Assessment of arterial stiffness in hemodialysis patients, using speckle tracking carotid strain ultrasonography

Assessment of arterial stiffness in hemodialysis patients, using speckle tracking carotid strain ultrasonography

REVIEWED BY Matt Adams | ASA SIG: Vascular

REFERENCE | Authors: Mustafa Gök, Hakan Akdam, Zeynep Gürlek Akol, Göksel Tuzcu, Yavuz Yeniçerioğlu

WHY THE STUDY WAS PERFORMED

There is existing evidence that atherosclerotic disease in the carotid arteries and increased arterial stiffness are both markers for cardiovascular (CV) risk. Arterial stiffness, which is a pathological, functional change to the artery that precedes plaque formation, can be reliably quantified by an emerging function of standard ultrasound called speckle tracking. This study was performed to see if a subclinical level of CV risk could be detected amongst end stage renal disease (ESRD) patients using carotid artery speckle tracking due to the increased incidence of CV death in this patient demographic.

HOW THE STUDY WAS PERFORMED

One hundred subjects split up into 50 healthy controls and 50 ESRD patients had carotid artery carotid ultrasound with speckle tracking between April 2021 – May 2022. Groups were matched for age, gender and body mass index and those with a history of significant carotid disease were excluded. Carotid artery stiffness measurements were automated using Samsung ultrasound systems on a segment of the common carotid artery (CCA) 5–10 mm beneath carotid bulb and was successfully performed on all participants.

Arterial stiffness was broken down into 7 different parameters: arterial compliance, arterial distensibility, pulse wave velocity, elastic modulus, displacement, strain and strain rate – all of which were measured in both longitudinal and axial planes.

“Measurement of arterial stiffness and strain parameters with the STCS technique helps in the early detection of potential cardiovascular incidents.”

WHAT THE STUDY FOUND

A significant difference was observed between the study and control groups across all study parameters in both imaging planes with the exception of arterial compliance. This observable difference between the two groups corresponds to the vascular remodelling that occurs in ESRD patients as a result of vessel calcification, inflammation and increased collagen deposition.

RELEVANCE TO CLINICAL PRACTICE

The findings of this study demonstrate the potential for speckle tracking of carotid strain to be used as a clinical tool in the evaluation of CV risk. Speckle tracking is a largely automated function of standard ultrasound that requires basic training to perform, which may lend itself well to future CV screening programs.