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Application of speckle-tracking in the evaluation of carotid artery function in subjects with hypertension and diabetes.

Yang EY, Brunner G, Dokainish H, Hartley CJ, Taffet G, Lakkis N, Taylor AA, Misra A, McCulloch ML, Morrisett JD, Virani SS, Ballantyne CM, Nagueh SF, Nambi V. Application of speckle-tracking in the evaluation of carotid artery function in subjects with hypertension and diabetes. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography. 2013 Aug 1; 26(8):901-909.e1.

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BACKGROUND: Speckle-tracking enables direct tracking of carotid arterial wall motion. Timing intervals determined with carotid speckle-tracking and slopes calculated from carotid artery area versus cardiac cycle curves may provide further information on arterial function and stiffness. The proposed arterial stiffness parameters were examined in healthy controls (n  = 20), nondiabetic patients with hypertension (n  = 20), and patients with type 2 diabetes (n  = 21). METHODS: Bilateral electrocardiographically gated ultrasonograms of the distal common carotid artery were acquired using a 12-MHz vascular probe. Four timing intervals were derived from speckle-tracked carotid arterial strain curves: (1) carotid predistension period, (2) peak carotid arterial strain time, (3) arterial distension period, and (4) arterial diastolic time. In addition, carotid artery area curves were recorded over the cardiac cycle and subdivided into four segments, S1 to S4, relating to arterial distention and contraction periods. RESULTS: Mean far wall predistension period and peak carotid arterial strain time were more delayed in patients with diabetes and hypertension than in controls. Global mean arterial distension period was prolonged and arterial diastolic time was shorter in patients with hypertension and diabetes than in controls. Slopes of segments S2 and S4 were markedly steeper in the combined group of patients with hypertension and diabetes compared with healthy controls (P  = .03 and P  = .02, respectively). CONCLUSIONS: Speckle-tracking-based measures of arterial stiffness may provide potential additive value in assessing vascular function in patients at risk for cardiovascular disease.

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