Background Maintenance hemodialysis (MHD) is the most important treatment for end stage renal disease (ESRD) patients. And cardiovascular disease is the main cause of death in maintenance hemodialysis patients, which is closely related to atherosclerosis. It has important clinical significance for detecting and preventing atherosclerosis early.
Objective To explore the clinical value of velocity vector imaging (VVI) in evaluating carotid artery elasticity in maintenance hemodialysis patients.
Methods Patients with maintenance hemodialysis (MHD) treated in the blood purification center of the Affiliated Hospital of Southwest Medical University from May to December in 2019 were enrolled. The patients were divided into CAP group and non-CAP group according to carotid artery plaque. And another 30 subjects without carotid artery plaque were severed as controls. Intima-media thickness (IMT) of carotid artery in each group was measured by conventional ultrasound. The systolic peak circumferential strain (CS), circumferential strain rate (CSR) and vascular area change rate (ΔS) of common carotid artery were obtained by VVI technique. CS was adjusted for pulse pressure (CS/PP). Statistical analysis was performed on each parameter.
Results There were 86 cases in the MHD group and 30 cases in the control group, and the MHD group was divided into the CAP group (n=30) and the non-CAP group (n=56). No significant difference was found in gender, age, BMI, and LDL-C between the three groups (P＞0.05). CS, CSR, ΔS and CS/PP of the CAP group were significantly lower than those of the non-CAP group and the control group (P＜0.01), and they were lower in the non-CAP group than in the control group (P＜0.05). IMT was negatively correlated with ΔS, CS, CSR, CS/PP (r=-0.395, -0.321, -0.341 and -0.461, respectively, P＜0.001). By the receiver operating characteristic curve (ROC) analysis, the area under the curve were 0.704, 0.669, 0.682 and 0.757 for ΔS, CS, CSR and CS/PP to predict the formation of carotid atherosclerotic plaque (all P＜0.05), and CS/PP had relatively high diagnostic value.
Conclusion VVI can evaluate the carotid elasticity changes of maintenance hemodialysis patients effectively, which suggests that it can find carotid atherosclerosis in maintenance hemodialysis patients in early stage.
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