Non-invasive Evaluation Of Arterial Stiffness Detection Of The Significance Of Cardiac Dysfunction

Background and ObjectiveWith better understanding of the mechanism of occurrence and development of cardiovascular diseases, atherosclerosis(AS) and other related vascular lesions were considered to be the main cause of cardiovascular diseases. So evaluation of arterial structure and function in early stage will help to prevent the cardiovascular diseases, and it has became an attractive focus in the field of cardiovascular disease control. The level of aldosterone (ALD), B-type natriuretic peptide (BNP), high-sensitivity C-reactive protein (hs-CRP) in serum and left ventricular ejection fraction (LVEF) were used for the evaluation of cardiovascular disease for many years. Recent studies indicated that the damage of arterial structure and function would lead to early changes of blood vessels, hypertension, coronary heart diseases and other cardiovascular disease. The cardio-ankle vascular index (CAVI) and ankle brachial index (ABI)are closely related with the stiffness and compliance of artery, and can be use for the evaluation of arterial stiffness. Several studies abroad have shown that congestive heart failure associated with increased arterial wall stiffness, and arterial stiffness to cardiac load increase, further increase left ventricular afterload. This study CAVI, ABI testing compared with traditional biochemical indicators, preliminary study of noninvasive detection of arterial stiffness in the joint significance of diagnosis of heart failure.Subjects and methods1. Subjects and group Hospital-based case-control study was conducted and all subjects were recruited from Cardiology patients from October 2008 to January 2009. The population investigated was comprised of 52 male and 58 female patients who agreed to take part in this study. The mean age of the 110 patients was 0.39±10.237. The whole samples were divided into three groups according to the Framingham Chronic heart failure standard. The number of level II, level III and level IV was 50, 30 and 30 respectively.2. Methods For quality control, basic information containing name, sex, ID number, age, height, body weight, body mass index (BMI), clinical diagnosis from samples were recorded. The one who have ever suffer from myocardial infarction, cerebral apoplexy, hepatic and kidney function obstacle, hepatic function insufficiency, chronic infection, autoimmune diseases, arteritis or thromboangiitis in the past three months was exclude from the samples.The CAVI and ABI of patients were determined in 3 days after hospitalization. Meanwhile the level of ALD, BNP and hs-CRP in serum and the LVEF were determined. All data were accumulated in a EXCEL file and were shown by mean±SD. Student's t test, one-way anova test and Pearson correlation test were used to statistical analysis of data by using software SPSS13.0. It was considered to be statistically significant when P<0.05.Results1. All samples investigated in this study reach the requirement of Framingham heart failure standard. No significant difference of age, sex, height, body weight and BMI was observed among the three groups.2. While investigating the stiffness index and compliance, the two parameters were significantly different among three divided groups. The stiffness index and compliance of patients with high-risk or compensation-missing chronic heart dysfunction were higher than that of primary chronic heart dysfunction. No significant difference was noted between the levelIII and level IV(P>0.05). Similar result was obtained when comparing the stiffness index and compliance of the right limbs with that of the left(P>0.05).3. Data from the laboratory examination were in consent with the previous studies, indicates that the level of ALD, BNP and hs-CRP in serum and LVEF could be used for the estimation of cardiovascular diseases.4. Result from correlation analysis indicates that the CAVI is positively related to the level of ALD, BNP and hs-CRP (r value is 0.344, 0.434, 0.406 respectively and P<0.05), and negatively related to LVEF (r=-0.678,P<0.05). Thus the CAVI is closely related with traditional parameters.Conclusions1. CAVI and ABI from simple and noninvasive examination method can be used for evaluation of cardiovascular disease.2. CAVI and ABI is an effecient parameter to the distinguish the different level of heart dysfunction, especially for the early stage and the severe heart dysfunction.3. CAVI is closely associated with the ALD, BNP, hs-CRP and LVEF, so it a good sign for the prediction of chronic heart dysfunction.