Carotid stiffness parameters are earlier markers of subclinical atherosclerosis than central aortic systolic pressure in patients with type 2 diabetes mellitus

Funding Acknowledgements Type of funding sources: None. Introduction Elevated central aortic systolic pressure (CASP) is a stronger predictor of atherosclerosis than peripherial blood pressure measurement. One-point echo-tracking is a novel noninvasive method for measurement of the local arterial stiffness (AS) of carotid artery (CA). As the cardio-vascular complications of patients with type 2 Diabetes Mellitus (T2DM) are the most clinically significant, establishing early signs of atherosclerosis is of utmost importance for the prognosis Purpose To compare the significance of CASP and of carotid echo-tracking parameters as early signs of atherosclerosis in patients T2DM without cardio-vascular disease Patients and methods 100 patients with T2DM without overt cardio-vascular diseases and 30 healthy age- and sex-matched controls were included in the study and examined for PWVβ, β-stiffness index, arterial compliance (АС), augmentation index (AI), Peterson’s modulus (Ep) of right CA with Aloka Hitachi Prosound α7. CASP was determined with Caspal A-pulse CASP-AL device. Patients with atrial fibrillation and increased blood pressure were excluded from the study. Results: Тhe mean values of CASP in T2DM were 126.4 mmHg vs 125.7 mmHg in controls (p = 0.84). PWVβ was increased in patients compared to controls: 7.42m/s vs 6.4m/s, p = 0.001. The same changes were found in β-stiffness index - 10.4 vs 7.7 (p = 0.001), AI - 13.3 vs 19.8 9 (p = 0.009), and Ep - 151.3 vs 112.1 (p = 0.001). There was no significant difference in АС - 0.77 vs 0.98 (p = 0.11). There was a mild correlation between the CASP and carotid stiffness indices (Table 1). Conclusions Parameters of local arterial stiffness of carotid artery are earlier signs of subclinical atherosclerosis than CASP in patients with T2DM without cardio-vascular disease. One-point echo tracking is a useful non-invasive and easy to perform novel ultrasound method. Table 1 PWV(L) AC(L) PWV(R) Ep(R) AC(R) AI(R) r p r p r p r p r p r p CASP 0.222 0.045 -.295 0.007 .286 0.011 .273 0.015 -0.214 0.05 .256 0.023 L-left CA, R-right CA

Augmentation index predicts mortality in patients with aortic stenosis. An echo-tracking study

Funding Acknowledgements Type of funding sources: None. Objective. Aortic valve stenosis (AS) shares similarities with the atherosclerotic process which is known to be responsible od arterial stiffness, but little is known on the direct effect of the mechanical properties of large arteries on the outcome in patients with significant AS and even less is known on the effect of the local stiffness of the large elastic arteries. The aims of the study were 1) to determine the relationship between indexes of local (carotid) arterial stiffness/compliance and the severity of AS and 2) to identify whether local arterial stiffness is independently associated with mortality. Methods. 133 patients with severe isolated AS and preserved left ventricular (LV) ejction fraction (EF) were prospectively recruited. Patients underwent data collection on cardiovascular risk factors and coronary artery disease, standardized transthoracic echocardiographic examination and local carotid stiffness evaluation by means of high-definition echo-tracking ultrasound system with the calculation of arterial stiffness/comliance and augmentation index (AIx). All cause death and the requirement of valvular interventions were recorded during the follow-up period until the occurrence of death or censoring. Deaths were confirmed by reviewing the electronic patient records. Results. None of the local AS parameters were significantly associated with AS severity. During a mean follow-up of 51.6 ± 39.4 months, 70 patients received aortic valve replacement and 45 died. Patients who died were older (79.2 ± 6.9 vs 73 ± 8.8 years, p < 0.0001), they had higher carotid stiffness (AIx) (21.3 ± 14 vs 16 ± 12%, p = 0.028). In multivariate Cox regression analysis AIx was independently associated with mortality also after the inclusion of age and renal function ((HR 1.048, 95% CI 1.01-1.07, p = 0.001). The Kaplan-Meier survival free event curve showed that there was an associated with AIx and the curves were statistically different in the group with no surgery (p = 0.016). Conclusion. In patients with severe AS and normal LVEF, AIx measured by means of echo-tracking system was higher in patients who deceased. AIx was independently associated with death and mortality was higher in the group of patients with higher AIx who did not underwent surgery. These data emphasize the importance of arterial stiffness that not only causes an increase in LV afterload but is also a harbinger of a long-term atherosclerotic burden. Hemodynamic, echocardiographic data

Early Detection of Convective Echoes and Their Development Using Ka-band Radar Network

Cumulonimbus clouds, which cause local heavy rainfall and urban floods, can develop within 20 minutes after being detected by operational centimeter-wavelength (X-, C-, or S-band) weather radars. To detect such clouds with greater lead times, Ka-band radars at a wavelength of 8.6 mm together with operational X-band radars were used in this study. The vertically averaged radar reflectivity (VAR) of convective echoes detected by the Ka-band and X-band radars were defined as mesoscale cloud echoes (MCEs) and mesoscale precipitation echoes (MPEs), respectively. The time series of each echo was analyzed by an echo tracking algorithm. On average, MCEs that developed into MPEs (denoted as developed MCEs) were detected 17 minutes earlier than the MPEs and 33 minutes earlier than the peak time of the area-averaged VAR (VARa) for MPEs. Some MCEs dissipated without developing into MPEs (denoted as non-developed MCEs). There were statistically significant differences between the developed and non-developed MCEs in terms of the maximum VARa values, maximum MCEs areas, and increase amounts of the VARa values and MCE areas for the first 6 to 12 minutes after their detection. Among these indicators, the maximum VARa for the first 9 minutes showed the most significant differences. Therefore, an algorithm for predicting MCE development using this indicator is discussed.

3D echocardiography, arterial stiffness, and biomarkers in early diagnosis and prediction of CHOP-induced cardiotoxicity in non-Hodgkin’s lymphoma

CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) represents standard chemotherapy in non-Hodgkin's lymphoma (NHL) with risk of cardiotoxicity. To define new parameters, such as 3D myocardial deformation, arterial stiffness, and biomarkers for early diagnosis and prediction of cardiotoxicity. 110 NHL patients with LVEF > 50%, scheduled for CHOP, were evaluated at baseline, after third cycle and chemotherapy completion. 3DE assessed LVEF and myocardial deformation: longitudinal (LS), radial, circumferential, area strain. Echo-tracking analysed arterial stiffness: PWV, β index, wave intensity. Troponin I and NT-pro-BNP were measured. After chemotherapy completion, 18 patients (16%) (group I) developed cardiotoxicity (LVEF decrease < 50%, with > 10% from baseline); 92 patients (group II) did not. Significant reduction of 3D LV deformation and increase of arterial stiffness developed starting with third cycle, with greater changes in group I. LS reduction and PWV increase after third cycle were the best independent predictors for LVEF decrease; the association of LS decrease by > 19% and PWV increase by > 27% after third cycle predicted cardiotoxicity after chemotherapy completion (90% sensitivity and 81% specificity). 3D LS and PWV can detect early chemotherapy-induced cardiotoxicity and predict LVEF decline. These parameters should be incorporated in clinical protocols to monitor cardiovascular function during chemotherapy and early intervention.

The variational echo tracking method and its application in convective storm nowcasting

&lt;p&gt;The objective extrapolation forecast is the main method for 0-1 hour convective storm nowcasting. Radar echo extrapolation was performed by using the 6 minute interval radar mosaics obtained from the radar images of 8 multi-radars in Beijing-Tianjin-Hebei region. A comparative study of two extrapolated forecasts of eighteen typical convective precipitation events occurred in Beijing-Tianjin-Hebei region from 2016 to 2018 was conducted. Compared with the tracking radar echoes by correlation method, the variational echo tracking method utilizes variational technique to compute the motion vector fields, and uses two strict constraints to get a better motion vector field. The results indicated that the variational echo tracking method performed better in prediction of the radar echo pattern, echo location, and echo intensity at 30- and 60-min forecast lead times: 1) A comparative study of the two extrapolated forecasts of four precipitation events in Beijing-Tianjin-Hebei region was conducted. The result indicated that the radar echo location, the echo pattern and echo intensity produced by the variational echo tracking method were closer to the real observation within one hour. 2) Quantitative evaluation for the two extrapolated forecasts of the eighteen typical convective precipitation events was conducted. Compared with the tracking radar echoes by correlation method, the probability of detection and the critical success index of the 30- or 60-min extrapolated forecast produced by the variational echo tracking method were higher, meanwhile the false alarm rate was lower when the radar echo threshold was 35dBz and 45dBz. Also, a quantitative evaluation classified by the weather type indicated that the variational echo tracking method performed better than the tracking radar echoes by correlation method in most weather types.&lt;/p&gt;