Evaluation Of Relationship Between Carotid Elasticity And Coronary Artery Disease Severity By Echo-tracking Technology

Background and objectiveAtherosclerosis (AS) is a group of general vascular diseases, as a part of it, coronary heart disease (CHD) had become the most common cardiovascular disease, which serious harms to people's health. There are various of methods to detect it, coronary angiography(CAG) as the best diagnosis has very important clinical value, but due to its traumatic occlusion and complicated operation, it can't extensive detect the high-risk group in the early time. So it has important clinical significance to find a device that diagnose and prevent CHD in early phases.In the recent years, people have been gradually realized that there have a close correlation between carotid arterioscleros and coronary arteries disease. As a result of fast development in ultrasound technique, the detection of carotid by ultrasound has been seen as the "windows" to forecast the CHD, but the previous studies most concentrated on the change of artery structural:the intima-media thickness (IMT) and the plaques incidence. Actually, AS is a vascular disease which both injure the arteries's structural and functional, the functional abnormity in AS is even earlier than structural change, and it even penetrate the whole arterioscleros process. This research use the Echo-tracking (ET) technology to measurement the carotid eleastic modules, then combine the IMT and plaques incidence, to invest whether there has realtion between the artriel eleastic and the coronary atherosclerosis. It aim to approach if there has any difference about the carotid arterioscleros among different degrees of coronary artery disease group, and to provide some valuable information for the clinical application of the change of artery elastic function。Patients and methodsThere are 308 patients who suspected CHD were examed by CAG, including 175 males and133 females, their mean age is (56.43±8.31) years, and they were classfied according to the CAG results as:normal control group88 cases,48 males and 40 females, mean age (55.62±6.83) years; and coronary artery disease group 222 cases,127males and 93 females, mean age (57.95±8.62) years. The coronary artery disease group be divied by different degrees to:69 subjects with 1-vessel disease,72 subjects with 2-vessel disease and 79 subjects with multiple-vessel disease. Cardiovascular risk (age, gender, hypertension, smoking, diabetes, et.) were obtained from each patient, Applied ALOKEa-10 color doppler ultrasonograph witn softwares of echo tracking technique and e-DMS (Digital Manage System) to observe the carotid, make the proximal 1.5cm of the bifurcation to be the measured position, measured and recorded the IMT and the plaques incidence, then ET technique was used to acquire the cartoid elasticity parameters included:the stiffness parameters(β), pressure-strain elastic modulus(Ep), arterial compliance(AC), pulse wave conducting velocity(PWVβ) and augment index(AI).All these parameters were statistically analyzed by SPSS16.0 to find whether there has any relationship between cartoid and Cornary heart disease.Continuous variables bad been analysis by One-Sample T Test, Means deciazione standard bad been analysis by Analysis of Variance(ANOVA), for all analysis, a p value less than 0.05 was considered significant.Results1. Comparison of CHD and control groups in all clinical indexBetween the two groups, statistically differences were significant in age, blood glucose level and low-density lipoprotein, but in gender, body mass index(BMI), total cholesterol, high-density lipoprotein, blood pressure level, there were no statistically difference.2. Comparison of carotid IMT and plaques incidence in CHD and control groupsIMT and the plaques incidence both have statistical significance among multiple-vessel disease group with 1-vessel disease group,2-vessel disease group and normal control group (p<0.05), they are in 2-vessel disease group also significantly higher than those in normal control group (p<0.05) IMT and the plaques incidence are higher in 1-vessel disease group than in normal control group, This tendency also exist in 2-vessel disease group and 1-vessel disease group, but they have no statistical significance (p>0.05).3. Comparison of carotid elasticity parameters in CHD and control groupsEρ,PWVβ,βall increased progressively along with the severity degree of stenosis of coronary aeteries in different groupes, but AC reduced graduaiiy.(p<0.05), the significance is escispally obviously in the multiple-vessel disease group and 1-vessel disease group,normal control group,2-vessel disease group and normal control group (p<0.01)AI is higher in 1-vessel disease group than that in normal control group, but have no statistical significance (p>0.05) Conclusion1. Carotid IMT and the plaques incidence can reflect the generation development and the severity degree of cornary arteries disease,but they have only small cliinical value to forecast cornary arteries disease in earlier time.2. The carotid elasticity parameters measured by ET can be regarded as good indexes reflecting of the artery function, they not only provide meaningful information of the severity degree of involved cornary arteries disease, but also to forecast the early cornary heart disease conveniently, quickly and ensitiveness. Echo-tracking detection carotid could be useful for patients with high-cardiovascular risk to prevente, prognose and comprehensive evaluate.3. Age, blood glucose level and low-density lipoprotein can be seen as the major risk factor to coronary heart disease.