Assessment of local pulse wave velocity in arteries using 2D distension waveforms

Abstract

The reciprocal of the arterial pulse wave velocity contains crucial information about the mechanical characteristics of the arterial wall but is difficult to assess noninvasively in vivo. In this paper, a new method to assess local pulse wave velocity (PWV) is presented. To this end, multiple adjacent distension waveforms are determined simultaneously along a short arterial segment, using a single 2D-vessel wall tracking system with a high frame rate (651 Hz). Each B-mode image consists of 16 echo lines spanning a total width of 15.86 mm. Dedicated software has been developed to extract the end-diastolic diameter from the B-mode image and the distension waveforms from the underlying radio frequency (rf) information for each echo-line. The PWV is obtained by determining the ratio of the temporal and spatial gradient of adjacent distension velocity waveforms. The proposed method is verified in a phantom and in the common carotid artery (CCA) of humans. Phantom experiments show a high concordance between the PWV obtained from 2D distension velocity waveforms (4.21 ± 0.02 m/s) and the PWV determined using two pressure catheters (4.26 ± 0.02 m/s). Assuming linear spatial gradients, the PWV can also be obtained in vivo for CCA and averages to 5.5 ± 1.5 m/s (intersubject variation, n = 23), which compares well to values found in literature. Furthermore, intrasubject PWV compares well with those calculated using the Bramwell-Hill equation. It can be concluded that the PWV can be obtained from the spatial and temporal gradient if the spatial gradient is linear over the observed length of the artery, i.e. the artery should be homogenous in diameter and distension and the influence of reflections must be small.