Stroke is a leading cause of morbidity and mortality worldwide, and characterization of vulnerable carotid plaque remains the spearhead of scientific research. Plaque destabilization, the key factor that induces the series of events leading to the clinical symptoms of carotid artery disease, is a consequence of complex mechanical, structural and biochemical processes. Novel imaging and molecular markers have been studied as predictors of disease outcome with promising results. The aim of this review is to present the current state of research on the association between ultrasound-derived echogenicity indices and blood parameters indicative of carotid plaque stability and activity. Bibliographic research revealed that there are limited available data. Among the biomarkers studied, those related to oxidative stress, lipoproteins and diabetes/insulin resistance are associated with echolucent plaques, whereas adipokines are associated with echogenic plaques. Biomarkers of inflammation and coagulation have not exhibited any conclusive relationship with plaque echogenicity, and it is not possible to come to any conclusion regarding calcification-, apoptosis- and neo-angiogenesis-related parameters because of the extremely limited bibliographic data.

The estimation of cardiovascular tissue motion from ultrasound images is a task of considerable importance but has remained difficult in clinical practice, mainly due to the limitations of ultrasound imaging and the complexity of tissue motion. This paper presents a survey of methodologies, along with physiologically relevant findings, regarding the estimation of motion of the myocardium and of central and peripheral arteries. Speckle tracking and modeling, and registration are the dominant methods used to calculate tissue displacements from sequences of images. Kinematic and mechanical indices are extracted from these displacements, which can provide valuable functional information about the cardiovascular system in normal and diseased conditions. An important application of motionbased strain indices involves the estimation of elastograms of the cardiovascular tissue. Motion analysis methods can be used to estimate a number of regional mechanical phenomena representing functional tissue properties, which are more sensitive to early changes due to ageing or disease. The importance of these methods lies in their potential to quantify in vivo tissue properties and to identify novel noninvasive personalized disease markers, toward early detection and optimal management of disease, along with increased patient safety. Their clinical usefulness remains to be demonstrated in larg trials.