Brachial artery vasodilatory response and wall shear rate determined by multigate Doppler in a healthy young cohort
Brachial artery vasodilatory response and wall shear rate determined by multigate Doppler in a healthy young cohort
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DOI：
10.1152/japplphysiol.00310.2017
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发表时间：
2018-01-01
影响因子：
3.3
通讯作者：
Palombo, Carlo
中科院分区：
文献类型：
--
作者：
Aizawa, Kunihiko;Sbragi, Sara;Palombo, Carlo
壁剪切率（WSR）是肱动脉血流介导扩张（FMD）反应的重要刺激因素。然而，常规多普勒估计动脉壁附近的WSR本身就很困难。为了克服这一限制，我们利用多门多普勒技术，利用集成的FMD系统[超声先进开放平台（ULA-OP）]，在FMD响应的同时，准确地确定血管壁附近的WSR刺激。利用该系统，我们旨在对健康年轻人群的WSR- fmd反应进行详细分析，并建立新的WSR参数。分析了33名年轻健康个体（27.5±4.9岁，19名女性）的数据。用ULAOP评价口蹄疫反应性充血。所有采集的原始数据使用定制的软件进行后处理，得到WSR和直径参数。获得的速度数据显示，在心脏周期内和不同血流状态下，非抛物型血流分布具有异质性。我们还确定了七个WSR震级和四个WSR时程参数。其中，曲线下直至恢复基线的WSR面积是反应性充血的绝对（R-2 = 0.25）和百分比（R-2 = 0.31）直径变化的最强预测因子。我们首次在我们的队列中发现了单相和双相的WSR刺激模式，它们产生了不同程度的FMD反应[绝对直径变化：0.24 +/- 0.10 mm（单相）vs. 0.17 +/- 0.09 mm（双相），P < 0.05]。我们得出结论，准确和详细地测量WSR刺激对于全面了解FMD反应是重要的，并且当前FMD技术的这一进展可能对更好地了解血管生理和病理具有重要意义。新的和值得注意的是，通过传统的多普勒超声估计动脉壁附近的壁剪切率（WSR）本身就是困难的。使用最近开发的综合血流介导扩张超声系统，我们能够准确地估计血管壁附近的WSR，并确定了一些新的WSR变量，这些变量可能在测量内皮功能（血管生理学和疾病的重要生物标志物）方面有用。
Wall shear rate (WSR) is an important stimulus for the brachial artery flow-mediated dilation (FMD) response. However, WSR estimation near the arterial wall by conventional Doppler is inherently difficult. To overcome this limitation, we utilized multigate Doppler to accurately determine the WSR stimulus near the vessel wall simultaneously with the FMD response using an integrated FMD system [Ultrasound Advanced Open Platform (ULA-OP)]. Using the system, we aimed to perform a detailed analysis of WSR-FMD response and establish novel WSR parameters in a healthy young population. Data from 33 young healthy individuals (27.5 +/- 4.9 yr, 19 females) were analyzed. FMD was assessed with reactive hyperemia using ULAOP. All acquired raw data were postprocessed using customdesigned software to obtain WSR and diameter parameters. The acquired velocity data revealed that nonparabolic flow profiles within the cardiac cycle and under different flow states, with heterogeneity between participants. We also identified seven WSR magnitude and four WSR time-course parameters. Among them, WSR area under the curve until its return to baseline was the strongest predictor of the absolute (R-2 = 0.25) and percent (R-2 = 0.31) diameter changes in response to reactive hyperemia. For the first time, we identified mono-and biphasic WSR stimulus patterns within our cohort that produced different magnitudes of FMD response [absolute diameter change: 0.24 +/- 0.10 mm (monophasic) vs. 0.17 +/- 0.09 mm (biphasic), P < 0.05]. We concluded that accurate and detailed measurement of the WSR stimulus is important to comprehensively understand the FMD response and that this advance in current FMD technology could be important to better understand vascular physiology and pathology.NEW & NOTEWORTHY An estimation of wall shear rate (WSR) near the arterial wall by conventional Doppler ultrasound is inherently difficult. Using a recently developed integrated flow-mediated dilation ultrasound system, we were able to accurately estimate WSR near the wall and identified a number of novel WSR variables that may prove to be useful in the measurement of endothelial function, an important biomarker of vascular physiology and disease.