A Review on Atherosclerotic Biology, Wall Stiffness, Physics of Elasticity, and Its Ultrasound-Based Measurement | springermedizin.de

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Current Atherosclerosis Reports

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01.12.2016 | Vascular Biology (J. Hamilton, Section Editor)

A Review on Atherosclerotic Biology, Wall Stiffness, Physics of Elasticity, and Its Ultrasound-Based Measurement

verfasst von: Anoop K. Patel, Harman S. Suri, Jaskaran Singh, Dinesh Kumar, Shoaib Shafique, Andrew Nicolaides, Sanjay K. Jain, Luca Saba, Ajay Gupta, John R. Laird, Argiris Giannopoulos, Jasjit S. Suri

Erschienen in: Current Atherosclerosis Reports | Ausgabe 12/2016

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Abstract

Functional and structural changes in the common carotid artery are biomarkers for cardiovascular risk. Current methods for measuring functional changes include pulse wave velocity, compliance, distensibility, strain, stress, stiffness, and elasticity derived from arterial waveforms. The review is focused on the ultrasound-based carotid artery elasticity and stiffness measurements covering the physics of elasticity and linking it to biological evolution of arterial stiffness. The paper also presents evolution of plaque with a focus on the pathophysiologic cascade leading to arterial hardening. Using the concept of strain, and image-based elasticity, the paper then reviews the lumen diameter and carotid intima-media thickness measurements in combined temporal and spatial domains. Finally, the review presents the factors which influence the understanding of atherosclerotic disease formation and cardiovascular risk including arterial stiffness, tissue morphological characteristics, and image-based elasticity measurement.

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1.

Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2015 update: a report from the American Heart Association. Circulation. 2015;131:29–322.CrossRef

2.

Pagidipati NJ, Gaziano TA. Estimating deaths from cardiovascular disease: a review of global methodologies of mortality measurement. Circulation. 2013;127:749–56.CrossRefPubMedPubMedCentral

3.

Schmidt R, Lauter J. MyHeart: fighting cardio-vascular diseases by preventive lifestyle and early diagnosis. Stud Health Technol Inform. 2005;117:51–9.PubMed

4.

Suri JS, Kathuria C, Molinari F. Atherosclerosis disease management. Springer; 2011

5.

• Boesen ME, Singh D, Menon BK, Frayne R. A systematic literature review of the effect of carotid atherosclerosis on local vessel stiffness and elasticity. Atherosclerosis. 2015;243:211–22. This article exhibits the effect of carotid atherosclerotic plaque on local arterial stiffness.

6.

Gamble G, Zorn J, Sanders G, MacMahon S, Sharpe N. Estimation of arterial stiffness, compliance, and distensibility from M-mode ultrasound measurements of the common carotid artery. Stroke. 1994;25:11–6.CrossRefPubMed

7.

Lechareas S, Yanni A, Golemati S, Chatziioannou A, Perrea D. Ultrasound and biochemical diagnostic tools for the characterization of vulnerable carotid atherosclerotic plaque. Ultrasound Med Biol. 2015;42:31–43.CrossRefPubMed

8.

Yuan LJ, Xue D, Duan YY, Coa TS, Yang HG, Zhou N. Carotid arterial intima–media thickness and arterial stiffness in pre-eclampsia: analysis with a radiofrequency Ultrasound technique. Ultrasound Obstet Gynecol. 2013;42:644–52.CrossRefPubMed

9.

Zhang L, Yin JK, Duan YY, Liu X, Xu L, Wang J, et al. Evaluation of carotid artery elasticity changes in patients with type 2 diabetes. Cardiovasc Diabetol. 2014;13:1–10.CrossRef

10.

Bianchini E, Gemignani V, Faita F, Giannarelli C, Ghiadoni L, Demi M, et al. Assessment of carotid stiffness and intima-media thickness from ultrasound data: comparison between two methods. J Ultrasound Med. 2010;29:1169–75.PubMed

11.

Blacher J, Asmar R, Djane S, London GM, Safar ME. Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients. Hypertension. 1999;33:1111–7.CrossRefPubMed

12.

Mattace-Raso FUS, van der Cammen TJM, Hofman A, van Popele NM, Bos ML, Schalekamp MADH, et al. Arterial stiffness and risk of coronary heart disease and stroke: the Rotterdam study. Circulation. 2006;113:657–63.CrossRefPubMed

13.

Greenwald SE. Pulse pressure and arterial elasticity. Q J Med. 2002;95:107–12.CrossRef

14.

Antonini-Canterin F, Roşca M, Beladan CC, Popescu BA, Piazza R, Leiballi E, et al. Echo-tracking assessment of carotid artery stiffness in patients with aortic valve stenosis. Echocardiography. 2009;26:823–31.CrossRefPubMed

15.

Gimbrone Jr MA, Cybulsky MI, Kume N, Collins T, Resnick N. Vascular endothelium: an integrator of pathophysiological stimuli in atherogenesis. Ann N Y Acad Sci. 1995;748:122–31.CrossRefPubMed

16.

Hansson GK, Libby P, Tabas I. Inflammation and plaque vulnerability. J Intern Med. 2015;278:483–93.CrossRefPubMedPubMedCentral

17.

Ross R. Cell Biology of atherosclerosis. Annu Rev Physiol. 1995;57:791–804.CrossRefPubMed

18.

Tabas I, Williams KJ, Borén J. Subendothelial lipoprotein retention as the initiating process in atherosclerosis: update and therapeutic implications. Circulation. 2007;116:1832–44.CrossRefPubMed

19.

Luthra K, Mishra A, Srivastava LM. Lipoprotein(a): biology and role in atherosclerotic vascular diseases. Curr Sci. 1999;76:1553–60.

20.

•• Libby P, Ridker PM PM, Hansson GK. Progress and challenges in translating the biology of atherosclerosis. Nature. 2011;473:317–25. This article discusses the pathophysiological formation of the atherosclerotic plaque.

21.

Raines EW, Ferri N. Thematic review series: the immune system and atherogenesis, cytokines affecting endothelial and smooth muscle cells in vascular disease. J Lipid Res. 2005;46:1081–92.CrossRefPubMed

22.

Arroyo LH, Lee RT. Mechanisms of plaque rupture: mechanical and biologic interactions. Cardiovasc Res. 1999;41:369–75.CrossRefPubMed

23.

Teng Z, Zhang Y, Huang Y, Feng J, Yuan J, Lu Q, et al. Material properties of components in human carotid atherosclerotic plaques: a uniaxial extension study. Acta Biomater. 2014;10:5055–63.CrossRefPubMedPubMedCentral

24.

Cohn JN, Colucci W. Cardiovascular effects of aldosterone and post-acute myocardial infarction pathophysiology. Am J Cardiol. 2006;97:4–12.CrossRef

25.

Tracqui P, Broisat A, Toczek J, Mesnier N, Ohayon J, Riou L. Mapping elasticity moduli of atherosclerotic plaque in situ via atomic force microscopy. J Struct Biol. 2011;174:115–23.CrossRefPubMed

26.

Geng YJ, Libby P. Evidence for apoptosis in advanced human atheroma: co-localization with interleukin-1-converting enzyme. Am J Pathol. 1995;147:251–66.PubMedPubMedCentral

27.

Isner JM, Kearney M, Bortman S, Passeri J. Apoptosis in human atherosclerosis and restenosis. Circulation. 1995;91:2703–11.CrossRefPubMed

28.

Geng YJ, Wu Q, Muszynski M, Libby P. Apoptosis of vascular smooth muscle cells induced by in vitro stimulation with interferon-gamma, tumor necrosis factor-alpha, and interleukin-1-beta. Arterioscler Thromb Vasc Biol. 1996;16:19–27.CrossRefPubMed

29.

Bruel A, Oxlund H. Changes in biomechanical properties, composition of collagen and elastin, and advanced glycation endproducts of the rat aorta in relation to age. Atherosclerosis. 1996;127:155–65.CrossRefPubMed

30.

Cheung YF, Wong SJ, Ho MH. Relationship between carotid intima-media thickness and arterial stiffness in children after Kawasaki disease. Arch Dis Child. 2007;92:43–7.CrossRefPubMed

31.

Cheung YF, Chow PC, Chan GC, Ha SY. Carotid intima media thickness is increased and related to arterial stiffening in patients with beta-thalassaemiamajor. Br J Haematol. 2006;135:732–34.CrossRefPubMed

32.

Zhang L, Yin JK, Duan YY, Liu X, Xu L, Wang J, et al. Evaluation of carotid artery elasticity changes in patients with type 2 diabetes. Cardiovasc Diabetol. 2014. doi:10.1186/1475-2840-13-39.

33.

•• Selzer RH, Mack WJ, Lee PL, Kwong-Fu H, Hodis HN. Improved common carotid elasticity and intima-media thickness measurements from computer analysis of sequential ultrasound frames. Atherosclerosis. 2011;154:185–93. The article uses computerized edge tracking method for carotid arterial diameter and carotid intima-media thickness measurement in multiple frames of the cardiac cycle.

34.

Avolio AP, Chen SG, Wang RP, Zhang CL, Li MF, O’Rourke MF. Effects of aging on changing arterial compliance and left ventricular load in a northern Chinese urban community. Circulation. 1983;68:50–8.CrossRefPubMed

35.

Huang X, Kang X, Xue J, Kang C, Lv H, Li Z. Evaluation of carotid artery elasticity changes in patients with cerebral small vessel disease. Int J Clin Exp Med. 2015;8:18825–30.PubMedPubMedCentral

36.

Laurent S, Katsahian S, Fassot C, Tropeano AI, Gautier I, Laloux B, et al. Aortic stiffness is an independent predictor of fatal stroke in essential hypertension. Stroke. 2003;34:1203–6.CrossRefPubMed

37.

Callaghan FJ, Geddes LA, Babba CF, Bourland JD. Relationship between pulse-wave velocity and arterial elasticity. Med Biol Eng Comput. 1986;24:248–54.CrossRefPubMed

38.

Soleimani E, Mokhtari-Dizaji M, Saberi H. A novel non-invasive ultrasonic method to assess total axial stress of the common carotid wall in healthy and atherosclerotic men. J Biomech. 2015;48:1860–7.CrossRefPubMed

39.

Meaume S, Benetos A, Henry OF. Aortic pulse wave velocity predicts cardiovascular mortality in subjects >70 years of age. Arterioscler Thromb Vasc Biol. 2001;21:2046–50.CrossRefPubMed

40.

Farrar DJ, Green HD, Bond MG, Wagner WD, Gobbeé RA. Aortic pulse wave velocity, elasticity, and composition in a nonhuman primate model of atherosclerosis. Circ Res. 1978;43:52–62.CrossRefPubMed

41.

Cinthio M, Ahlgren AR, Bergkvist J, Jansson T, Persson HW, Lindström K. Longitudinal movements and resulting shear strain of the arterial wall. Am J Physiol Heart Circ Physiol. 2006;291:394–402.CrossRef

42.

Svedlund S, Gan LM. Longitudinal wall motion of the common carotid artery can be assessed by velocity vector imaging. Clin Physiol Funct Imaging. 2011;31:32–8.CrossRefPubMedPubMedCentral

43.

Oates CP, Naylor AR, Hartshorne T, Charles SM, Fail T, Humphries K, et al. Joint recommendations for reporting carotid ultrasound investigations in the United Kingdom. Eur J Vasc Endovasc Surg. 2009;37:251–61.CrossRefPubMed

44.

Wong CB, Wong JC. A novel method to quantify carotid artery stenosis by Doppler ultrasound: Using the continuity principle. Int J Angiol. 2010;19:86–90.CrossRef

45.

Shapiro GL, Stockman CG. Computer Vision. 1^st ed. Pearson; 2000.

46.

Destrempes F, Meunier J, Giroux MF, Soulez G, Cloutier G. Segmentation in ultrasonic B-mode images of healthy carotid arteries using mixtures of nakagami distributions and stochastic optimization. IEEE Trans Med Imaging. 2009;28:215–29.CrossRefPubMed

47.

Haas C, Ermert H, Holt S, Grewe P, Machraoui A, Barmeyer J. Segmentation of 3-D intravascular ultrasonic images based on a random field model. Ultrasound Med Biol. 2000;26:297–306.CrossRefPubMed

48.

Francois O. Global optimization with exploration/selection algorithms and simulated annealing. Ann Appl Probab. 2002;12:248–71.CrossRef

49.

Molinari F, Zeng G, Suri JS. An integrated approach to computer-based automated tracing and its validation for 200 common carotid arterial wall ultrasound images: a new technique. J Ultrasound Med. 2010;29:399–418.PubMed

50.

Seabra JC, Ciompi F, Pujol O, Mauri J, Radeva P, Sanches J. Rayleigh mixture model for plaque characterization in intravascular ultrasound. IEEE Trans Biomed Eng. 2011;58:1314–24.CrossRefPubMed

51.

Menchon-Lara RM, Bastida-Jumilla MC, Morales-Sanchez J, Sancho-Gomez JL. Automatic detection of the intima-media thickness in ultrasound images of the common carotid artery using neural networks. Med Biol Eng Comput. 2014;52:169–81.CrossRefPubMed

52.

Carvalho DDB, Akkus Z, Van den Oord SCH, Schinkel AFL, Van der Steen AFW, Niessen WJ, et al. Lumen segmentation and motion estimation in B-mode and contrast-enhanced ultrasound images of the carotid artery in patients with atherosclerotic plaque. IEEE Trans Med Imaging. 2015;34:883–93.CrossRef

53.

Jayaram S, Esakkirajan S, Veerakumar T. Digital image processing. 1^st ed. Tata McGraw-Hill Education; 2009.

54.

Kass M, Witkin A, Terzopoulos D. Snakes: active contours models. Int J Comput Vis. 1988;4:321–31.CrossRef

55.

Suri JS, Farah A. Deformable models volumes I and II: biomedical and clinical applications (Topics in biomedical engineering). 1^st ed. Springer; 2007.

56.

Loizou CP, Pattichis CS, Pantziaris M, Tyllis T, Nicolaides A. Snakes based segmentation of the common carotid artery intima media. Med Biol Eng Comput. 2007;45:35–49.CrossRefPubMed

57.

Molinari F, Meiburger KM, Zeng G, Nicolaides A, Suri JS. CAUDLES-EF: carotid automated ultrasound double line extraction system using edge flow. J Digit Imaging. 2011;24:1059–77.CrossRefPubMedPubMedCentral

58.

Golemati S, Stoitsis J, Sifakis EG, Balkizas T, Nikita KS. Using the Hough transform to segment ultrasound images of longitudinal and transverse sections of the carotid artery. Ultrasound Med Biol. 2007;33:918–32.CrossRef

59.

Liang Q, Wendelhag I, Wikstrand J, Gustavsson T. A multiscale dynamic programming procedure for boundary detection in ultrasonic artery images. IEEE Trans Med Imaging. 2000;19:127–42.CrossRefPubMed

60.

Meiburger KM, Molinari F, Acharya UR, Saba L, Rodrigues P, Liboni W, et al. Automated carotid artery intima layer regional segmentation. Phys Med Biol. 2011;56:4073–90.CrossRefPubMed

61.

Ilea DE, Duffy C, Kavanagh L, Stanton A, Whelan PF. Fully automated segmentation and tracking of the intima media thickness in ultrasound video sequences of the common carotid artery. IEEE Trans Ultrason Ferroelectr Freq Control. 2013;60:158–77.CrossRefPubMed

62.

Kanber B, Ramnarine KV. A probabilistic approach to computerized tracking of arterial walls in ultrasound image sequences. Int Sch Res Netw (ISRN). 2012. doi:10.5402/2012/179087.

63.

Chen Y, Peng B, Liu DC. Fully automated intima media thickness measurement of posterior wall in longitudinal ultrasound B-mode scans. Int J Signal Process Image Process Pattern Recog. 2014;7:9–18.

64.

Touboul PJ, Prati P, Scarabin PY, Adrai V, Thibout E, Ducimetiere P. Use of monitoring software to improve the measurement of carotid wall thickness by B-mode imaging. J Hypertens. 1992;10:37–41.CrossRef

65.

Molinari F, Meiburger KM, Zeng G, Acharya UR, Liboni W, Nicolaides A, et al. Carotid artery recognition system: a comparison of three automated paradigms for ultrasound images. Med Phys. 2012;39:378–91.CrossRefPubMed

66.

• Molinari F, Zeng G, Suri JS. A state of the art review on intima-media thickness (IMT) measurement and wall segmentation techniques for carotid ultrasound. Comput Methods Prog Biomed. 2010;100:201–21. The paper presents review different methods for lumen-intima and mediaadventitia boundary segmentation techniques such as: dynamic programming, local statistics, edge-detection, active contours, statistical modelling, Hough transform, and hybrid techniques. It also discusses about carotid IMT measurement techniques.

67.

Meiburger KM, Molinari F, Zeng G, Saba L, Suri JS. Carotid automated ultrasound double line extraction system (CADLES) via Edge-Flow. Conf Proc IEEE Eng Med Biol Soc. 2011. doi:10.1109/IEMBS.2011.6090107.

68.

Suri JS. Computer vision, pattern recognition and image processing in left ventricle segmentation: the last 50 years. Pattern Anal Applic. 2000;3:209–42.CrossRef

69.

El-Baz A, Gimel’farb D, Suri JS. Stochastic modeling for medical image analysis. 1^st ed. CRC Press; 2015.

70.

Molinari F, Meiburger KM, Acharya UR, Zeng G, Rodrigues PS, Saba L, et al. CARES 3.0: a two stage system combining feature-based recognition and edge-based segmentation for CIMT measurement on a multi-instititional ultrasound database of 300 images. Conf Proc IEEE Eng Med Biol Soc. 2011. doi:10.1109/IEMBS.2011.6091275.

71.

Hassan M, Chaudhry A, Khan A, Iftikhar MA. Robust information gain based fuzzy c-means clustering and classification of carotid artery ultrasound images. Comput Methods Prog Biomed. 2014;113:593–609.CrossRef

72.

Rocha R, Campilho A, Silva J, Azevedo E, Santos R. Segmentation of ultrasound images of the carotid using RANSAC and cubic splines. Comput Methods Prog Biomed. 2011;101:94–106.CrossRef

73.

Yamagishi T, Kato M, Koiwa Y, Hasegawa H, Kanai H. Impact of lifestyle-related diseases on carotid arterial wall elasticity as evaluated by an ultrasonic phased-tracking method in Japanese subjects. J Med Ultrason. 2009;16:782–92.

74.

Araki T, Ikeda N, Dey N, Chakraborty S, Saba L, Kumar D, et al. A comparative approach of four different image registration techniques for quantitative assessment of coronaryartery calcium lesions using intravascular ultrasound. Comput Methods Prog Biomed. 2015;118:158–72.CrossRef

75.

Zhang P, Guo R, Xiao D, Chu S, Gong L, Zhang C, et al. Influence of smoking cessation on carotid artery wall elasticity evaluated by echo-tracking. J Clin Ultrasound. 2012;40:352–6.CrossRefPubMed

76.

Apostolakis IZ, Gastounioti A, Golemati S, Nikita KS. Ultrasound-image-based displacement and strain maps of the human carotid artery using weighted-least-squares optical flow. IEEE Int Conf Imaging Syst Tech (IST). 2012. doi:10.1109/IST.2012.6295565.

77.

Saba L, Molinari F, Meiburger KM, Piga M, Zeng G, Rajendra Achraya U, et al. What is the correct distance measurement metric when measuring carotid ultrasound intima-media thickness automatically? Int Angiol. 2012;31:483–9.PubMed

78.

Molinari F, Meiburger KM, Zeng G, Saba L, Rajendra Acharya U, Famiglietti L, et al. Automated carotid IMT measurement and its validation in low contrast ultrasound database of 885 patient Indian population epidemiological study: results of AtheroEdge™ Software. Int Angiol. 2012;31:42–53.PubMedPubMedCentral

79.

Huttenlocher DP, Klanderman GA, Rucklidge WJ. Comparing images using the Hausdorff distance. IEEE Trans Pattern Anal Mach Intell. 1993;15:850–63.CrossRef

80.

Thacher T, Gambillara V, da Silva RF, Silacci P, Stergiopulos N. Reduced cyclic stretch, endothelial dysfunction, and oxidative stress: an ex vivo model. Cardiovasc Pathol. 2010;19:91–8.CrossRef

81.

Palombo C, Kozakova M. Arterial stiffness, atherosclerosis and cardiovascular risk: pathophysiologic mechanisms and emerging clinical indications. Vasc Pharmacol. 2015;15:332–68.

82.

Cardoso L, Kelly-Arnold A, Maldonado N, Laudier D, Weinbaum S. Effect of the tissue properties, shape and orientation of micro calcification on vulnerable cap stability using different hyperelastic constitutive models. J Biomech. 2014;47:870–7.CrossRefPubMedPubMedCentral

83.

Gronholdt ML, Nordestgaard BG, Bentzon J, Wiebe BM, Zhou J, Falk E, et al. Macrophages are associated with lipid-rich carotid artery plaques, echolucency on B-mode imaging, and elevated plasma lipid levels. J Vasc Surg. 2002;35:137–45.PubMed

84.

Packard RRS, Libby P. Inflammation in atherosclerosis: from vascular biology to biomarker discovery and risk prediction. Clin Chem. 2008;54:24–38.CrossRefPubMed

85.

Sehgel NL, Sun Z, Hong Z, Hunter WC, Hill MA, Vatner DE, et al. Augmented vascular smooth muscle cell stiffness and adhesion when hypertension is superimposed on aging. Hypertension. 2015;65:370–7.CrossRefPubMed

86.

Pahkala K, Hernelahti M, Heinonen OJ, Raittinen P, Hakanen M, Lagström H, et al. Body mass index, fitness and physical activity from childhood through adolescence. Br J Sports Med. 2013;47:71–7.CrossRefPubMed

87.

Cecelja M, Chowienczyk P. Dissociation of aortic pulse wave velocity with risk factors for cardiovascular disease other than hypertension: a systematic review. Hypertension. 2009;54:1328–36.CrossRefPubMed

88.

Miyamoto M, Kotani K, Okada K, Ando A, Hasegawa H, Kanai H, et al. Arterial wall elasticity measured using the phased tracking method and atherosclerotic risk factors in patients with type 2 diabetes. J Atheroscler Thromb. 2013;20:678–87.CrossRefPubMed

89.

• Laurent S, Boutouyrie P, Lacolley P. Structural and genetic bases of arterial stiffness. Hypertension. 2005;45:1050–5. The paper talks about biological factors responsible for arterial stiffness. This change in stiffness has association with the genetic components.

90.

Mahmud A, Feely J. Effect of smoking on arterial stiffness and pulse pressure amplification. Hypertension. 2003;41:183–7.CrossRefPubMed

91.

Simons PC, Algra A, Bots ML, Grobbee DE, van der Graaf Y. Common carotid intima-media thickness and arterial stiffness indicators of cardiovascular risk in high-risk patients. Circulation. 1999;100:951–7.CrossRefPubMed

92.

Zahnd G, Orkisz M, Sérusclat A, Moulin P, Vray D. Simultaneous extraction of carotid artery intima-media interfacesin ultrasound images: assessment of wall thickness temporal variation during the cardiac cycle. Int J CARS. 2014;9:645–58.CrossRef

93.

Niu L, Qian M, Song R, Meng L, Liu X, Zheng H. A texture matching method considering geometric transformations in noninvasive ultrasonic measurement of arterial elasticity. Ultrasound Med Biol. 2012;38:524–33.CrossRefPubMed

94.

Hasegawa H, Kanai H, Hoshimiya N, Koiwa Y. Evaluating the regional elastic modulus of a cylindrical shell with nonuniform wall thickness. J Med Ultrason. 2004;31:81–90.CrossRef

95.

Pahkala K, Laitinen TT, Heinonen J, Viikari JSA, Rönnemaa T, Niinikoski H, et al. Association of fitness with vascular intima-media thickness and elasticity in adolescence. Pediatrics. 2013;132:77–84.CrossRef

96.

Mitchell GF, Hwang SJ, Vasan RS, Larson MG, Pencina MJ, Hamburg NM, et al. Arterial stiffness and cardiovascular events: the Framingham Heart Study. Circulation. 2010;4:505–11.CrossRef

97.

Saba L, Meiburger KM, Molinari F, Ledda G, Anzidei M, Acharya UR, et al. Carotid IMT variability (IMTV) and its validation in symptomatic versus asymptomatic Italian population: can this be a useful index for studying symptomaticity? Echocardiography. 2012;29(9):1111–9.CrossRefPubMed

98.

Saba L, Banchhor SK, Suri HS, Londhe ND, Araki T, Ikeda N, et al. Accurate cloud-based smart IMT measurement, its validation and stroke risk stratification in carotid ultrasound: a web-based point-of-care tool for multicenter clinical trial. Comput Biol Med. 2016;75:217–34.CrossRefPubMed

Titel: A Review on Atherosclerotic Biology, Wall Stiffness, Physics of Elasticity, and Its Ultrasound-Based Measurement
verfasst von: Anoop K. Patel
Harman S. Suri
Jaskaran Singh
Dinesh Kumar
Shoaib Shafique
Andrew Nicolaides
Sanjay K. Jain
Luca Saba
Ajay Gupta
John R. Laird
Argiris Giannopoulos
Jasjit S. Suri
Publikationsdatum: 01.12.2016
Verlag: Springer US
Erschienen in: Current Atherosclerosis Reports / Ausgabe 12/2016
Print ISSN: 1523-3804
Elektronische ISSN: 1534-6242
DOI: https://doi.org/10.1007/s11883-016-0635-9

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