Shear Wave Elastography to Evaluate the Effect of Hemoperfusion on Carotid Artery Elasticity in Uremic Patients Treated With Hemodialysis.

This study aimed to use shear wave elastography (SWE) to evaluate the effect of hemoperfusion (HP) on carotid artery elasticity in uremic patients treated with hemodialysis (HD). Seventy-eight uremic patients were divided into Group B (using HP + HD) and Group C (using HD) according to the dialysis method the patients already used, while 40 healthy volunteers were included as Group A. The clinical data and biochemical indices were collected. Conventional carotid parameters, including carotid intima-media thickness (IMT), carotid artery inner diameter at the end of systole (D s), carotid artery inner diameter at the end of diastole (D d), and peak systolic flow velocity (PSV) were measured. The wall motion degree (∆D) and the stiffness coefficient (β) were calculated. SWE-derived elastic moduli (MEmean, MEmax, and MEmin) were measured. Ten-year cardiovascular disease risk (10-year ASCVD risk) was calculated using the Framingham risk score (FRS). There was no significant difference in the D s, D d, ∆D, and PSV among the three groups (all p > 0.05). Uremic groups exhibited elevated BUN, Scr, BUA, TG, LDL-C, IMT, β, SWE parameters, and 10-year ASCVD risk compared to controls (p < 0.05). Group C showed significantly higher BUN, Scr, BUA, TC, TG, LDL-C, SWE values, and 10-year ASCVD risk than Group B (p < 0.05), though IMT and β did not differ. SWE parameters correlated positively with LDL-C, IMT, β, and 10-year ASCVD risk (all r > 0.372, p < 0.01), and demonstrated superior diagnostic accuracy (AUCs: 0.919-0.953) compared to conventional measures. These data suggest that SWE is helpful in quantitatively assessing the change in carotid artery elasticity. It could be a useful method for monitoring the progression of atherosclerosis in uremic patients undergoing HD with or without HP and may provide guidance for clinicians to identify individuals at heightened cardiovascular risk.