In vivo vascular wall tissue characterization using a strain tensor measuring (STM) technique for flow-mediated vasodilation analyses.
Endothelial dysfunction is considered to be a key factor in the development of atherosclerosis, and the measurement of flow-mediated vasodilation (FMD) in brachial and other conduit arteries has become a common method to assess the status of endothelial function in vivo. Based on the direct relationship between the FMD response and local shear stress on the conduit brachial artery endothelium, we hypothesize that measuring relevant changes in the brachial wall strain tensor would provide a non-invasive tool for assessing vascular mechanics during post-occlusion reactive hyperemia. Direct measurement of the wall strain tensor due to FMD has not yet been reported in the literature. In this work, a noninvasive direct ultrasound-based strain tensor measuring (STM) technique is presented to assess changes in the mechanical parameters of the vascular wall during post-occlusion reactive hyperemia and/or FMD, including local velocities and displacements, diameter change, local strain tensor and strain rates. The STM technique utilizes sequences of B-mode ultrasound images as its input with no extra hardware requirement, and its algorithm starts with segmenting a region of interest within the artery and providing the acquisition parameters. Then a block matching technique based on speckle tracking is employed to measure the frame-to-frame local velocities. Displacements, diameter change, local strain tensor and strain rates are then calculated by integrating or differentiating velocity components. The accuracy of the STM algorithm was assessed in vitro using phantom studies, where an average error of 7% was reported using different displacement ranging from 100 microm to 1000 microm. Furthermore, in vivo studies using human subjects were performed to test the STM algorithm during pre- and post-occlusion. Good correlations (|r| >0.5, P < 0.05) were found between the post-occlusion responses of diameter change and local wall strains. Results indicate the validity and versatility of the STM algorithm and describe how parameters other than the diameter change are sensitive to reactive hyperemia following occlusion. This work suggests that parameters such as local strains and strain rates within the arterial wall are promising metrics for the assessment of endothelial function, which can then be used for accurate assessment of atherosclerosis. In summary, this study describes a simple and computationally efficient algorithm that can be integrated with ultrasound machines for vascular research. Moreover, it suggests that monitoring the local strain and strain rates of the brachial artery wall can replace or augment the measurement of arterial diameter in FMD studies.
Department of Mechanical and Aerospace Engineering, West Virginia University, Morgantown, WV 26506, USA.
Ahmed M
AM
Mahmoud
Jefferson C
JC
Frisbee
Alexandre
A
D'Audiffret
Osama M
OM
Mukdadi
D000328:Adult; D000465:Algorithms; D050197:Atherosclerosis; D001331:Automation; D001916:Brachial Artery / Q000473:pathology; D002318:Cardiovascular Diseases / Q000473:pathology; D004730:Endothelium, Vascular / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D006940:Hyperemia / Q000473:pathology; D008297:Male; D019047:Phantoms, Imaging; D015203:Reproducibility of Results; D013314:Stress, Mechanical; D014664:Vasodilation / Q000187:drug effects*