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Lindqvist, Per
Publications (10 of 93) Show all publications
Henein, M. Y., Tossavainen, E., Aroch, R., Söderberg, S. & Lindqvist, P. (2019). Can Doppler echocardiography estimate raised pulmonary capillary wedge pressure provoked by passive leg lifting in suspected heart failure?. Clinical Physiology and Functional Imaging, 39(2), 128-134
Open this publication in new window or tab >>Can Doppler echocardiography estimate raised pulmonary capillary wedge pressure provoked by passive leg lifting in suspected heart failure?
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2019 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 39, no 2, p. 128-134Article in journal (Refereed) Published
Abstract [en]

AIMS: Non-invasive estimation of left ventricular filling pressure (LVFP) during stress is important for explaining exertional symptoms in patients with heart failure (HF). The aim of this study was to evaluate ability of Doppler echocardiographic measures of elevated LVFP with passive leg lifting (PLL) in patients with suspected HF.

METHODS: Twenty-nine patients with clinical signs of HF who underwent simultaneous Doppler echocardiography and right heart catheterization (RHC) at rest and during PLL were consecutively investigated. Seventeen patients had normal PCWP (≤15 mmHg) at rest and during PLL and 12 with normal PCWP at rest but >15 mmHg with PLL. Conventional echo and 2D strain were used to assess early diastolic blood flow velocity (E), LV strain rate during early diastole (LVSRe), left atrial SR during atrial contraction (LASRa) and myocardial tissue Doppler velocities to assess lateral e' and further calculate E/e' and E/LVSRe and their relationship with PCWP, at rest and during PLL.

RESULTS: Resting LAVI (β = 0·45, P = 0·009) and LASRa (β = -0·51, P = 0·004) were independently related to PCWP during PLL. Also, LASRa (β = -0·77, P<0·001), E/e' (β = 0·40, P = 0·04) and E/LVSRe (β = 0·47, P = 0·021) during PLL correlated with PCWP during PLL. Multiple regression analysis identified E/LVSRe (β = 0·46, P = 0·001) and LASRa (β = -0·58, P = 0·002) during PLL as being independently associated with PCWP during PLL.

CONCLUSION: Left atrial volume and myocardial contraction (LASRa) at rest both predict unstable LV filling pressures measured as raised PCWP when provoked by PLL. Furthermore, LASRa at PLL seems to have the strongest association to PCWP during PLL.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
deformation, passive leg lifting, pulmonary capillary wedge pressures, strain rate
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-152550 (URN)10.1111/cpf.12547 (DOI)000458316200003 ()30298591 (PubMedID)
Funder
Swedish Heart Lung Foundation
Available from: 2018-10-11 Created: 2018-10-11 Last updated: 2019-05-10Bibliographically approved
Bytyçi, I., Bajraktari, G., Lindqvist, P. & Henein, M. Y. (2019). Compromised left atrial function and increased size predict raised cavity pressure: a systematic review and meta-analysis. Clinical Physiology and Functional Imaging, 39(5), 297-307
Open this publication in new window or tab >>Compromised left atrial function and increased size predict raised cavity pressure: a systematic review and meta-analysis
2019 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 39, no 5, p. 297-307Article, review/survey (Refereed) Published
Abstract [en]

Aim: This meta-analysis assesses left atrial (LA) cavity and myocardial function measurements that predict pulmonary capillary wedge pressure (PCWP). Methods: PubMed-MEDLINE, EMBASE, Scopus, Google Scholar and the Cochrane Central Registry were searched up to December 2018 for studies on the relationship of LA diameter, LA indexed volume (LAVI max, LAVI min), peak atrial longitudinal (PALS), peak atrial contraction (PACS) strain and total emptying fraction (LAEF) with PCWP. Eighteen studies with 1343 patients were included. sensitivity and specificity (with 95% CI) for evaluation of diagnostic accuracy and the best cut-off values for different LA indices in predicting raised PCWP were estimated using summary receiver operating characteristic analysis. Results: The pooled analysis showed association between PCWP and LA diameter: Cohen's d = 0 center dot 87, LAVI max: d = 0 center dot 92 and LAVI min: d = 1 center dot 0 (P<0 center dot 001 for all). A stronger correlation was found between PCWP and PALS: d = 1 center dot 26, and PACS: d = 1 center dot 62, total EF d = 1 center dot 22 (P<0 center dot 0001 for all). PALS <= 19% had a summary sensitivity of 80% (65-90) and summary specificity of 77% (52-92), positive likelihood ratio (LR+) 3 center dot 74, negative likelihood ratio (LR-) DOR > 15 center dot 1 whereas LAVI >= 34 ml m(-2) had summary sensitivity of 75% (55-89) and summary specificity 77% (57-90), with LR+ >3, LR- 0 center dot 32 and DOR >10 center dot 1. Conclusions: Compromised LA myocardial function and increased size predict raised cavity pressure. These results should assist in optimum follow-up of patients with fluctuating LA pressure.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
left atrial, left atrial function, left atrial size, left atrial strain, pulmonary capillary wedge pressure
National Category
Physiology
Identifiers
urn:nbn:se:umu:diva-162835 (URN)10.1111/cpf.12587 (DOI)000479117100001 ()31136072 (PubMedID)
Available from: 2019-09-13 Created: 2019-09-13 Last updated: 2019-09-13Bibliographically approved
Forsblad-d'Elia, H., Law, L., Bengtsson, K., Söderberg, S. & Lindqvist, P. (2019). Educed strain and increased stiffness of common carotid arteries in patients with ankylogin spondylitis. Paper presented at Annual European Congress of Rheumatology (EULAR), Madrid, Spain, June 12-15, 2019. Annals of the Rheumatic Diseases, 78, 1241-1241
Open this publication in new window or tab >>Educed strain and increased stiffness of common carotid arteries in patients with ankylogin spondylitis
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2019 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, p. 1241-1241Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Ankylosing spondylitis (AS) is associated with an increased risk of cardiovascular disease (CVD) which also contributes to the increased mortality observed in AS. It is therefore important to develop non-invasive, accurate methods for early detection of atherosclerotic vascular changes. Studies, in other populations, have demonstrated associations between arterial stiffness and atherosclerotic burden and incident cardiovascular events. The arterial stiffness can be examined by ultrasound providing the β stiffness index that evaluates mechanical deformation properties. Technological advancements in ultrasound have developed a method assessing strain, using speckle tracking technique, which measures deformation mechanics in more dimensions. The speckle tracking method assessing arterial wall motion might permit earlier detection of subclinical CVD.

Objectives: To study, for the first time, bilateral common carotid arterial (CCA) circumferential strain and β stiffness index in patients with AS and 1) compare the results with age and sex-matched controls and 2) explore relationships between circumferential strain and β stiffness index with disease activity, physical function and traditional risk factors for CVD in patients with AS.

Methods: A cohort of 149 patients with AS from Northern Sweden (Modif NY, mean age 55.3±11.2 years, 102(68.5%) men, 146(98%) HLAB27) were assessed with spinal radiographs for mSASSS, clinical examination and BASMI, BASFI, ASDAS-CRP and BASDAI. Forty-six patients with AS (50.4±8.7 years, 31(67%) men) and 46 age- and sex-matched controls (49.8±9.2 years, 31(67%) men) with no known hypertension, diabetes or previous CV events were compared. Bilateral CCA ultrasound was carried out on all patients and controls. The circumferential systolic strain was measured and the β stiffness index was calculated. To analyze factors associated with strain and β stiffness index univariate and standard multivariable linear regression analyses were used. Variables with a univariate p-value ≤ 0.1 were considered for the multivariable models. For dichotomous variables, yes was coded 1 and no was coded 0.

Results: The mean strain was significantly lower in AS patients compared with controls, 7.9±2.6% vs 10.3±1.9%, p<0.001 and the mean β stiffness index was significantly higher in AS compared to controls, 13.1±1.6 mmHg/mm vs 12.3±1.3 mmHg/mm, p=0.018.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-161723 (URN)10.1136/annrheumdis-2019-eular.4587 (DOI)000472207103509 ()
Conference
Annual European Congress of Rheumatology (EULAR), Madrid, Spain, June 12-15, 2019
Note

Supplement: 2

Meeting Abstract: SAT0325

Available from: 2019-07-26 Created: 2019-07-26 Last updated: 2019-07-26Bibliographically approved
Bytyci, I., Bajraktari, G., Fabiani, I., Lindqvist, P., Poniku, A., Pugliese, N. R., . . . Henein, M. (2019). Left atrial compliance index predicts exercise capacity in patients with heart failure and preserved ejection fraction irrespective of right ventricular dysfunction. Echocardiography, 36(6), 1045-1053
Open this publication in new window or tab >>Left atrial compliance index predicts exercise capacity in patients with heart failure and preserved ejection fraction irrespective of right ventricular dysfunction
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2019 (English)In: Echocardiography, ISSN 0742-2822, E-ISSN 1540-8175, Vol. 36, no 6, p. 1045-1053Article in journal (Refereed) Published
Abstract [en]

Background and Aim: Predictors of exercise capacity in heart failure (HF) with preserved ejection fraction (HFpEF) remain of difficult determination. The aim of this study was to identify predictors of exercise capacity in a group of patients with HFpEF and right ventricle (RV) dysfunction

Methods: In 143 consecutive patients with HFpEF (age 62 ± 9 years, LV EF ≥45) and 41 controls, a complete echocardiographic study was performed. In addition to conventional measurements, LA compliance was calculated using the formula: [LAV max − LAV min/LAV min × 100]. Exercise capacity was assessed using the six‐minute walking test (6‐MWT). Tricuspid annular plane systolic excursion (TAPSE) < 1.7 cm was utilized to categorize patients with RV dysfunction (n = 40) from those with maintained RV function (n = 103).

Results: Patients with RV dysfunction were older (= 0.002), had higher NYHA class (= 0.001), higher LV mass index (= 0.01), reduced septal and lateral MAPSE (all < 0.001), enlarged LA (= 0.001) impaired LA compliance index (< 0.001) and exhibited a more compromised 6‐MWT (= 0.001). LA compliance index correlated more closely with 6‐MWT (= 0.51, < 0.001) compared with the other LA indices (AP diameter, transverse diameter and volume indexed; = −0.30, = −0.35 and = −0.38, respectively). In multivariate analysis, LA compliance index <60% was 88% sensitive and 61% specific (AUC 0.80, CI = 0.67–0.92 = 0.001) in predicting exercise capacity.

Conclusion: An impairment in LA compliance was profound in patients with HFpEF and RV dysfunction and seems to be most powerful independent predictor of limited exercise capacity.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2019
Keywords
exercise capacity, heart failure with preserved ejection fraction, left atrial compliance, right ventricular dysfunction, six-minute walking test
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-161526 (URN)10.1111/echo.14377 (DOI)000471831300004 ()31148237 (PubMedID)
Available from: 2019-07-11 Created: 2019-07-11 Last updated: 2019-07-11Bibliographically approved
Matteo, L., Cameli, M., Di Tommaso, C., Curci, V., Reccia, R., D'Ascenzi, F., . . . Henein, M. (2018). Mitral regurgitation severity correlates with symptoms and extent of left atrial dysfunction: Effect of mitral valve repair. Journal of Clinical Ultrasound, 46(1), 32-40
Open this publication in new window or tab >>Mitral regurgitation severity correlates with symptoms and extent of left atrial dysfunction: Effect of mitral valve repair
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2018 (English)In: Journal of Clinical Ultrasound, ISSN 0091-2751, E-ISSN 1097-0096, Vol. 46, no 1, p. 32-40Article in journal (Refereed) Published
Abstract [en]

Purpose: We aimed to assess the relationship between mitral regurgitation (MR) severity, symptoms, and left atrial (LA) structure and function, before and after mitral valve repair (MVR).

Methods: Global peak atrial longitudinal strain (PALS) was evaluated in 37 patients with severe symptomatic MR and preserved left ventricular (LV) ejection fraction (60.4% ± 4.6%) before and 3 months after MVR and was compared with values from 30 age- and gender-matched controls.

Results: Before surgery, PALS was worse in patients than in controls and indexed LA volume was greater (P < .0001 for both). After MVR, PALS deteriorated further and LA volume decreased (P = .001 and P = .05, respectively) as did LV ejection fraction, longitudinal strain (P = .05 and P < .001, respectively), and LV mass (P < .0001). Before surgery, LA volume correlated modestly with LV end-diastolic volume (R = 0.51; P = .01); effective regurgitant orifice area (EROA) correlated with PALS (R = −0.69, P < .001) and with LV longitudinal strain (R = 0.54, P = .01), and New York Heart Association class correlated with PALS (R = −0.69, P < .001), EROA (R = 0.69, P < .001), and LA volume (R = 0.51, P = .04). LA volume was the strongest predictor of global PALS reduction (P < .001), whereas global PALS was the main predictor of postoperative atrial fibrillation (AF) (P < .001).

Conclusions: In patients with severe MR, EROA correlate with symptoms and LA PALS, which itself predicts the occurrence of postoperative AF. Strain values were superior to 2D data for the prediction of postoperative AF.

Keywords
heart failure, left atrial strain, mitral regurgitation, mitral valve repair, symptoms
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-127291 (URN)10.1002/jcu.22521 (DOI)000418242100005 ()28949022 (PubMedID)
Note

Originally published in manuscript form

Available from: 2016-11-04 Created: 2016-11-04 Last updated: 2019-05-17Bibliographically approved
Pilebro, B., Arvidsson, S., Lindqvist, P., Sundström, T., Westermark, P., Antoni, G., . . . Sörensen, J. (2018). Positron emission tomography (PET) utilizing Pittsburgh compound B (PIB) for detection of amyloid heart deposits in hereditary transthyretin amyloidosis (ATTR). Journal of Nuclear Cardiology, 25(1), 240-248
Open this publication in new window or tab >>Positron emission tomography (PET) utilizing Pittsburgh compound B (PIB) for detection of amyloid heart deposits in hereditary transthyretin amyloidosis (ATTR)
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2018 (English)In: Journal of Nuclear Cardiology, ISSN 1071-3581, E-ISSN 1532-6551, Vol. 25, no 1, p. 240-248Article in journal (Refereed) Published
Abstract [en]

Background: DPD scintigraphy has been advocated for imaging cardiac amyloid in ATTR amyloidosis. PET utilizing 11C-Pittsburgh compound B (PIB) is the gold standard for imaging brain amyloid in Alzheimer’s disease. PIB was recently shown to identify cardiac amyloidosis in both AL and ATTR amyloidosis. In the ATTR population, two types of amyloid fibrils exist, one containing fragmented and full-length TTR (type A) and the other only full-length TTR (type B). The aim of this study was to further evaluate PIB-PET in patients with hereditary ATTR amyloidosis.

Methods: Ten patients with biopsy-proven V30M ATTR amyloidosis and discrete or no signs of cardiac involvement were included. Patients were grouped according to TTR-fragmentation. All underwent DPD scintigraphy, echocardiography, and PIB-PET. A left ventricular PIB-retention index (PIB-RI) was established and compared to five normal volunteers.

Results: PIB-RI was increased in all patients (P < 0.001), but was significantly higher in type B than in type A (0.129 ± 0.041 vs 0.040 ± 0.006 min−1, P = 0.009). Cardiac DPD uptake was elevated in group A and absent in group B.

Conclusion: PIB-PET, in contrast to DPD scintigraphy, has the potential to specifically identify cardiac amyloid depositions irrespective of amyloid fibril composition. The heart appears to be a target organ for amyloid deposition in ATTR amyloidosis.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Cardiomyopathy, amyloidosis, Pittsburgh compound B
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-127300 (URN)10.1007/s12350-016-0638-5 (DOI)000423585200038 ()27645889 (PubMedID)2-s2.0-84988421982 (Scopus ID)
Available from: 2016-11-07 Created: 2016-11-07 Last updated: 2019-05-21Bibliographically approved
Henein, M. Y., Suhr, O. B., Arvidsson, S., Pilebro, B., Westermark, P., Hörnsten, R. & Lindqvist, P. (2018). Reduced left atrial myocardial deformation irrespective of cavity size: a potential cause for atrial arrhythmia in hereditary transthyretin amyloidosis. Amyloid: Journal of Protein Folding Disorders, 25(1), 46-53
Open this publication in new window or tab >>Reduced left atrial myocardial deformation irrespective of cavity size: a potential cause for atrial arrhythmia in hereditary transthyretin amyloidosis
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2018 (English)In: Amyloid: Journal of Protein Folding Disorders, ISSN 1350-6129, E-ISSN 1744-2818, Vol. 25, no 1, p. 46-53Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Cardiac amyloidosis (CA) is a myocardial disease and commonly under-diagnosed condition. In CA patients, atrial fibrillation might occur in the absence of left atrial (LA) enlargement.

OBJECTIVES: The aim of this study is to assess LA size and function, and its relationship with atrial arrhythmia in patients with hereditary transthyretin amyloidosis (ATTR).

METHODS: Forty-six patients with confirmed ATTR amyloidosis on abdominal biopsy were studied. Assessment with 2D echocardiography and 2D strain showed 31 patients had increased LV wall thickness (LVWT) (septal thickness >12 mm), and 15 had normal LVWT. In addition to conventional measurements, LV and LA global longitudinal strain (GLS%) and strain rate (SR) were obtained. Western blot analysis was done to assess fibril type. ATTR patients with increased LVWT were compared with 23 patients with hypertrophic cardiomyopathy (HCM) and 31 healthy controls. ATTR amyloidosis patients also underwent 24 hour Holter monitoring to determine the presence of atrial arrhythmia.

RESULTS: Atrial deformation during atrial systole was reduced in ATTR amyloidosis patients with increased LVWT independent of LA size and in contrast to HCM. Twenty of the ATTR amyloidosis patients (54%) had ECG evidence of significant atrial arrhythmic events. LA strain rate, during atrial systole, was the only independent predictor of atrial arrhythmia (β = 3.28, p = .012).

CONCLUSION: In ATTR cardiomyopathy with increased LVWT, LA myocardial function is abnormal, irrespective of atrial cavity size. Reduced LA myocardial SR during atrial systole, irrespective of cavity volume, E/e' and LV deformation, is also a strong predictor for atrial arrhythmic events.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Arrhythmia, Holter ECG, deformation echocardiography, left atrial function
National Category
Other Clinical Medicine
Identifiers
urn:nbn:se:umu:diva-145431 (URN)10.1080/13506129.2018.1430027 (DOI)000428570300007 ()29369708 (PubMedID)
Available from: 2018-03-05 Created: 2018-03-05 Last updated: 2019-05-17Bibliographically approved
Henein, M. Y. & Lindqvist, P. (2018). Response: Atrial impairment in transthyretin cardiac amyloidosis: an early marker of cardiac involvement and a prognostic factor [Letter to the editor]. Amyloid: Journal of Protein Folding Disorders, 25(2), 136-136
Open this publication in new window or tab >>Response: Atrial impairment in transthyretin cardiac amyloidosis: an early marker of cardiac involvement and a prognostic factor
2018 (English)In: Amyloid: Journal of Protein Folding Disorders, ISSN 1350-6129, E-ISSN 1744-2818, Vol. 25, no 2, p. 136-136Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
Taylor & Francis Group, 2018
National Category
Medical Biotechnology (with a focus on Cell Biology (including Stem Cell Biology), Molecular Biology, Microbiology, Biochemistry or Biopharmacy)
Identifiers
urn:nbn:se:umu:diva-153001 (URN)10.1080/13506129.2018.1450241 (DOI)000446965400012 ()29529882 (PubMedID)
Available from: 2018-11-01 Created: 2018-11-01 Last updated: 2019-05-17Bibliographically approved
Arvidsson, S., Henein, M. Y., Wikström, G., Suhr, O. B. & Lindqvist, P. (2018). Right ventricular involvement in transthyretin amyloidosis. Amyloid: Journal of Protein Folding Disorders, 25(3), 160-166
Open this publication in new window or tab >>Right ventricular involvement in transthyretin amyloidosis
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2018 (English)In: Amyloid: Journal of Protein Folding Disorders, ISSN 1350-6129, E-ISSN 1744-2818, Vol. 25, no 3, p. 160-166Article in journal (Refereed) Published
Abstract [en]

Background: The extent of right ventricular (RV) involvement in transthyretin amyloidosis (ATTR) is unknown.

Objectives: This study sought to establish the degree of RV involvement in ATTR amyloidosis, and compare findings with RV involvement in hypertrophic cardiomyopathy (HCM).

Methods: Forty-two patients with ATTR amyloidosis and echocardiographic evidence of cardiac amyloidosis (cardiac ATTR), 19 ATTR patients with normal left ventricular (LV) wall thickness (non-cardiac ATTR), 25 patients with diagnosed HCM and 30 healthy controls were included in this study. Echocardiographic measurements for conventional parameters, as well as RV global and segmental strain, were recorded.

Results: When comparing RV structure and function between cardiac ATTR amyloidosis and HCM patients, only segmental strain differed between the two groups. In cardiac ATTR amyloidosis, we found an RV apex-to-base strain gradient with highest deformation in the apex. This pattern was reversed in patients with HCM.

Conclusions: RV involvement is common in cardiac ATTR patients. The present study also detected an RV apical sparing pattern in patients with ATTR cardiomyopathy, similar to what has previously been described for the left ventricle in these patients. This pattern was not seen in HCM patients. Further studies are needed to assess the clinical importance of these findings.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Hypertrophic cardiomyopathy, apical sparing, strain, amyloid cardiomyopathy, right ventricle
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-113889 (URN)10.1080/13506129.2018.1493989 (DOI)000451980700004 ()30193533 (PubMedID)
Note

Originally included in thesis in manuscript form.

Available from: 2016-01-04 Created: 2016-01-04 Last updated: 2019-05-17Bibliographically approved
Nyman, E., Lindqvist, P., Näslund, U. & Grönlund, C. (2018). Risk marker variability in subclinical carotid plaques based on ultrasound is influenced by cardiac phase, echogenicity and size. Ultrasound in Medicine and Biology, 44(8), 1742-1750
Open this publication in new window or tab >>Risk marker variability in subclinical carotid plaques based on ultrasound is influenced by cardiac phase, echogenicity and size
2018 (English)In: Ultrasound in Medicine and Biology, ISSN 0301-5629, E-ISSN 1879-291X, Vol. 44, no 8, p. 1742-1750Article in journal (Refereed) Published
Abstract [en]

Identification of risk markers based on quantitative ultrasound texture analysis of carotid plaques has the ability to define vulnerable components that correlate with increased cardiovascular risk. However, data describing factors with the potential to influence the measurement variability of risk markers are limited. The aim of this study was to evaluate the influence of electrocardiogram-guided image selection, plaque echogenicity and area on carotid plaque risk markers and their variability in asymptomatic carotid plaques. Plaque risk markers were measured in 57 plaques during three consecutive heartbeats at two cardiac cycle time instants corresponding to the electrocardiogram R-wave (end diastole) and end of T-wave (end systole), resulting in six measurements for each plaque. Risk marker variability was quantified by computing the coefficient of variation (CV) across the three heartbeats. The CV was significantly higher for small plaques (area <15 mm2, 10%) than for large plaques (area >15 mm2, 6%) (p <0.001) in measurements of area, and the CV for measurements of gray-scale median were higher for echolucent plaques (<40, 15%) than for echogenic plaques (>40, 9%) (p <0.001). No significant differences were found between systole and diastole for the mean of any risk marker or the corresponding CV value. However, in a sub-analysis, the echolucent plaques were found to have a higher CV during systole compared with diastole. The variability also caused plaque type reclassification in 16% to 25% of the plaques depending on cutoff value. The results of this study indicate that echolucent and small plaques each contribute to increased risk marker variability. Based on these results, we recommend that measurements in diastole arc preferred to reduce variation, although we found that it may not be possible to characterize small plaques accurately using contemporary applied risk markers. 

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Carotid plaque, Risk markers, Cardiac cycle, Echogenicity, Size, Classification
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-150664 (URN)10.1016/j.ultrasmedbio.2018.03.013 (DOI)000436561500018 ()29735317 (PubMedID)2-s2.0-85046670751 (Scopus ID)
Funder
Swedish Research Council, 2015-04461
Available from: 2018-08-28 Created: 2018-08-28 Last updated: 2019-05-21Bibliographically approved
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