2 , Wei Chen  1   2 , Cuiwei Yang  1 , Yan Zheng  2 , Ju Hao  2 , Ke Chang  1 , Boyi Li  3 , Chengcheng Liu  3   4 , Dean Ta  1   2   3   4
Affiliations

Associations between electrocardiogram and carotid ultrasound parameters: a healthy chinese group study

Lingwei Shi et al. Front Physiol. .

Abstract

Background: Electrocardiogram (ECG) and carotid ultrasound (CUS) are important tools for the diagnosis and prediction of cardiovascular disease (CVD). This study aimed to investigate the associations between ECG and CUS parameters and explore the feasibility of assessing carotid health with ECG. Methods: This cross-sectional cohort study enrolled 319 healthy Chinese subjects. Standard 12-lead ECG parameters (including the ST-segment amplitude [STA]), CUS parameters (intima-media thickness [IMT] and blood flow resistance index [RI]), and CVD risk factors (including sex, age, and systolic blood pressure [SBP]) were collected for analysis. Participants were divided into the high-level RI group (average RI ≥ 0.76, n = 171) and the normal RI group (average RI < 0.76, n = 148). Linear and stepwise multivariable regression models were performed to explore the associations between ECG and CUS parameters. Results: Statistically significant differences in sex, age, SBP, STA and other ECG parameters were observed in the normal and the high-level RI group. The STA in lead V3 yielded stronger significant correlations (r = 0.27-0.42, p < 0.001) with RI than STA in other leads, while ECG parameters yielded weak correlations with IMT (|r| ≤ 0.20, p < 0.05). STA in lead V2 or V3, sex, age, and SBP had independent contributions (p < 0.01) to predicting RI in the stepwise multivariable models, although the models for IMT had only CVD risk factors (age, body mass index, and triglyceride) as independent variables. The prediction model for RI in the left proximal common carotid artery (CCA) had higher adjusted R2 (adjusted R2 = 0.31) than the model for RI in the left middle CCA (adjusted R2 = 0.29) and the model for RI in the right proximal CCA (adjusted R2 = 0.20). Conclusion: In a cohort of healthy Chinese individuals, the STA was associated with the RI of CCA, which indicated that ECG could be utilized to assess carotid health. The utilization of ECG might contribute to a rapid screening of carotid health with convenient operations.

Keywords: ST-segment amplitude (STA); cardiovascular disease (CVD); carotid ultrasound (CUS); cohort study; electrocardiogram (ECG); resistance index (RI).

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Process of ECG signals collecting and CUS examinations.
FIGURE 2
FIGURE 2
Examples of carotid ultrasound. (A) B-mode ultrasound for IMT; (B) Doppler ultrasound for RI.
FIGURE 3
FIGURE 3
The scatter plots between (A) ST-segment amplitude in lead V2 and RI in the left middle common carotid artery. (B) ST-segment amplitude in lead V2 and RI in the right middle common carotid artery. (C) ST-segment amplitude in lead V3 and RI in the left middle common carotid artery. (D) ST-segment amplitude in lead V3 and RI in the right middle common carotid artery.
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