A novel non-invasive ultrasonic method to assess total axial stress of the common carotid artery wall in healthy and atherosclerotic men.

In the present study, developing a new non-invasive method independent from blood flow, we estimated and compared the total axial stress of the common carotid artery wall in healthy and atherosclerotic subjects. Consecutive ultrasonic images of the common carotid artery of 48 male subjects including healthy, with less and more than 50% stenosis in carotid artery were recorded. Longitudinal displacement and acceleration was extracted from ultrasonic image processing using a block matching algorithm. Furthermore, images were examined using a maximum gradient algorithm and time rate changes of the internal diameter and intima-media thickness were extracted. Finally, axial stress was estimated using an appropriate constitutive equation. Statistical analysis results showed that with stenosis initiation and its progression, axial acceleration and stress increase significantly. According to the results of the present study, maximum axial stress of the arterial wall is 1.713±0.546, 1.993±0.731 and 2.610±0.603 (kPa) in normal, with less and more than 50% stenosis in carotid artery respectively. Whereas minimum axial stress is -1.714±0.676, -1.982±0.663 and -2.593±0.661 (kPa) in normal, with less and more than 50% stenosis in carotid artery respectively. Moreover, internal diameter and intima-media thickness of the artery also increase significantly with stenosis initiation and its progression. In this study, the feasibility of axial wall stress computation for human common carotid arteries based on non-invasive in vivo clinical data is concluded. We found a strong and graded association between axial stress and severity of carotid stenosis, which might be used to discriminate healthy from atherosclerotic arteries.

[1]  Jay D Humphrey,et al.  Mechanisms of arterial remodeling in hypertension: coupled roles of wall shear and intramural stress. , 2008, Hypertension.

[2]  P. Challande,et al.  Intrinsic stiffness of the carotid arterial wall material in essential hypertensives. , 2000, Hypertension.

[3]  Alberto Avolio,et al.  Dynamic Stress Analysis of the Arterial Wall Utilizing Physiological Pressure Waveforms , 2008 .

[4]  Kazuhiro Sunagawa,et al.  Simultaneous measurement of blood flow and arterial wall vibrations in radial and axial directions , 2000, 2000 IEEE Ultrasonics Symposium. Proceedings. An International Symposium (Cat. No.00CH37121).

[5]  A. Hughes,et al.  Image-based carotid flow reconstruction: a comparison between MRI and ultrasound. , 2004, Physiological measurement.

[6]  Jason W Nichol,et al.  Tissue engineering of arteries by directed remodeling of intact arterial segments. , 2003, Tissue engineering.

[7]  F. Gao,et al.  Stress analysis in a layered aortic arch model under pulsatile blood flow , 2006, Biomedical engineering online.

[8]  J. D’hooge,et al.  In-vivo assessment of radial and longitudinal strain in the carotid artery using speckle tracking , 2010, 2010 IEEE International Ultrasonics Symposium.

[9]  Lambros Kaiktsis,et al.  Wall shear stress: theoretical considerations and methods of measurement. , 2007, Progress in cardiovascular diseases.

[10]  S. Chow,et al.  Sample Size Calculations In Clinical Research , 2007 .

[11]  William J Easson,et al.  Distribution of wall shear rate throughout the arterial tree: a case study. , 2007, Atherosclerosis.

[12]  D. Vray,et al.  Longitudinal displacement of the carotid wall and cardiovascular risk factors: associations with aging, adiposity, blood pressure and periodontal disease independent of cross-sectional distensibility and intima-media thickness. , 2012, Ultrasound in medicine & biology.

[13]  Å. Ahlgren,et al.  Evaluation of an ultrasonic echo-tracking method for measurements of arterial wall movements in two dimensions , 2005, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[14]  K. Cunningham,et al.  The role of shear stress in the pathogenesis of atherosclerosis , 2005, Laboratory Investigation.

[15]  Matilda Larsson,et al.  Ultrasound speckle tracking for radial, longitudinal and circumferential strain estimation of the carotid artery--an in vitro validation via sonomicrometry using clinical and high-frequency ultrasound. , 2015, Ultrasonics.

[16]  J. Humphrey,et al.  Characterization of arterial wall mechanical behavior and stresses from human clinical data. , 2008, Journal of biomechanics.

[17]  R S Reneman,et al.  Wall shear stress in the human common carotid artery as function of age and gender. , 1998, Cardiovascular research.

[18]  T. Jansson,et al.  Non-invasive measurement of arterial longitudinal movement , 2002, 2002 IEEE Ultrasonics Symposium, 2002. Proceedings..

[19]  Spyretta Golemati,et al.  Carotid artery wall motion estimated from B-mode ultrasound using region tracking and block matching. , 2003, Ultrasound in medicine & biology.

[20]  L. V. von Segesser,et al.  Systolic axial artery length reduction: an overlooked phenomenon in vivo. , 2001, American journal of physiology. Heart and circulatory physiology.

[21]  J D Humphrey,et al.  Fundamental role of axial stress in compensatory adaptations by arteries. , 2009, Journal of biomechanics.

[22]  G Mancia,et al.  Regression of radial artery wall hypertrophy and improvement of carotid artery compliance after long-term antihypertensive treatment in elderly patients. , 1998, Journal of the American College of Cardiology.

[23]  D Jegelevicus,et al.  ULTRASONIC MEASUREMENTS OF HUMAN CAROTID ARTERY WALL INTIMA-MEDIA THICKNESS , 2002 .

[24]  B. Balkau,et al.  Noninvasive measurement of carotid extra-media thickness: associations with cardiovascular risk factors and intima-media thickness. , 2009, JACC. Cardiovascular imaging.

[25]  L. Gan,et al.  Longitudinal wall motion of the common carotid artery can be assessed by velocity vector imaging , 2011, Clinical physiology and functional imaging.

[26]  G A Holzapfel,et al.  Determination of constitutive equations for human arteries from clinical data. , 2003, Journal of biomechanics.

[27]  Effat Soleimani,et al.  Carotid Artery Wall Motion Estimation from Consecutive Ultrasonic Images: Comparison between Block-Matching and Maximum-Gradient Algorithms , 2011, The journal of Tehran Heart Center.

[28]  Å. Ahlgren,et al.  Intra-observer variability of longitudinal displacement and intramural shear strain measurements of the arterial wall using ultrasound noninvasively in vivo. , 2010, Ultrasound in medicine & biology.

[29]  R. Ogden,et al.  A New Constitutive Framework for Arterial Wall Mechanics and a Comparative Study of Material Models , 2000 .

[30]  Chengpei Xu,et al.  Arterial enlargement, tortuosity, and intimal thickening in response to sequential exposure to high and low wall shear stress. , 2004, Journal of vascular surgery.

[31]  D. J. Patel,et al.  Longitudinal Tethering of Arteries in Dogs , 1966, Circulation research.

[32]  Tim Idzenga,et al.  Estimating cyclic shear strain in the common carotid artery using radiofrequency ultrasound. , 2012, Ultrasound in medicine & biology.

[33]  J. Keul,et al.  Assessment of carotid wall motion and stiffness with tissue Doppler imaging. , 1998, Ultrasound in medicine & biology.

[34]  K. Kohara,et al.  Association Between Risk Factors for Atherosclerosis and Mechanical Forces in Carotid Artery , 2000, Stroke.

[35]  Tomas Jansson,et al.  Longitudinal movements and resulting shear strain of the arterial wall. , 2006, American journal of physiology. Heart and circulatory physiology.

[36]  M Zamir,et al.  Mechanical events within the arterial wall under the forces of pulsatile flow: a review. , 2011, Journal of the mechanical behavior of biomedical materials.

[37]  Francis Loth,et al.  Mean-average wall shear stress measurements in the common carotid artery. , 2006, Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance.

[38]  D. Marquardt An Algorithm for Least-Squares Estimation of Nonlinear Parameters , 1963 .

[39]  J. D’hooge,et al.  Ultrasound-based Speckle Tracking for 3D Strain estimation of the Arterial wall — An experimental validation study in a tissue mimicking phantom , 2011 .

[40]  R M Lehman,et al.  Mechanism of enlargement of major cerebral collateral arteries in rabbits. , 1991, Stroke.

[41]  L. Wilkins North American Symptomatic Carotid Endarterectomy Trial. Methods, patient characteristics, and progress. , 1991, Stroke.