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An ultrasound automated method for non-invasive assessment of carotid artery pulse wave velocity
  1. Enrico Maria Zardi1,
  2. Luca Di Geso2,
  3. Antonella Afeltra1,
  4. Domenico Maria Zardi3,
  5. Chiara Giorgi4,
  6. Fausto Salaffi2,
  7. Marina Carotti5,
  8. Marwin Gutierrez6,
  9. Emilio Filippucci2,
  10. Walter Grassi2
  1. 1 Department of Immunorheumatology, Università "Campus Bio-Medico", Roma, Italy
  2. 2 Department of Rheumatology, Polytechnic University of the Marche, Jesi - Ancona, Italy
  3. 3 Division of Cardiology, Faculty of Medicine and Psychology, University of Rome "Sapienza", Sant’Andrea Hospital, Rome, Italy
  4. 4 Department of Radiology, S. Maria della Misericordia Hospital, Urbino, Italy
  5. 5 Istituto di Radiologia, Università Politecnica delle Marche, Ancona, Italy
  6. 6 Division of Musculoskeletal and Rheumatic Diseases, Instituto Nacional de Rehabilitacion, Mexico City, Mexico
  1. Correspondence to Dr Enrico Maria Zardi, Department of Immunorheumatology, Campus Bio-Medico University, Via Álvaro del Portillo 200, Rome 00128, Italy; e.zardi{at}


To validate the clinical applicability and feasibility of an automated ultrasound (US) method in measuring the arterial stiffness of patients with chronic inflammatory rheumatic diseases, comparing automated measurements performed by a rheumatologist without experience in vascular sonography with those obtained by a sonographer experienced in vascular US, using a standardized manual method. Twenty subjects affected by different chronic inflammatory rheumatic disorders were consecutively recruited. For each patient, the arterial stiffness of both common carotids was manually calculated. Subsequently, the measure of the pulse wave velocity (PWV) was obtained using an US device called Radio Frequency - Quality Arterial Stiffness (RF-QAS), provided by the same US system (ie, My Lab 70 XVG, Esaote SpA, Genoa, Italy) equipped with a 4–13 MHz linear probe. The reliability comparison between the two US methods was calculated using the intraclass correlation coefficient (ICC). ICC between the values obtained with the two methods for calculating the arterial stiffness resulted 0.789. A significant positive correlation between the two methods was also established with Pearson’s (r=0.62, p<0.0001) and Spearman’s analysis (r=0.66, p=0.001). A significant performance comparison was seen using Bland-Altman plot. The acquisition of the arterial stiffness parameter with the automated method required about 2 min for each patient. Clinical applicability of this US automated method to assess PWV at common carotid level by a rheumatologist is reliable and feasible in comparison with a conventional manual method.

  • arteriosclerosis
  • cardiovascular diseases
  • diagnostic imaging
  • ultrasonography doppler

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  • Contributors EMZ and LDG conception and design of research; EMZ and LDG performed sonography; DMZ, CG and AA analyzed data; FS, MC, EF and WG interpreted the results of the work; LDG and MG prepared the figure; EMZ, LDG and EF drafted manuscript; EMZ, AF, DMZ, CG, FS, MC, MG, EF and WG edited and revised manuscript; all authors approved final version of manuscript.

  • Competing interests EMZ, AA, DMZ, CG, FS, MC declare no competing interests. LDG has received speaking fees from Esaote Spa. EF has received speaking fees from AbbVie, UCB Pharma, Bristol-Myers Squibb, Merck Sharp & Dohme. WG has attended advisory board meetings and scientific consultancies and has received speaking fees from General Electric Medical System, Esaote Spa, Bristol-Myers Squibb, Merck Sharp & Dohme, Schering Plough, UCB Pharma, AbbVie, Savient, Pfizer, Menarini, Wyeth and Fidia.

  • Ethics approval Comitato Etico dell’Azienda Sanitaria Unica Regionale di Ancona.

  • Provenance and peer review Not commissioned; externally peer reviewed.