超音波ベースの方法を用いた心臓-頸動脈脈波伝播速度測定の新アプローチ

Currently, regional or global assessments of vessel elasticity are per-formed by measuring pulse wave velocity (PWV) along a long arterial segment. However, this method of evaluating arterial stiffness is subject to bias due to several factors, including the difficulty of accurately measuring the arterial distance. The aim of this research was: (a) to develop a non-invasive method for calculating pulse wave velocity in the heart-carotid pathway (hc-PWV) using electrocardiographic and ultrasonic im-ages; (b) to measure hc-PWV in an adult hypertensive population using this new method and compare the results with values reported in the specialized literature; and (c) to perform a cor-relation analysis between hc-PWV and heart-femoral pulse wave velocity (hf-PWV) in a pop-ulation of adult hypertensive subjects.

In this study, PWV was calculated using an image analysis technique developed in our laboratory. As an original technique, the theoretical background is first de-scribed, followed by its application in hypertensive volunteers. For each subject in the analysed population, the hc-PWV was calculated using the new technique, and the hc-PWV was meas-ured using mechanotransducers.

in the analysed cohort of hypertensive patients, values of hc-PWV (8.57 ± 0.51 m/s) were similar to those obtained in the carotid-femoral pathway (8.57 ± 0.51 m/s versus 8.19 ± 1.27 m/s; PNS). Moreover, hc-PWV in our cohort of treated hypertensive patients (8.57 ± 0.51 m/s) was higher than that reported by other authors for healthy subjects in similar territories (4.9 ± 1.1 to 8.12 ± 3.54 m/s). Furthermore, the hc-PWV values in our cohort of treated hypertensive patients (8.57 ± 0.51 m/s) were lower than those reported in older subjects with systemic hyper-tension (11.56 ± 1.74 m/s). A significant correlation was observed between the hc-PWV and cf-PWV (r=0.73, p <0.05). A regression analysis was performed, yielding a slope of 0.2903.

This work showed a novel approach to measuring heart-carotid pulse wave veloc-ity using ultrasound-based methods. In this initial exploration, our aim was not to evaluate or confirm a categorical result, but rather to highlight a trend toward a new methodology for cal-culating arterial stiffness, contrasted against previously validated standard methods.

This study confirmed that hc-PWV can be calculated non-invasively using elec-trocardiographic and ultrasonic images. The calculated hc-PWV values were in the range of those reported in the literature.