title: Usefulness of vascular wall deformation for assessment of carotid arterial stiffness and association with previous stroke in elderly.
abstract: BACKGROUND
  Carotid arterial stiffness measured by techniques of speckle tracking echocardiography is helpful to assess vascular wall deformation. We conducted a study to investigate the relationship between vascular deformation of the carotid artery and ischemic stroke in the elderly.
  
  
  METHODS
  We recruited 89 consecutive individuals aged ≥60 years (mean age = 72±6 years; 31 men) from a community health survey program. Ten (11%) had a history of ischemic stroke. Carotid B-mode images were acquired using a high-resolution vascular probe equipped on an echocardiographic system. Circumferential strain (CS) and strain rate (CSR) were obtained by speckle tracking techniques with a region of interest covering the entire depth of the common carotid arterial wall.
  
  
  RESULTS
  Both CS and CSR were significantly correlated with beta index and distensibility but not with carotid intima-medial thickness and pulse wave velocity. In the comparison between patients with or without history of stroke, carotid CS (1.46% ± 0.54% vs. 2.75% ± 1.23%; P = 0.002) and CSR (0.30±0.13 1/s vs. 0.47±0.18 1/s; P = 0.007) were significantly lower in patients with stroke. Multivariable analysis showed that both carotid CS and CSR were independent factors associated with previous strokes.
  
  
  CONCLUSIONS
  Carotid wall deformation indices are useful for assessment of local carotid arterial stiffness. CS and CSR of carotid artery measured by speckle tracking techniques were associated with previous ischemic stroke in the elderly.
authors.affiliation: Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan. wctsai@seed.net.tw
authors.forename: Wei-Chuan
authors.initials: WC
authors.lastname: Tsai
authors.forename: Yuan-Ting
authors.initials: YT
authors.lastname: Sun
authors.forename: Yen-Wen
authors.initials: YW
authors.lastname: Liu
authors.forename: Chin-Shan
authors.initials: CS
authors.lastname: Ho
authors.forename: Ju-Yi
authors.initials: JY
authors.lastname: Chen
authors.forename: Ming-Chen
authors.initials: MC
authors.lastname: Wang
authors.forename: Liang-Miin
authors.initials: LM
authors.lastname: Tsai
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D059289:Vascular Stiffness
keywords: arterial stiffness; blood pressure; carotid artery; carotid ultrasound; cerebrovascular accident; hypertension.