Ultrasound entropy may be a new non-invasive measure of pre-clinical vascular damage in young hypertensive patients

• Published in: Cardiovascular ultrasound 2015-03, Vol.13 (1), p.12-12, Article 12
• Main Authors: Bleakley, Caroline, McCann, Aaron, McClenaghan, Vivienne, Hamilton, Paul Kevin, Millar, Auleen, Pumb, Richard, Harbinson, Mark, McVeigh, Gary Eugene
• Format: Article
• Language: English
• Subjects: Adult; Algorithms; Carotid Arteries - diagnostic imaging; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - etiology; Entropy; Female; Humans; Hypertension - diagnostic imaging; Hypertension - etiology; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; Male; Middle Aged; Pattern Recognition, Automated - methods; Reproducibility of Results; Sensitivity and Specificity; Ultrasonography - methods; Wavelet Analysis
• ISSN: 1476-7120; 1476-7120
• DOI: 10.1186/s12947-015-0006-7

The identification of pre-clinical microvascular damage in hypertension by non-invasive techniques has proved frustrating for clinicians. This proof of concept study investigated whether entropy, a novel summary measure for characterizing blood velocity waveforms, is altered in participants with hypertension and may therefore be useful in risk stratification. Doppler ultrasound waveforms were obtained from the carotid and retrobulbar circulation in 42 participants with uncomplicated grade 1 hypertension (mean systolic/diastolic blood pressure (BP) 142/92 mmHg), and 26 healthy controls (mean systolic/diastolic BP 116/69 mmHg). Mean wavelet entropy was derived from flow-velocity data and compared with traditional haemodynamic measures of microvascular function, namely the resistive and pulsatility indices. Entropy, was significantly higher in control participants in the central retinal artery (CRA) (differential mean 0.11 (standard error 0.05 cms(-1)), CI 0.009 to 0.219, p 0.017) and ophthalmic artery (0.12 (0.05), CI 0.004 to 0.215, p 0.04). In comparison, the resistive index (0.12 (0.05), CI 0.005 to 0.226, p 0.029) and pulsatility index (0.96 (0.38), CI 0.19 to 1.72, p 0.015) showed significant differences between groups in the CRA alone. Regression analysis indicated that entropy was significantly influenced by age and systolic blood pressure (r values 0.4-0.6). None of the measures were significantly altered in the larger conduit vessel. This is the first application of entropy to human blood velocity waveform analysis and shows that this new technique has the ability to discriminate health from early hypertensive disease, thereby promoting the early identification of cardiovascular disease in a young hypertensive population. Clinical Trials.gov, NCT01047423.