Correlation Between Brachial-Ankle Pulse Wave Velocity And Anakle Brachial Index And Coronary Artery Disease

Background:Cardiovascular disease especially coronary atherosclerotic heart disease (coronary artery disease, CAD) is a serious threat to the health of the major people. While the development of atherosclerosis is hidden, without clinical symptoms for a long period of time,severe cardiovascular events will happen all of a sudden.Therefore, It is important to early distinguish the patients with coronary artery disease.A decade ago, a German researcher found that carotid-femoral pulse wave velocity (cfPWV) can well predicted the risk of coronary heart disease. cfPWV has been extensive researched and applied in clinic in the following years. Researchers in Japan have invented a new method of PWV, brachial-ankle pulse wave velocity(baPWV),to cope with the inconvenience of cfPWV. So far, PWVs have been used in clinic for more than 10 years. Several types of arterial stiffness measurement methods were applied to detect arterial elasticity, to predict the risk of cardiovascular disease. While principles of these methods are the same, the specific measuring methods are different. The clincal application value of these methods are different as well. Our study focused on exploring the correlation between baPWV, ABI and the severity of CAD and looking for low-costly and non-injured detective method or methods.Aim:To explore the correlation between brachial-ankle pulse wave velocity(baPWV%) and severity of coronary artery disease,and to explore the correlation between ankle brachial index(ABI) and the severity of coronary heart disease. To explore the value which baPWV,ABI wre applied to predicting CAD.Methods:452 patients who were hospitalized in Beijing Army General Hospital on 2008,6～2010,6 were recruited, and divided into coronary artery disease(CAD) group(251 cases) and non-CAD group(201 cases) according to coronary angiography(CAG). Patients of CAD group were divided into mild,moderate and severe pathological group,all patients were measured with baPWV, baPWV%, ABI and ECG before CAGApply ROC curve to evaluate the predicting CAD value of baPWV, baPWV%and ABI,and calculate its sensitity,specificity; Apply spearman correlation analysis method to analyze the correlation between baPWV and SYNTAX scores, baPWV% and SYNTAX scores,ABI and SYNTAX scores.Combine baPWV with baPWV% to explore the predicting value of CAD. Combine baPWV with ECG to explore the predicting value of CAD. The main CHD risk of age,sex,smoking,diabetes and hypertension were applied to multiple facters Logistic analysis to detect its damaging role. Results:BaPWV, and BaPWV% had statistically significant difference(p<0.001) between CAD group and non-CAD group. BaPWV had statistically significant difference(p<0.001) between the mild and moderate pathological group of CAD,but had not statistically difference(p =0.087) between the mild and moderate pathological group of CAD. BaPWV% had statistically significant difference(p<0.001) among the mild,moderate and severe pathological group of CAD.ABI had statistically significant difference(p=0.024) between CAD group and non-CAD group.In the subgroup of CAD,ABI had statistically significant difference (P<0.001).There was a moderate correlation between SYNTAS scores and BaPWV, BaPWV%,but comparable correlation was not found in ABI(r=-0.443 p<0.001). A moderate predictive value was verfied when we used each of the baPWV and baPWV%and its sensitivity and specificity were 88.0% and 25.8% related to baPWV respectively, 70.1% and 65.1% related to baPWV% respectively.However, a advanced predictive value was detected as well when we combined the baPWV with baPWV%(series test).Its sensitivity and specificity were 68.0% and 80.1% respectively.The same result was seen in the combination of baPWV and ECG (series test).Its sensitivity and specificity were 59.7% and 89.0% respectively. To our surprise, a remarkable predictive value method emerged when we combined the baPWV% with ECG (parallel test).Its sensitivity and specificity were 68.0% and 80.1% respectively.Conclusions:Each of baPWV and baPWV% had a moderate correlation related to severity of CAD.BaPWV had a limited application value related to predicting CAD when it used alone. BaPWV% had a advanced application value compared with baPWV. When combined baPWV with baPWV%(series test), combinied baPWV with ECG (series test),a advanced method of predicting CAD was detected. A remarkable predictive method was verfied when we combined the baPWV% with ECG (parallel test).Therefore,this mothed is worthy of being promoted in clinic.