Quantitative imaging in medicine and surgery · 2025
Evaluation of subclinical atherosclerosis in women with polycystic ovary syndrome based on ultra-high-frequency ultrasound and vector flow imaging.
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Dong Yinghui, Hong Shaofu, Wang Zimo, Song Di, Liu Mengmeng, Zeng Jieying, Du Yigang, Xu Jinfeng, Shi Liyun, Gao Wenjing, Dong Fajin
Аннотация
BACKGROUND: The diagnosis of subclinical atherosclerosis is the key to the primary prevention of atherosclerotic cardiovascular disease (CVD). Considering the increased risk of CVD in women with polycystic ovary syndrome (PCOS), the purpose of this study was to detect the early damage of the carotid artery in PCOS patients using carotid ultra-high frequency ultrasound (UHFUS) and vector flow imaging (V Flow).
METHODS: This study prospectively recruited 40 PCOS patients and 30 age-matched control subjects (mean age 29±5 vs. 30±6 years, P=0.189). All subjects underwent comprehensive medical history collection, anthropometric and hematological examination. The maximum frequency 33 and 24 MHz probes were used to measure the intima/media thickness of common carotid artery (CCA) and the intima-media thickness (IMT) of carotid bulb (CB). The presence of atherosclerotic plaques was also assessed. V Flow was used to measure the wall shear stress (WSS), long-axis strain (LAS) and oscillatory shear index (OSI) of the anterior and posterior walls in CCA and CB.
RESULTS: Subclinical atherosclerosis was detected in 20.0% of PCOS patients and 3.3% of the control group (P=0.039). Clinical/biochemical-hyperandrogenism and insulin resistance (IR) demonstrated significantly higher prevalence in the PCOS group (40% vs. 0%, P<0.001) (45% vs. 3.3%, P<0.001) compared to the control group. The PCOS group exhibited a higher mean body mass index (BMI) (23.7±4.1 vs. 21.1±2.62 kg/m2, P=0.002) and waist-to-hip ratio (WHR) (0.825±0.086 vs. 0.775±0.043, P<0.001) compared to the control group. Compared with the control group, the intima thickness (IT) (0.165±0.055 vs. 0.126±0.022, P=0.001) and IMT (0.767±0.281 vs. 0.681±0.086, P=0.002) of the PCOS group increased, while the WSS of the anterior wall (1.10±0.377 vs. 1.26±0.325 Pa, P=0.027) in CCA and the WSS of the anterior and posterior walls in CB decreased ( 0.450±0.175 vs. 0.572±0.126 Pa, P<0.001; 0.727±0.383 vs. 1.08±0.477 Pa, P=0.001). When the WSS was less than 0.985 Pa, the IT of CCA was thickened, especially for PCOS patients.
CONCLUSIONS: The incidence of early vascular injury in PCOS patients is higher than that in healthy individuals. In addition to systemic metabolic factors such as androgen levels and IR, local disturbed hemodynamic characteristics are more prone to induce the development of plaques, which could potentially be another contributing factor to the premature onset of carotid atherosclerosis. HRFUS and V Flow imaging would provide additional valuable information for characterizing the early development of atherosclerosis.
METHODS: This study prospectively recruited 40 PCOS patients and 30 age-matched control subjects (mean age 29±5 vs. 30±6 years, P=0.189). All subjects underwent comprehensive medical history collection, anthropometric and hematological examination. The maximum frequency 33 and 24 MHz probes were used to measure the intima/media thickness of common carotid artery (CCA) and the intima-media thickness (IMT) of carotid bulb (CB). The presence of atherosclerotic plaques was also assessed. V Flow was used to measure the wall shear stress (WSS), long-axis strain (LAS) and oscillatory shear index (OSI) of the anterior and posterior walls in CCA and CB.
RESULTS: Subclinical atherosclerosis was detected in 20.0% of PCOS patients and 3.3% of the control group (P=0.039). Clinical/biochemical-hyperandrogenism and insulin resistance (IR) demonstrated significantly higher prevalence in the PCOS group (40% vs. 0%, P<0.001) (45% vs. 3.3%, P<0.001) compared to the control group. The PCOS group exhibited a higher mean body mass index (BMI) (23.7±4.1 vs. 21.1±2.62 kg/m2, P=0.002) and waist-to-hip ratio (WHR) (0.825±0.086 vs. 0.775±0.043, P<0.001) compared to the control group. Compared with the control group, the intima thickness (IT) (0.165±0.055 vs. 0.126±0.022, P=0.001) and IMT (0.767±0.281 vs. 0.681±0.086, P=0.002) of the PCOS group increased, while the WSS of the anterior wall (1.10±0.377 vs. 1.26±0.325 Pa, P=0.027) in CCA and the WSS of the anterior and posterior walls in CB decreased ( 0.450±0.175 vs. 0.572±0.126 Pa, P<0.001; 0.727±0.383 vs. 1.08±0.477 Pa, P=0.001). When the WSS was less than 0.985 Pa, the IT of CCA was thickened, especially for PCOS patients.
CONCLUSIONS: The incidence of early vascular injury in PCOS patients is higher than that in healthy individuals. In addition to systemic metabolic factors such as androgen levels and IR, local disturbed hemodynamic characteristics are more prone to induce the development of plaques, which could potentially be another contributing factor to the premature onset of carotid atherosclerosis. HRFUS and V Flow imaging would provide additional valuable information for characterizing the early development of atherosclerosis.