Shear wave elastography to evaluate the effect of serum uric acid levels on carotid artery elasticity in patients with high-normal blood pressure

Effects of SUA on carotid artery elasticity in patients with high-normal BP

  • Yifan Wang
  • Xinyu Wang
  • Xiya Li
  • Zhen Li
  • Mengmeng Zhang
  • Siran Zhang
  • Le Ma
  • Dongmei Huang
  • Guangsen Li the Second Affiliated Hospital of Dalian Medical University
DOI: https://doi.org/10.5937/jomb0-52077
Keywords: Shear wave elastography, High-normal blood pressure, Carotid artery elasticity, Serum uric acid level

Abstract


Background: Populations with normal high blood pressure often already have elevated blood uric acid levels and a higher chance of developing atherosclerosis, which accelerates the process of cardiovascular disease. The risk of atherosclerosis increases with thickening of the carotid artery intima-media, and changes in carotid artery elasticity precede intima-media changes, so early monitoring of carotid artery elasticity is of great significance in the prevention of cardiovascular disease. Using shear wave elastography (SWE) to evaluate the effect of serum uric acid (SUA) levels on carotid artery elasticity in patients with high-normal blood pressure (BP).

Methods: One hundred and fifteen patients with high-normal BP were selected, and then divided into tertiles according to the SUA levels. The left carotid intima-media thickness (IMT), peak systolic velocity (PSV) and diameter of common carotid artery were measured by two-dimensional ultrasound and Doppler flow imaging. Longitudinal elasticity of the left anterior carotid wall was measured by SWE, including the mean values of the minimum elastic modulus (MEmin), maximum elastic modulus (MEmax) and mean elastic modulus (MEmean).

Results: IMT, MEmean, MEmin and MEmax were obviously higher in the 3rd tertile (all P < 0.05), while there were no obviously different between the 1st tertile and 2nd tertile. Pearson correlation analysis showed positive correlations between SUA and SWE-related parameters, while there was no correlation with IMT. Multiple linear regression analysis found that age, systolic BP, and SUA levels were independently associated with SWE-related parameters.

Conclusion: SWE will be more helpful than IMT in monitoring the effect of blood uric acid levels on carotid artery elasticity in patients with high-normal BP.

References

1. Wang Z, Chen Z, Zhang L, Wang X, Hao G, Zhang Z, et al. Status of Hypertension in China: Results From the China Hypertension Survey, 2012-2015. Circulation 2018; 137(22): 2344-56.
2. Soletsky B, Feig DI. Uric acid reduction rectifies prehypertension in obese adolescents. Hypertension 2012; 60(5): 1148-56.
3. Bawazier LA, Sja'Bani M, Irijanto F, Zulaela Z, Widiatmoko A, Kholiq A, et al. Association of serum uric acid, morning home blood pressure and cardiovascular risk factors in a population with previous prehypertension: a cross-sectional study. Bmj Open 2020; 10(9): e038046.
4. Thitiwuthikiat P, Siriwittayawan D, Nuamchit T. Prehypertension and high serum uric acid increase risk of arterial stiffness. Scand J Clin Lab Inv 2017; 77(8): 673-8.
5. Albu A, Para I, Porojan M. Uric Acid and Arterial Stiffness. Ther Clin Risk Manag 2020; 16: 39-54.
6. Tanaka A, Kawaguchi A, Tomiyama H, Ishizu T, Matsumoto C, Higashi Y, et al. Cross-sectional and longitudinal associations between serum uric acid and endothelial function in subjects with treated hypertension. Int J Cardiol 2018; 272: 308-13.
7. Cho YS, Bae JH, Moon SH, Hyun SH, Choi JY, Kim BT, et al. Serum uric acid in asymptomatic adults is weakly associated with carotid artery FDG uptake but not intima-media thickness. J Nucl Cardiol 2020; 27(5): 1537-46.
8. Burulday V, Celebi UO, Ogden M, Akgul MH, Dogan A, Ozveren MF. Preoperative and postoperative ultrasound elastography findings of the sciatic nerve in patients with unilateral lumbar foraminal disc herniation: a pre-test and post-test design. Eur Rev Med Pharmaco 2022; 26(6): 1923-9.
9. Pruijssen JT, de Korte CL, Voss I, Hansen H. Vascular Shear Wave Elastography in Atherosclerotic Arteries: A Systematic Review. Ultrasound Med Biol 2020; 46(9): 2145-63.
10. Wang YH, Kang YQ, Jin XY, Meng PP, Guan ZY, Jia DL, et al. Reference values of the carotid elastic modulus using shear wave elastography and arterial stiffness change in coronary slow flow. Eur J Radiol 2022; 157: 110582.
11. Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, et al. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension 2020; 75(6): 1334-57.
12. Qureshi AI, Suri MF, Kirmani JF, Divani AA. Prevalence and trends of prehypertension and hypertension in United States: National Health and Nutrition Examination Surveys 1976 to 2000. Med Sci Monitor 2005; 11(9): CR403-9.
13. Tatsumi Y, Asayama K, Morimoto A, Satoh M, Sonoda N, Miyamatsu N, et al. Hyperuricemia predicts the risk for developing hypertension independent of alcohol drinking status in men and women: the Saku study. Hypertens Res 2020; 43(5): 442-9.
14. Ma M, Wang L, Huang W, Zhong X, Li L, Wang H, et al. Meta-analysis of the correlation between serum uric acid level and carotid intima-media thickness. Plos One 2021; 16(2): e0246416.
15. Tanaka K, Kabayama M, Sugimoto K, Akasaka H, Takami Y, Takeya Y, et al. Association between uric acid and atherosclerosis in community-dwelling older people: The SONIC study. Geriatr Gerontol Int 2021; 21(1): 94-101.
16. Weir CJ, Muir SW, Walters MR, Lees KR. Serum urate as an independent predictor of poor outcome and future vascular events after acute stroke. Stroke 2003; 34(8): 1951-6.
17. Frostegard J. Immunity, atherosclerosis and cardiovascular disease. Bmc Med 2013; 11: 117.
18. Falk E. Pathogenesis of atherosclerosis. J Am Coll Cardiol 2006; 47(8 Suppl): C7-12.
19. Cao JJ, Arnold AM, Manolio TA, Polak JF, Psaty BM, Hirsch CH, et al. Association of carotid artery intima-media thickness, plaques, and C-reactive protein with future cardiovascular disease and all-cause mortality: the Cardiovascular Health Study. Circulation 2007; 116(1): 32-8.
20. Gennisson JL, Deffieux T, Fink M, Tanter M. Ultrasound elastography: principles and techniques. Diagn Interv Imag 2013; 94(5): 487-95.
21. Valente G, Rinaldi L, Moggio G, Piai G. Point shear wave elastography and vibration controlled transient elastography for estimating liver fibrosis in a cohort of liver transplant patients. Eur Rev Med Pharmaco 2020; 24(13): 7357-65.
22. Taljanovic MS, Gimber LH, Becker GW, Latt LD, Klauser AS, Melville DM, et al. Shear-Wave Elastography: Basic Physics and Musculoskeletal Applications. Radiographics 2017; 37(3): 855-70.
23. Li Z, Du L, Wang F, Luo X. Assessment of the arterial stiffness in patients with acute ischemic stroke using longitudinal elasticity modulus measurements obtained with Shear Wave Elastography. Med Ultrason 2016; 18(2): 182-9.
24. Calabuig I, Martinez-Sanchis A, Andres M. Sonographic Tophi and Inflammation Are Associated With Carotid Atheroma Plaques in Gout. Front Med-Lausanne 2021; 8(795984.
25. Rao GN, Corson MA, Berk BC. Uric acid stimulates vascular smooth muscle cell proliferation by increasing platelet-derived growth factor A-chain expression. J Biol Chem 1991; 266(13): 8604-8.
26. Corry DB, Eslami P, Yamamoto K, Nyby MD, Makino H, Tuck ML. Uric acid stimulates vascular smooth muscle cell proliferation and oxidative stress via the vascular renin-angiotensin system. J Hypertens 2008; 26(2): 269-75.
27. Cipolli JA, Ferreira-Sae MC, Martins RP, Pio-Magalhaes JA, Bellinazzi VR, Matos-Souza JR, et al. Relationship between serum uric acid and internal carotid resistive index in hypertensive women: a cross-sectional study. Bmc Cardiovasc Disor 2012; 12: 52.
28. Mohd NM, Malek KA, Isa MR, Hamdan MF, Abdul KR, Ahmad F, et al. Association between elevated carotid intima-media thickness and serum uric acid levels among patients with essential hypertension in primary care setting in Sungai Buloh, Malaysia. Int J Clin Pract 2021; 75(9): e14445.
Published
2024/10/13
Issue
Ahead of print
Section
Original paper

Copyright (c) 2024 Yifan Wang, Xinyu Wang, Xiya Li, Zhen Li, Mengmeng Zhang, Siran Zhang, Le Ma, Dongmei Huang, Guangsen Li

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