Journal of Medical Ultrasonics

, Volume 44, Issue 2, pp 183–190 | Cite as

Measurement of carotid pulse wave velocity using ultrafast ultrasound imaging in hypertensive patients

  • Xiaopeng Li
  • Jue Jiang
  • Hong Zhang
  • Hua Wang
  • Donggang Han
  • Qi ZhouEmail author
  • Ya Gao
  • Shanshan Yu
  • Yanhua Qi
Original Article



The study aimed to assess the utility of ultrafast ultrasound imaging for evaluation of carotid pulse wave velocity (PWV) in newly diagnosed hypertension patients.


This prospective non-randomized study enrolled 90 hypertensive patients in our hospital from September to December 2013 as a hypertension group. An age- and sex-matched cohort of 50 healthy adults in our hospital from September to December 2013 was also included in the study as a control group. Carotid PWV at the beginning and at the end of systole (PWV-BS and PWV-ES, respectively) and intima-media thickness (IMT) were measured by ultrafast ultrasound imaging technology. The associations of PWV-BS, PWV-ES, and IMT with hypertension stage were evaluated by Spearman correlation analysis.


PWV-BS and PWV-ES in the hypertension group were significantly elevated compared with those in control group. Different hypertension stages significantly differed in PWV-BS and PWV-ES. PWV-BS and PWV-ES appeared to increase with the hypertension stage. Moreover, IMT, PWV-BS, and PWV-ES were positively correlated with the hypertension stage in hypertensive patients.


Ultrafast ultrasound imaging was a valid and convenient method for the measurement of carotid PWV in hypertensive patients. Ultrafast ultrasound imaging might be recommended as a promising alternative method for early detection of arterial abnormality in clinical practice.


Ultrafast ultrasound imaging Essential hypertension Carotid artery elasticity Carotid pulse wave velocity 


Compliance with ethical standards

Conflict of interest


Ethical statements

The study was approved by the medical ethics committee of the Second Affiliated Hospital of Xi’an Jiaotong University, and written informed consent was received from each participant.


  1. 1.
    Organization WH. A global brief on hypertension: silent killer, global public health crisis. Geneva: WHO; 2013.
  2. 2.
    Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Blood Press. 2013;22:193–278.CrossRefGoogle Scholar
  3. 3.
    Li H, Liu F, Xi B. Control of hypertension in China: challenging. Int J Cardiol. 2014;174:797.CrossRefPubMedGoogle Scholar
  4. 4.
    Chow CK, Teo KK, Rangarajan S, et al. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. JAMA. 2013;310:959–68.CrossRefPubMedGoogle Scholar
  5. 5.
    van Popele NM, Grobbee DE, Bots ML, et al. Association between arterial stiffness and atherosclerosis The Rotterdam Study. Stroke. 2001;32:454–60.CrossRefPubMedGoogle Scholar
  6. 6.
    Chirinos J. Arterial stiffness: basic concepts and measurement techniques. J Cardiovasc Transl Res. 2012;5:243.CrossRefPubMedGoogle Scholar
  7. 7.
    Mitchell GF. Arterial stiffness and hypertension. Hypertension. 2014;64:37–46.Google Scholar
  8. 8.
    Davies JI, Struthers AD. Pulse wave analysis and pulse wave velocity: a critical review of their strengths and weaknesses. J Hypertens. 2003;21:463–72.CrossRefPubMedGoogle Scholar
  9. 9.
    Montaldo G, Tanter M, Bercoff J, et al. Coherent plane-wave compounding for very high frame rate ultrasonography and transient elastography. IEEE Trans Ultrason Ferroelectr Freq Control. 2009;56:489–506.CrossRefPubMedGoogle Scholar
  10. 10.
    Van Bortel LM, Laurent S, Boutouyrie P, et al. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens. 2012;30:445–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Tine WH, Staessen JA, Christian TP, et al. Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population. Circulation. 2006;113:664–70.CrossRefGoogle Scholar
  12. 12.
    Kim ST, Najjar SS, Boudreau RM, et al. Elevated aortic pulse wave velocity, a marker of arterial stiffness, predicts cardiovascular events in well-functioning older adults. Circulation. 2006;111:3384–90.Google Scholar
  13. 13.
    Messas E, Pernot M, Couade M. Arterial wall elasticity: state of the art and future prospects. Diagn Interv Imaging. 2013;94:561–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Tanter M, Fink M. Ultrafast imaging in biomedical ultrasound. Ultrason Ferroelectr Freq Control IEEE Trans. 2014;61:102–19.CrossRefGoogle Scholar
  15. 15.
    Montaldo G, Tanter M, Bercoff J, et al. Coherent plane-wave compounding for very high frame rate ultrasonography and transient elastography. Ultrason Ferroelectr Freq Control IEEE Trans. 2009;56:489–506.CrossRefGoogle Scholar
  16. 16.
    Mirault T, Papadacci C, Dizier BT, et al. Non invasive and real time evaluation of mice aortic stiffness by ultrafast ultrasound imaging: a new tool for evaluation of preclinical vascular disease models. Eur Heart J. 2013;34:P2527.CrossRefGoogle Scholar
  17. 17.
    Couade M, Pernot M, Messas E, et al. Ultrafast imaging of the arterial pulse wave. Irbm. 2011;32:106–8.CrossRefGoogle Scholar
  18. 18.
    Couade M, Flanagan C, Lee WN, et al. Evaluation of local arterial stiffness using ultrafast imaging: a comparative study using local arterial pulse wave velocity estimation and shear wave imaging. Ultrasonics Symposium (IUS), 2010 IEEE; 2010: IEEE.Google Scholar
  19. 19.
    Gu D, Reynolds K, Wu X, et al. Prevalence, awareness, treatment, and control of hypertension in China. Hypertension. 2002;40:920–7.CrossRefPubMedGoogle Scholar
  20. 20.
    Schlaich M, Hering D. Central arteriovenous anastomosis in resistant hypertension? Lancet. 2015;385:1596–7.CrossRefPubMedGoogle Scholar
  21. 21.
    Asmar R, Topouchian J, Pannier B, et al. Pulse wave velocity as endpoint in large-scale intervention trial. The Complior® study. J Hypertens. 2001;19:813–8.CrossRefPubMedGoogle Scholar
  22. 22.
    Hermeling E, Reesink KD, Kornmann LM. The dicrotic notch as alternative time-reference point to measure local pulse wave velocity in the carotid artery by means of ultrasonography. J Hypertens. 2009;27:2028–35.CrossRefPubMedGoogle Scholar
  23. 23.
    Blacher J, Asmar R, Djane S, et al. Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients. Hypertension. 1999;33:1111–7.CrossRefPubMedGoogle Scholar
  24. 24.
    Ben-Shlomo Y, Spears M, Boustred C, et al. Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects. J Am Coll Cardiol. 2014;63:636–46.CrossRefPubMedGoogle Scholar
  25. 25.
    Lurbe E, Torro I, Garcia-Vicent C, et al. Blood pressure and obesity exert independent influences on pulse wave velocity in youth. Hypertension. 2012;60:550–5.CrossRefPubMedGoogle Scholar
  26. 26.
    Asmar R, Benetos A, Topouchian J, et al. Assessment of arterial distensibility by automatic pulse wave velocity measurement validation and clinical application studies. Hypertension. 1995;26:485–90.CrossRefPubMedGoogle Scholar
  27. 27.
    Sueta D, Yamamoto E, Tanaka T, et al. Association of estimated central blood pressure measured non-invasively with pulse wave velocity in patients with coronary artery disease. Ijc Heart Vasc. 2015;55:52–4.CrossRefGoogle Scholar
  28. 28.
    Zureik FZM. Mannheim carotid intima-media thickness consensus (2004–2006). Cerebrovasc Dis. 2007;23:75–80.PubMedGoogle Scholar
  29. 29.
    Lande MB, Carson NL, Roy J, et al. Effects of childhood primary hypertension on carotid intima media thickness a matched controlled study. Hypertension. 2006;48:40–4.CrossRefPubMedGoogle Scholar
  30. 30.
    Gil TY, Sung CY, Shim SS, et al. Intima-media thickness and pulse wave velocity in hypertensive adolescents. J Korean Med Sci. 2008;23:35–40.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Koivistoinen T, Virtanen M, Hutri-Kähönen N, et al. Arterial pulse wave velocity in relation to carotid intima-media thickness, brachial flow-mediated dilation and carotid artery distensibility: the Cardiovascular Risk in Young Finns Study and the Health 2000 Survey. Atherosclerosis. 2012;220:387–93.CrossRefPubMedGoogle Scholar
  32. 32.
    Safar ME, Blacher J, Protogerou A, et al. Arterial stiffness and central hemodynamics in treated hypertensive subjects according to brachial blood pressure classification. J Hypertens. 2008;26:130–7.CrossRefPubMedGoogle Scholar

Copyright information

© The Japan Society of Ultrasonics in Medicine 2016

Authors and Affiliations

  • Xiaopeng Li
    • 1
  • Jue Jiang
    • 1
  • Hong Zhang
    • 1
  • Hua Wang
    • 1
  • Donggang Han
    • 1
  • Qi Zhou
    • 1
    Email author
  • Ya Gao
    • 1
  • Shanshan Yu
    • 1
  • Yanhua Qi
    • 1
  1. 1.Department of Ultrasound, The Second Affiliated HospitalMedical School of Xi’an Jiaotong UniversityXi’anChina

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