A Virtual Instrument for Automated Measurement of Arterial Compliance

Measurement of arterial distensibility is very important in cardiovascular diagnosis for early detection of coronary heart disease and possible prediction of future cardiac events. Conventionally, B-mode ultrasound imaging systems have been used along with expensive vessel wall tracking systems for estimation of arterial distension and calculation of various estimates of compliance. We present a simple instrument for noninvasive in vivo evaluation of arterial compliance using a single element ultrasound transducer. The measurement methodology is initially validated using a proof of concept pilot experiment using a commercial ultrasound pulser-receiver. A prototype system is then developed around a PXI chassis using LABVIEW software. The virtual instrument employs a dynamic threshold algorithm to identify the artery walls and then utilizes a correlation based tracking technique to estimate arterial distension. The end-diastolic echo signals are averaged to reduce error in the automated diameter measurement process. The instrument allows automated measurement of the various measures of arterial compliance with minimal operator intervention. The performance of the virtual instrument was first analyzed using simulated data sets to establish the maximum measurement accuracy achievable under different input signal to noise ratio (SNR) levels. The system could measure distension with accuracy better than 10 μm for positive SNR. The measurement error in diameter was less than 1%. The system was then thoroughly evaluated by the experiments conducted on phantom models of the carotid artery and the accuracy and resolution were found to meet the requirements of the application. Measurements performed on human volunteers indicate that the instrument can measure arterial distension with a precision better than 5%. The end-diastolic arterial diameter can be measured with a precision better than 2% and an accuracy of 1%. The measurement system could lead to the development of small, portable, and inexpensive equipment for estimation of arterial compliance suitable in mass screening of "at risk" patients. The automated compliance measurement algorithm implemented in the instrument requires minimal operator input. The instrument could pave the way for dedicated systems for arterial compliance evaluation targeted at the general medical practitioner who has little or no expertise in vascular ultrasonography.

[1]  R. Reneman,et al.  Inhomogeneities in arterial wall properties under normal and pathological conditions , 1992, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[2]  W.D. O'Brien,et al.  Current time-domain methods for assessing tissue motion by analysis from reflected ultrasound echoes-a review , 1993, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[3]  R. Begom,et al.  Prevalence of coronary artery disease and its risk factors in the urban population of South and North India. , 1995, Acta cardiologica.

[4]  R. Singh,et al.  Prevalence of coronary artery disease and coronary risk factors in rural and urban populations of north India. , 1997, European heart journal.

[5]  A. Dart,et al.  Non-invasive measurements of arterial structure and function: repeatability, interrelationships and trial sample size. , 1998, Clinical science.

[6]  M. Jensen-Urstad,et al.  Carotid artery diameter correlates with risk factors for cardiovascular disease in a population of 55-year-old subjects. , 1999, Stroke.

[7]  M L Bots,et al.  Common carotid intima-media thickness and arterial stiffness: indicators of cardiovascular risk in high-risk patients. The SMART Study (Second Manifestations of ARTerial disease). , 1999, Circulation.

[8]  R. Reneman,et al.  An integrated system for the non-invasive assessment of vessel wall and hemodynamic properties of large arteries by means of ultrasound. , 1999, European journal of ultrasound : official journal of the European Federation of Societies for Ultrasound in Medicine and Biology.

[9]  I. Kallikazaros,et al.  Carotid artery disease as a marker for the presence of severe coronary artery disease in patients evaluated for chest pain. , 1999, Stroke.

[10]  R. Reneman,et al.  Noninvasive vascular ultrasound: an asset in vascular medicine. , 2000, Cardiovascular research.

[11]  A. Hofman,et al.  Association Between Arterial Stiffness and Atherosclerosis: The Rotterdam Study , 2001, Stroke.

[12]  Sergio Shiguemi Furuie,et al.  Automatic measurement of carotid diameter and wall thickness in ultrasound images , 2002, Computers in Cardiology.

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

[14]  D. Webb,et al.  Noninvasive assessment of arterial stiffness and risk of atherosclerotic events. , 2003, Arteriosclerosis, thrombosis, and vascular biology.

[15]  D. Grobbee,et al.  Carotid Stiffness Indicates Risk of Ischemic Stroke and TIA in Patients With Internal Carotid Artery Stenosis: The SMART Study , 2004, Stroke.

[16]  G. Mancia,et al.  Arterial stiffness in heart failure patients: dependance on diastolic dysfunction and plasma aldosterone levels , 2004 .

[17]  P Tortoli,et al.  A novel ultrasound instrument for investigation of arterial mechanics. , 2004, Ultrasonics.

[18]  A. Algra,et al.  Carotid stiffness and the risk of new vascular events in patients with manifest cardiovascular disease. The SMART study. , 2005, European heart journal.

[19]  R. Reneman,et al.  Non-invasive ultrasound in arterial wall dynamics in humans: what have we learned and what remains to be solved. , 2005, European heart journal.

[20]  M. Zamir The Physics of Coronary Blood Flow , 2005 .

[21]  Zoran Bursac,et al.  Common carotid arterial interadventitial distance (diameter) as an indicator of the damaging effects of age and atherosclerosis, a cross-sectional study of the Atherosclerosis Risk in Community Cohort Limited Access Data (ARICLAD), 1987–89 , 2006, Cardiovascular ultrasound.

[22]  Zoran Bursac,et al.  Common carotid artery wall thickness and external diameter as predictors of prevalent and incident cardiac events in a large population study , 2007, Cardiovascular ultrasound.

[23]  K. S. Nikita,et al.  Automated detection of the carotid artery wall in B-mode ultrasound images using active contours initialized by the Hough transform , 2008, 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[24]  Y. Yokota,et al.  Estimation of carotid diameter with heartbeat on longitudinal B-mode ultrasonic images , 2008, 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[25]  Jayaraj Joseph,et al.  A virtual instrument for real time in vivo measurement of carotid artery compliance , 2008, 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[26]  V. J. Kumar,et al.  A PC based system for non-invasive measurement of carotid artery compliance , 2009, 2009 IEEE Instrumentation and Measurement Technology Conference.

[27]  Jayaraj Joseph,et al.  An improved echo tracking algorithm for arterial distensibility measurements , 2009, 2009 International Conference on Biomedical and Pharmaceutical Engineering.

[28]  S. Mandal,et al.  Prevalence of Ischemic Heart Disease Among Urban Population of Siliguri, West Bengal , 2009, Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine.