High blood pressure (BP) is among significant risk factor for stroke and other vascular occurrences, it experiences nonstop fluctuations over time as a result of a complex interface among cardiovascular control mechanisms. Large blood pressure variability (BPV) has been proved to be promising in providing potential regulatory mechanisms of the cardiovascular system. Although the previous studies also showed that BPV is associated with increased carotid intima-media thickness (IMT) and plaque, whether the correlation between variability in blood pressure and left common carotid artery-intima-media thickness (LCCA-IMT) is stronger than right common carotid artery-intima-media thickness (RCCA-IMT) remains uncertain in hypertension. We conduct a study (78 hypertensive subjects, aged 28–79) to evaluate the relationship between BPV and carotid intima-media thickness in Shenzhen. The blood pressure was collected using the 24 h ambulatory blood pressure monitoring, and its variability was evaluated using standard deviation (SD), coefficient of variation (CV), and average real variability (ARV) during 24 h, daytime and nighttime. All the IMT measurements are collected by ultrasound. As the results showed, 24 h systolic blood pressure variability (SBPV) evaluated by SD and ARV were significantly related to LCCA-IMT (r1 = 0.261, P = 0.021; r1 = 0.262, P = 0.021, resp.). For the daytime diastolic blood pressure variability (DBPV), ARV indices were significantly related to LCCA-IMT (r1 = 0.239, P = 0.035), which differed form BPV evaluated by SD and CV. For the night time, there is no significant correlation between the BPV and IMT. Moreover, for all the subjects, there is no significant correlation between the BPV and RCCA-IMT/number of plaques, whereas, the SD, CV, and ARV of daytime SBP showed a positive correlation with LCCA-IMT (r1 = 0.312, P = 0.005; r1 = 0.255, P = 0.024; r1 = 0.284, P = 0.012, resp.). Moreover, the ARV of daytime SBPV, 24 h SBPV and nighttime DBPV showed a positive correlation with the number of plaques of LCCA (r1 = 0.356, P = 0.008; r1 = 0.297, P = 0.027; r1 = 0.278, P = 0.040, resp.). In addition, the number of plaques in LCCA had higher correlation with pulse pressure and diastolic blood pressure than that in RCCA. And multiple regression analysis indicated LCCA-IMT might not only be influenced by age or smoking but also by the SD index of daytime SBPV (p = 0.035). The results show that SBPV during daytime and 24 h had significant correlation with IMT, for the hypertensive subjects from the southern area of China. Moreover, we also found the daytime SBPV to be the best predictor for the progression of IMT in multivariate regression analysis. In addition, the present study suggests that the correlation between BPV and left common carotid artery—intima-media thickness/number of plaques is stronger than right common carotid artery-intima-media thickness/number of plaques.

Blood pressure (BP) is associated with early atherosclerosis and plaque rupture because the BP variability can significantly affect the blood flow velocity and shear stress over the plaque. However, the mechanical response of BP variability to the plaque remains unclear. Therefore, we investigated the correlation between different maximum systolic blood pressure (SBP) and the stress distribution on plaque, as well as the stress over the plaque and blood velocity around the plaque using different BP variations, which are the BP variability in different phases during one cardiac cycle and beat-to-beat BP variability. We established a two-dimensional artery model with stenosis at the degree of 62.5%. Eight combinations of pulsatile pressure gradients between the inflow and outflow were implemented at the model. Three levels of fibrous cap thickness were taken into consideration to investigate the additional effect on the BP variability. Wall shear stress and stress/strain distribution over the plaque were derived as well as the oscillation shear index (OSI) to analyze the impact of the changing rate of BP. The stresses at diastole were 2.5% ± 1.8% lower than that at systole under the same pressure drop during one cycle. It was also found that elevated SBP might cause the immediate increment of stress in the present cycle (292% ± 72.3%), but slight reduction in the successive cycle (0.48% ± 0.4%). The stress/strain distribution over the plaque is sensitive to the BP variability during one cardiac cycle, and the beat-to-beat BP variability could cause considerable impact on the progression of atherosclerosis in long-term.

Atherosclerotic intracranial internal carotid artery stenosis (IICAS) is a leading cause of strokes. Due to the limitations of major cerebral imaging techniques, the early diagnosis of IICAS remains challenging. Clinical studies have revealed that arterial stenosis may have complicated effects on the blood flow’s velocity from a distance. Therefore, based on a patient-specific one-dimensional hemodynamic model, we quantitatively investigated the effects of IICAS on extracranial internal carotid artery (ICA) flow velocity waveforms to identify sensitive hemodynamic indices for IICAS diagnoses. Classical hemodynamic indices, including the peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI), were calculated on the basis of simulations with and without IICAS. In addition, the first harmonic ratio (FHR), which is defined as the ratio between the first harmonic amplitude and the sum of the amplitudes of the 1st–20th order harmonics, was proposed to evaluate flow waveform patterns. To investigate the diagnostic performance of the indices, we included 52 patients with mild-to-moderate IICAS ( 0.05) between the two groups, except for the PSV of the right ICA (p = 0.011). The FHR was significantly higher in the stenosis group than in the control group (p < 0.001), with superior diagnostic performance. Taken together, the FHR is a promising index for the early diagnosis of IICAS using carotid Doppler ultrasound methods.

Several studies have demonstrated the difficulties in distinguishing malignant lesions of the breast from benign lesions owing to overlapping morphological features on ultrasound. Consequently, we aimed to develop a nomogram based on shear wave elastography (SWE), Angio Planewave Ultrasensitive imaging (Angio PLUS (AP)), and conventional ultrasound imaging biomarkers to predict malignancy in patients with breast lesions. This prospective study included 117 female patients with suspicious lesions of the breast. Features of lesions were extracted from SWE, AP, and conventional ultrasound images. The least absolute shrinkage and selection operator (Lasso) algorithms were used to select breast cancer-related imaging biomarkers, and a nomogram was developed based on six of the 16 imaging biomarkers. This model exhibited good discrimination (area under the receiver operating characteristic curve (AUC): 0.969; 95% confidence interval (CI): 0.928, 0.989) between malignant and benign breast lesions. Moreover, the nomogram also showed demonstrated good calibration and clinical usefulness. In conclusion, our nomogram can be a potentially useful tool for individually-tailored diagnosis of breast tumors in clinical practice.