Assessment of carotid plaque characteristics by RVP technology and their correlation with ischemic stroke risk in H-type hypertension

doi:10.3877/cma.j.issn.1672-6448.2025.09.006

Abstract

Abstract:

Objective

To investigate the mechanical characteristics of carotid plaques in patients with H-type hypertension using RawVision^® plaque quantification technology (RVP), and to analyze their correlation with the risk of ischemic stroke.

Methods

A total of 485 subjects who underwent carotid artery ultrasound examination and were diagnosed with carotid atherosclerotic plaques at the Second Affiliated Hospital of Harbin Medical University from September 2024 to April 2025 were selected as the research subjects. According to hypertension and homocysteine (HCY) status, they were divided into four groups: H-type hypertension group (202 cases), simple hypertension group (128 cases), isolated hyperhomocysteinemia group (HHCY) (86 cases), and control group (69 cases). RVP technology was used to extract plaque strain parameters, including contrast (CNT), equality (ENT), non-relationship (NRT), and capabilities (CPT). Logistic regression, multivariate subgroup analysis, receiver operating characteristic (ROC) curve analysis, and restricted cubic spline (RCS) models were employed to assess the association between these parameters and stroke risk.

Results

There were statistically significant differences in CNT (57.75±27.31 vs 52.18±22.04 vs 56.84±23.16 vs 47.22±18.96) and ENT (0.46±0.08 vs 0.47±0.07 vs 0.46±0.07 vs 0.50±0.09) values among the four groups (P=0.008 and 0.003, respectively). The H-type hypertension group had the highest stroke incidence (48.02%), which was significantly greater than that of the other groups (33.72%, 27.34%, and 11.59%, respectively). Logistic regression analysis showed that hypertension subtype was significantly associated with stroke events in all three models. ROC analysis showed that the AUC values of CNT and ENT for predicting stroke risk were 0.814 and 0.757, respectively, and their evaluation efficacy was superior to that of HCY (AUC=0.670), while the evaluation capabilities of NRT and CPT were relatively weak. RCS analysis revealed a nonlinear positive association between HCY and stroke risk; CNT was linearly positively correlated and ENT negatively correlated with stroke risk, whereas NRT showed a fluctuating nonlinear relationship.

Conclusion

H-type hypertension potentially elevates ischemic stroke risk through increased plaque core strain, while RVP technology demonstrates clinical utility for stroke risk assessment by effectively quantifying carotid plaque mechanical characteristics.

Key words: Ultrasound, Carotid atherosclerosis, RawVision^? plaque quantification, H-type hypertension, Carotid plaque mechanics

Rui Pan, Shouqiang Li, Shuang Chen, Xin Fu, Zhuo Wang, Xiaoping Leng. Assessment of carotid plaque characteristics by RVP technology and their correlation with ischemic stroke risk in H-type hypertension[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2025, 22(09): 824-831.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2025.09.006

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Figures/Tables 9

特征	H型高血压组（202例）	单纯高血压组（128例）	HHCY组（86例）	对照组（69例）	统计值	P值
年龄（岁， $x ¯$ ±s）	64±10	63±8	64±9	62±9	F=1.016	0.385
性别[例（%）]					χ²=23.507	＜0.001
男	131（64.85）	58（45.31）	63（73.26）	33（47.83）
女	71（35.15）	70（54.69）^a	23（26.74）^b	36（52.17）^ac
糖尿病[例（%）]	75（37.13）	58（45.31）	27（31.40）	27（39.13）	χ²=6.083	0.108
血脂异常[例（%）]	124（61.39）	71（55.47）	49（56.98）	26（37.68）^abc	χ²=11.784	0.008
吸烟史[例（%）]	33（16.34）	12（9.38）	10（11.63）	3（4.35）^a	χ²=8.294	0.040
饮酒史[例（%）]	24（11.88）	8（6.25）	8（9.30）	1（1.45）^ac	χ²=8.324	0.040
脂蛋白a升高[例（%）]	52（25.74）	25（19.53）	17（19.77）	7（10.14）^a	χ²=7.924	0.048

特征	H型高血压组（202例）	单纯高血压组（128例）	HHCY组（86例）	对照组（69例）	统计值	P值
年龄（岁， $x ¯$ ±s）	64±10	63±8	64±9	62±9	F=1.016	0.385
性别[例（%）]					χ²=23.507	＜0.001
男	131（64.85）	58（45.31）	63（73.26）	33（47.83）
女	71（35.15）	70（54.69）^a	23（26.74）^b	36（52.17）^ac
糖尿病[例（%）]	75（37.13）	58（45.31）	27（31.40）	27（39.13）	χ²=6.083	0.108
血脂异常[例（%）]	124（61.39）	71（55.47）	49（56.98）	26（37.68）^abc	χ²=11.784	0.008
吸烟史[例（%）]	33（16.34）	12（9.38）	10（11.63）	3（4.35）^a	χ²=8.294	0.040
饮酒史[例（%）]	24（11.88）	8（6.25）	8（9.30）	1（1.45）^ac	χ²=8.324	0.040
脂蛋白a升高[例（%）]	52（25.74）	25（19.53）	17（19.77）	7（10.14）^a	χ²=7.924	0.048

特征	非脑卒中组（316例）	脑卒中组（169例）	统计值	P值
年龄（岁， $x ¯$ ±s）	63±9	64±10	t=1.121	0.263
性别[例（%）]			χ²=5.122	0.024
男	174（55.06）	111（65.68）
女	142（44.94）	58（34.32）
高血压[例（%）]	198（62.66）	132（78.11）	χ²=12.085	＜0.001
糖尿病[例（%）]	116（36.71）	71（42.01）	χ²=1.307	0.253
血脂异常[例（%）]	167（52.85）	103（60.95）	χ²=2.926	0.087
吸烟史[例（%）]	28（8.86）	30（17.75）	χ²=8.262	0.004
饮酒史[例（%）]	19（6.01）	22（13.02）	χ²=6.982	0.008
脂蛋白a升高[例（%）]	49（15.51）	52（30.77）	χ²=15.557	＜0.001
HCY升高[例（%）]	162（51.27）	126（74.56）	χ²=24.763	＜0.001

特征	非脑卒中组（316例）	脑卒中组（169例）	统计值	P值
年龄（岁， $x ¯$ ±s）	63±9	64±10	t=1.121	0.263
性别[例（%）]			χ²=5.122	0.024
男	174（55.06）	111（65.68）
女	142（44.94）	58（34.32）
高血压[例（%）]	198（62.66）	132（78.11）	χ²=12.085	＜0.001
糖尿病[例（%）]	116（36.71）	71（42.01）	χ²=1.307	0.253
血脂异常[例（%）]	167（52.85）	103（60.95）	χ²=2.926	0.087
吸烟史[例（%）]	28（8.86）	30（17.75）	χ²=8.262	0.004
饮酒史[例（%）]	19（6.01）	22（13.02）	χ²=6.982	0.008
脂蛋白a升高[例（%）]	49（15.51）	52（30.77）	χ²=15.557	＜0.001
HCY升高[例（%）]	162（51.27）	126（74.56）	χ²=24.763	＜0.001

组别	例数	CNT	ENT	NRT（%）	CPT
对照组	69	47.22±18.96	0.50±0.09	99.88±0.07	0.00±0.00
单纯高血压组	128	52.18±22.04	0.47±0.07	99.89±0.08	0.00±0.00
HHCY组	86	56.84±23.16^a	0.46±0.07^a	99.89±0.06	0.00±0.00
H型高血压组	202	57.75±27.31^a	0.46±0.08^a	99.89±0.06	0.00±0.00
F值		3.95	4.71	1.00	1.24
P值		0.008	0.003	0.395	0.295

组别	例数	未发生脑卒中	发生脑卒中
对照组	69	61（88.41）	8（11.59）
单纯高血压组	128	93（72.66）	35（27.34）^a
HHCY组	86	57（66.28）	29（33.72）^a
H型高血压组	202	105（51.98）	97（48.02）^abc
χ²值		35.09
P值		＜0.001

高血压分型	模型1			模型2			模型3
高血压分型	OR值	95%CI	P值	OR值	95%CI	P值	OR值	95%CI	P值
H型高血压组	-	-	-	-	-	-	-	-	-
单纯高血压组	0.407	0.253~0.656	＜0.001	0.450	0.276~0.735	＜0.001	0.428	0.239~0.765	0.004
HHCY组	0.551	0.326~0.931	0.026	0.568	0.332~0.972	0.039	0.464	0.242~0.891	0.021
对照组	0.142	0.065~0.312	＜0.001	0.169	0.076~0.377	＜0.001	0.150	0.060~0.374	＜0.001

参数	RVP技术	传统弹性成像技术
同一观察者
CNT	0.95（-5.8，4.7）	0.92（-6.9，6.8）
ENT	0.96（-4.3，4.5）	0.93（-6.5，5.9）
NRT	0.97（-4.8，6.9）	0.89（-5.1，4.7）
CPT	0.96（-4.9，7.1）	0.94（-5.2，6.5）
不同观察者
CNT	0.92（-4.2，4.8）	0.85（-5.6，4.1）
ENT	0.91（-4.7，5.3）	0.87（-5.4，4.7）
NRT	0.93（-5.3，6.5）	0.90（-4.8，5.9）
CPT	0.92（-4.5，5.9）	0.86（-5.1，4.2）

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