| Objective:Coronary atherosclerotic heart disease (CHD) is a frequent and familiar disease in the internal department of cardiology. The coronary arteriography is "gold standard" of CHD diagnosis which already developed at clinic extensively. But the expenses of this kind of examination is higher, It is hard for the patients to accept. Therefore, the noninvasive methods to artery atherosclerotic played an important role in clinical research. The examination of artery compliance and Endothelial function is a main research direction. The artery compliance or artery elasticity, mainly reflects the contraction and distention function of the artery. It is decided by diameter of the artery and hardness of the wall or artery distensibility. The artery compliance is function change and endothelial function is structural change in the process of the atherosclerosis, which can cause a series of pathological changes. The artery compliance reflects the function of endothelial to some extent, while endothelial function is usually the preface of the cardiovascular disease. Our research evaluates the endothelial dysfunction and the changes of artery compliance, and contrasts the result with the coronary arteriography. The relation of the artery compliance and the endothelial dysfunction is studied in the meantime.Method:From September 2005 to August 2006, 92 resident patient in our hospital were enrolled in the study. Their ages is from 38 to 73. The mean age is: male 58.3±9.7 years, female 56.0±9.6 years(male 58, female 34). Selected coronary angiography with Judkins method was perfomed, and the subjects were divided by coronary arteriography into three groups as mutiple branch lesion groups, single branch lesion groups and the non-coronary heart disease group. The enrolled patients were examined the ascending aortic compliance by ultrasound and aortic upperwall tissue velocities (Sao, Eao, Aao, m/s) in Doppler tissue imaging(DTI). Ascending aortic compliance was shown by stiffness index beta (β) and distensibility coefficient (D). The plasma concentration of von Willebrand factor(vWF) were determined at the same time.Result:1. With the aggravation of lesions of coronary artery, the ascending plasma concentration of vWF was significantly different between these groups: [The normal group (61.55±59.55)% vs. the single branch lesion group (97.40±44.65)% vs. the mutiple branch lesion group (140.89±93.26)%, p=0.005];while aortic distensibility coefficient in CHD group was lower than the control group[(35.30±24.65)×10-4cm2/dyn vs. (15.30±8.40)×10-4cm2/dyn vs. (15.61±12.42)×10-4cm2/dyn,p=0.001];β:[(13.81±7.34) vs.(18.84±11.43) vs. (22.08±15.87),p=0.001].2. The descending aortic upperwall tissue velocities: Sao[(0.10±0.08) m/s vs. (0.08±0.03)m/s vs. (0.08±0.02)m/s,p=0.012];Eao[ (0.07±0.02)m/s vs. (0.05±0.01)m/s vs. (0.04±0.01)m/s,p=0.001], while Aao was same in these groups.3. The plasma concentration of vWF negatively correlated with aortic coefficient D (r=-0.880,p=0.001),and positively correlated withβ(r= 0.634,p=0.003). (4) Sao and Eao in doppler tissue imaging correlated with aortic distensibility and Ascending stiffness index, but Aao was not correlated with the above two.Conclusion:1. With the aggravation of lesions of coronary artery, the plasma concentration of vWF significantly ascends and aortic distensibility coefficient (D) descends, aortic stiffness (β) ascends. This explains the aortic compliance and the endothelial dysfunction present a parallel relation.2. The descending aortic upperwall tissue velocities, Sao and Eao. The result of direct doppler tissue imaging is consistent with the trend of the changing of artery elasticity. So we supposed that Sao and Eao are clinic index to examine artery elasticity.3. The plasma concentration of vWF negatively correlated with aortic coefficient D, and positively correlated withβ. It showed that the aortic compliance correlated with the endothelial dysfunction intimately.4. Sao, Eao correlated with aortic coefficient D and aortic stiffnessβ. It provided that DTI technique can be a clinic index to examine artery elasticity.In a word, the parameters which we talk about can be very valuable examination to CHD. With the development of our country large-scale artery atherosclerotic examination, normal reference value and abnormality value can be built up. The cardiovascular disease diagnosis and treatment level would be exalted in the future.
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