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A Flow Based Diagnostic Test for Early Diagnosis of Cardiovascular Disease

A Malone1*, S Cournane2, I Naydenova1, J Browne3 , (1) Technological University Dublin, Dublin, Ireland, (2) St. Vincent's University Hospital, Dublin, Ireland, (3) Mayo Clinic, Rochester, MN


(Sunday, 7/14/2019)  

Room: ePoster Forums

Purpose: The gold standards for the diagnosis of cardiovascular disease (CVD) are digital subtraction angiography and pulse wave Doppler ultrasound. Both techniques rely on detecting the presence of atherosclerotic plaque in the arteries. There is, therefore, a clinical need for a robust diagnostic screening technique for CVD prior to plaque formation. One possible biomarker for the onset of the disease is wall shear stress, which is related to the stiffening of arterial walls.

Methods: In this work, three methods were evaluated for their ability to discern differences in blood flow behaviour in a range of geometrically identical walled flow phantoms exhibiting varying levels of vessel stiffness (60kPa, 110kPa, & 320kPa). The methods tested were a traditional gated pulsed wave Doppler assessment of blood velocity, an approximation method based on the Hagen-Poiseuille equation, and a spectral analysis technique; multifrequency Doppler, which utilised additional transmitted ultrasound frequencies to further interrogate velocity and reduce spectral variance. For each technique a series of full vessel velocity maps and wall shear stress maps were produced. These maps were analysed using a paired t-test to assess each techniques ability to differentiate between the three stiffness values.

Results: All techniques tested were able to detect a significant difference between the 60 kPa and the 320 kPa vessels (p=0.041, p=0.039, p=0.032). However, the pulsed wave Doppler and Hagen-Poiseuille approximation could not a detect significant difference between the 60 kPa and 110 kPa vessels (p=0.161, p=0.154). Only the multifrequency method was able to resolve a significant difference for this test (p=0.045).

Conclusion: These results indicate that the multifrequency method provides the greatest possibility of developing a robust diagnostic screening technique for atherosclerosis. Although, it should be noted that the other tested techniques were each highly suggestive of significance, therefore further testing for their applicability may be warranted.


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IM- Ultrasound : Doppler

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