R-QVS combined with VFI identified significant differences in carotid parameters, with PWV and HC showing high diagnostic performance for early changes in GDM (AUC 0.87 and 0.85, respectively).
Observational (n=162)
No
Does multimodal carotid ultrasound using R-QVS and VFI accurately detect structural and functional carotid artery changes in pregnant women with gestational diabetes mellitus?
VFI combined with R-QVS provides a noninvasive method to detect early structural and functional carotid artery changes, such as increased pulse wave velocity and altered wall shear stress, in women with gestational diabetes mellitus.
p-value: p=<0.01
BACKGROUND AND AIMS To explore the value of RF-data-based quantitative analysis on vessel stiffness (R-QVS) analysis combined with dynamic vector flow imaging (VFI) in evaluating carotid artery structural and functional changes in patients with gestational diabetes mellitus (GDM). This approach aims to improve the early detection of vascular dysfunction during pregnancy by providing quantitative and noninvasive assessment of arterial remodeling. METHODS In this prospective study, 117 pregnant women with GDM between 24 and 40 weeks of gestation and 45 healthy pregnant women were enrolled at Xiangyang No.1 People's Hospital from November 2024 to July 2025. Based on carotid intima-media thickness (CIMT), GDM patients were classified into normal CIMT (n = 63) and thickened CIMT groups (n = 54), alongside 45 healthy pregnant women as controls. All participants underwent multimodal carotid ultrasound including R-QVS analysis and VFI. Structural parameters (Diam, Dist, HC, PWV) and functional parameters (WSSmax, WSSmean, Vmax) were recorded. Group differences were analyzed using appropriate statistical tests. Receiver operating characteristic (ROC) curves were generated to assess the diagnostic performance of each parameter. RESULTS Significant differences were observed among the three groups in terms of CIMT, Diam, Dist, HC, PWV, WSSmax, WSSmean, and Vmax (all p < 0.01). CIMT was significantly higher in the GDM group with thickened CIMT (1.15 ± 0.17 mm) compared to the GDM group with normal CIMT (0.76 ± 0.10 mm) and the healthy controls (0.62 ± 0.12 mm). Additionally, the GDM group with thickened CIMT exhibited significantly higher Diam (7.72 ± 0.94 mm), PWV (8.67 ± 0.82 m/s), and HC (5.14 ± 0.72) compared to both the normal CIMT and control groups (p < 0.01). ROC curve analysis demonstrated that PWV and HC had the highest diagnostic performance for detecting early carotid changes in GDM patients, with AUC values of 0.87 and 0.85, respectively. WSSmax and WSSmean also showed good discriminatory ability, with AUC values of 0.90 and 0.84. In contrast, Diam and Vmax yielded lower AUC values of 0.73 and 0.69, respectively. In multivariate linear regression analysis, PWV (β = 0.364, p = 0.011), HC (β = 0.217, p = 0.033), WSSmax (β = -0.112, p = 0.065), and WSSmean (β = -0.150, p = 0.039) were identified as independent factors associated with CIMT. These results suggest that functional vascular changes, including increased PWV and altered WSS, may precede structural thickening of the carotid intima-media in GDM-related vascular remodeling. CONCLUSION VFI combined with R-QVS provides a valuable noninvasive approach for assessing carotid artery structural and functional alterations in GDM. Quantitative parameters such as PWV, HC, and WSS may serve as sensitive indicators of early vascular dysfunction in GDM. The integration of VFI and R-QVS enhances the precision of vascular assessment, offering potential clinical utility for early detection, risk stratification, and individualized cardiovascular management in pregnant women with GDM.
He et al. (Fri,) conducted a observational in Gestational diabetes mellitus (n=162). R-QVS analysis combined with VFI vs. Healthy pregnant women was evaluated on Carotid artery structural and functional parameters (CIMT, Diam, Dist, HC, PWV, WSSmax, WSSmean, Vmax) (p=<0.01). R-QVS combined with VFI identified significant differences in carotid parameters, with PWV and HC showing high diagnostic performance for early changes in GDM (AUC 0.87 and 0.85, respectively).