A prospective cohort study was undertaken to determine whether the peak systolic velocities detected by TCD can predict the subsequent stroke risk among habitants from the Shijingshan district of Beijing, China.Īfter obtaining written informed consent and following a 12 hour fast, participants were asked standardized questions about their demographics, past medical history, and classic cardiovascular risk factors, such as cigarette smoking, alcohol use, and degree of physical exercise. Even more important, STOP demonstrated that TCD identification of a high risk population and selecting patients for treatment (exchange transfusion) lowered the risk of stroke by 92%.įor TCD to be an effective and valuable screening tool in a large Chinese population, it should be demonstrated that an abnormal population as identified by TCD would be at increased risk for stroke. It has been confirmed by the Stroke Prevention Trial in Sickle Cell Anemia (STOP) that high flow velocities are correlated with subsequent stroke risk in children with sickle cell disease (SCD), and that TCD is a powerful predictor of stroke due to SCD. As a non-invasive, safe, portable, relatively low-cost and well-tolerated technique, TCD is used for real-time evaluation of blood flow velocities in the major cerebral arteries and seems suited for screening high risk individuals among a large population. In one study, the sensitivity was 91.6% and the specificity was 93.1% when diagnosing unilateral middle cerebral artery (MCA) stenosis by peak systolic velocities as detected by TCD. As blood flow velocity is inversely related to arterial diameter, intracranial arterial stenosis can be identified by an increase in velocity. Ischemic stroke typically results from occlusion or stenosis of cerebral large arteries. Transcranial Doppler ultrasound (TCD), which was introduced almost 30 years ago, has shown its potential screening value for stroke. Considering the limited resources in China, high-risk prevention strategies with ideal cost-effectiveness that are valid and suitable for identifying those at risk for stroke are needed. Although a great many stroke prevention approaches have been implemented, the incidence and burden of stroke in China has been increasing over the past two decades, suggesting that primary prevention strategies are not well translated into practice. In China, stroke remained the leading cause of death and became the second leading cause of adult disability. Stroke age-standardized incidence has been declining in developed countries over the last 30 years, but there was a striking increase in developing countries, with approximately 70% of strokes occurring in developing nations. The Global Burden of Disease study in 2013 (GBD 2013) ranked stroke as the second most common cause of death and the third leading cause of life years lost worldwide, causing 110.1 deaths/100,000 persons and representing 12.5% of all-cause mortality. Stroke Prevention Trial in Sickle Cell Anemia DBP, This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the paper and its Supporting Information files.įunding: This study was supported by the People’s Republic of China Ministry of Science and Technology and the Ministry of Health through the 10th and 11th National Five-Year Plan Projects (contracts 2001BA703BBAI01A02).Ĭompeting interests: The authors have declared that no competing interests exist. Received: Accepted: JPublished: August 11, 2016Ĭopyright: © 2016 Wang et al. PLoS ONE 11(8):Įditor: Yan Li, Shanghai Institute of Hypertension, CHINA (2016) Peak Systolic Velocity Measurements with Transcranial Doppler Ultrasound Is a Predictor of Incident Stroke among the General Population in China. Citation: Wang H-B, Laskowitz DT, Dodds JA, Xie G-Q, Zhang P-H, Huang Y-N, et al.
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