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Comparative reproducibility of the noninvasive ultrasound methods for the assessment of vascular function

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Abstract

The aim of this work was to assess the reproducibility of ultrasound parameters of vascular function, since these measurements are currently recommended by the guidelines for the evaluation of the cardiovascular risk. Twenty subjects (51 ± 17 years, 11 men) had vascular ultrasound (Aloka Prosound α10) performed by two observers, at the level of the right common carotid artery for assessment of intima-media thickness (IMT), “wall tracking”, and “wave-intensity analysis”, and at the level of the right brachial artery for the assessment of flow-mediated dilation (FMD). Wave intensity is a hemodynamic index, evaluating ventriculo-arterial interaction and can be measured in real time by a double-beam ultrasound technique through simultaneous recording of carotid arterial blood flow velocity and diameter. Carotido-femoral pulse wave velocity (PWV) was determined using the Complior method. Intra- and inter-observer reproducibility was assessed during a first session, when three consecutive acquisitions were made (first observer → second observer → first observer); repeatability was evaluated 1 week later (second observer). The most reproducible and repeatable parameters were PWV (intraobserver ±3.3%, interobserver ±2.6%, repeatability ±5.6%) and IMT (±3.7, ±4.3, ±4.9%, respectively). Intraobserver reproducibility for arterial stiffness and ventriculo-arterial coupling parameters was the highest for the beta index (±3.8%), and the lowest for the second systolic peak (±22.4%). Interobserver reproducibility and repeatability varied between very good for the wave speed (±5.5 and ±4.3%), and unsatisfactory for the negative area (±31.8 and ±38.6%). FMD had good reproducibility (intraobserver ±11.6%, interobserver ±8%, repeatability ±7%), whereas augmentation index had only satisfactory results (±17.8, ±8.4, ±23.8%, respectively). Only some parameters of vascular function have good reproducibility and repeatability, better or similar to other ultrasound methods and, therefore, these are ready to be used in routine clinical practice.

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Acknowledgments

This study was supported by two grants from the Ministry of Education from Romania (13/2005 and 135/2007).

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Authors and Affiliations

  1. University of Medicine and Pharmacy Carol Davila, Splaiul Independentei 169, 050098, Bucharest, Romania

    Andrea O. Ciobanu & Dragos Vinereanu

  2. University and Emergency Hospital, Bucharest, Romania

    Stefania L. Magda, Maria Florescu & Dragos Vinereanu

Authors
  1. Stefania L. Magda
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  2. Andrea O. Ciobanu
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  3. Maria Florescu
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  4. Dragos Vinereanu
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Corresponding author

Correspondence to Dragos Vinereanu.

Electronic supplementary material

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ESM Figure 1. Intraobserver (left panel) and interobserver (right panel) variability of intima media thickness (IMT), measured at the level of the right carotid artery. Bland–Altman analysis; the horizontal lines in the center represent the 95% confidence limits. Diff, Difference

ESM Figure 2. Intraobserver (left panel) and interobserver (right panel) variability of augmentation index (AIx), measured at the level of the right carotid artery. Bland–Altman analysis; the horizontal lines in the center represent the 95% confidence limits. Diff, Difference

ESM Figure 3. Intraobserver (left panel) and interobserver (right panel) variability of first systolic peak (FP), measured at the level of the right carotid artery. Bland–Altman analysis; the horizontal lines in the center represent the 95% confidence limits. Diff, Difference

ESM Figure 4. Intraobserver (left panel) and interobserver (right panel) variability of second systolic peak (SP), measured at the level of the right carotid artery. Bland–Altman analysis; the horizontal lines in the center represent the 95% confidence limits. Diff, Difference

ESM Figure 5. Intraobserver (left panel) and interobserver (right panel) variability of beta index, measured at the level of the right carotid artery. Bland–Altman analysis; the horizontal lines in the center represent the 95% confidence limits. Diff, Difference

ESM Figure 6. Intraobserver (left panel) and interobserver (right panel) variability of negative area (NA), measured at the level of the right carotid artery. Bland–Altman analysis; the horizontal lines in the center represent the 95% confidence limits. Diff, Difference

ESM Figure 7. Intraobserver (left panel) and interobserver (right panel) variability of Young elastic module (Ep), measured at the level of the right carotid artery. Bland–Altman analysis; the horizontal lines in the center represent the 95% confidence limits. Diff, Difference

ESM Figure 8. Intraobserver (left panel) and interobserver (right panel) variability of arterial compliance (AC), measured at the level of the right carotid artery. Bland–Altman analysis; the horizontal lines in the center represent the 95% confidence limits. Diff, Difference

ESM Figure 9. Intraobserver (left panel) and interobserver (right panel) variability of FMD, measured at the level of the right brachial artery. Bland–Altman analysis; the horizontal lines in the center represent the 95% confidence limits. Diff, Difference

ESM Figure 10. Intraobserver (left panel) and interobserver (right panel) variability of carotido-femoral pulse wave velocity (PWV), measured through Complior method. Bland–Altman analysis; the horizontal lines in the center represent the 95% confidence limits. Diff, Difference

ESM Figure 11. Repeatability of IMT (left panel) and AIx (right panel), measured at the level of the right carotid artery. Bland–Altman analysis; the horizontal lines in the center represent the 95% confidence limits. Diff, Difference

ESM Figure 12. Repeatability of first (left panel) and second systolic peak (right panel) measured at the level of the right carotid artery. Bland–Altman analysis; the horizontal lines in the center represent the 95% confidence limits. Diff, Difference

ESM Figure 13. Repeatability of beta index (left panel) and Young elastic module (right panel) measured at the level of the right carotid artery. Bland–Altman analysis; the horizontal lines in the center represent the 95% confidence limits. Diff, Difference

ESM Figure 14. Repeatability of negative area (left panel) and arterial compliance (right panel) measured at the level of the right carotid artery. Bland–Altman analysis; the horizontal lines in the center represent the 95% confidence limits. Diff, Difference

ESM Figure 15. Repeatability of FMD (left panel) and carotido-femoral PWV (right panel). Bland–Altman analysis; the horizontal lines in the center represent the 95% confidence limits. Diff, Difference

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Magda, S.L., Ciobanu, A.O., Florescu, M. et al. Comparative reproducibility of the noninvasive ultrasound methods for the assessment of vascular function. Heart Vessels 28, 143–150 (2013). https://doi.org/10.1007/s00380-011-0225-2

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