An DSCT-based Clinical Research On Correlation Of Aortic Elasticity With Coronary Artery Stenosis And Associated Risk Factors

Objective: To analyze retrospectively ECG-gated coronary angiographicmeasurement of aortic elasticity index value and the degree of coronary artery stenosis,by firstly analyzing aortic elastic function and coronary artery stenosis and their degreeof correlation, followed by analysis of extent of risk factors leading to coronary arterystenosis, and finally exploring the clinical value of DSCT evaluation of elasticity of theascending aorta.Methods: Between August2012to January2013, a total of104hospitalizedpatients with suspected coronary heart disease in the Department of Cardiology atZhongshan Hospital of Dalian University, were enrolled in the study,[males54, females50cases, age range25-83years, mean (57.31±11.00) years], and underwent DSCTcoronary angiography. Their detailed clinical data for coronary stenosis related riskfactors were evaluated. The patients were divided into4groups according to thepresence or absence of coronary artery stenosis and hypertension, coronary stenosisgroup were divided into mild, moderate and severe groups, and finally by the presenceor absence of hypertension as coronary stenosis or stenosis divided into four groups,into a total of11groups. Siemens DSCT (SOMATOM Definition) machine was usedfor scanning, combined with ECG editing functions to obtain ECG T wave to R wave atthe top of the aortic systole and end-diastolic image reconstruction using INSPACEvascular measurement software, to measure the heart pulsation period of the same level(main artery above the sinus25mm) diameter and cross-sectional area of the ascendingaorta, and the narrowed coronary score (CAS) followed by statistical analysis.Results:1. Elastic indicators of the ascending aorta: The relative change in diameter of thelumen and expansion (%AO, AoD) and wall compliance elasticity (the AOC, AoSI)),in coronary stenosis and no stenosis groups were statistically significant (P <0.05), especially the AOD and AoSI (P <0.001).2. Ascending aorta’s elastic indicator for coronary stenosis group was statisticall-y significant (P <0.05).3. Ascending aortic elastic indicators for wall stiffness (AoSI) with Gensini rating,showed a significant positive correlation (P <0.01, r=0.716), In addition, the diameterof the lumen’s rate of change and expansion (%AO, AoD) with Gensini score showeda significant negative correlation (P <0.01, r were-0.428,-0.251).4. Among the three groups, hypertension, diabetes, high cholesterol, smoking andold age are risk factors for coronary stenosis. High blood pressure factor was used forgrouping, the rest of the factors smoking, diabetes, age and serum total cholesterol (TC)are independent risk factors for coronary stenosis (P <0.05, OR were6.287/7.4096.995,1.073,15.249). Except for the age factor, independent risk factors and level ofcoronary stenosis were positively correlated (P <0.05).5. High-density lipoprotein (HDL-C) independent protective factors in coronarystenosis, and the decline of the level and extent of coronary stenosis was negativelycorrelated (P <0.05, r=-0.314).Conclusion:1. Aortic elastic indicators at the level of coronary artery stenosis severity has agood correlation and can be used as an independent predictor of coronary heart disease.2. The study further suggests that indicators such as hypertension, diabetes, highcholesterol, smoking and age are risk factors for coronary artery stenosisThe degree and duration of hypertension, diabetes, high cholesterol and smoking canaffect the extent of coronary artery stenosis.3. DSCT can more accurately measure and assess the elasticity of the ascendingaorta; it can be used as a useful screening technique for evaluation of degree of aorticelasticity in patients susceptible to aortic heart diseases.