Correlation Between Left Ventricular Weight Index And Severity Of Coronary Artery Disease In Patients With Coronary Heart Disease

Objectives To explore the relationship between left ventricular mass index and severity of coronary artery disease in patients with coronary heart disease,and to evaluate the predictive value of left ventricular mass index to the severity of coronary artery diseaseMethods A retrospective analysis was performed on 1,452 patients who underwent coronary angiography in our hospital on January 1,2015(solstice)and December 31,2018.According to the Coronary angiography results,988 cases were divided into CHD group,464 cases were divided into Non-coronary heart disease group(control group).The left ventricular diameter,ventricular septum thickness and left vent ricular posterior wall thickness of the selected subjects were measured by color doppler echocardiography,and LVMI was calculated according to the relevant formula.(1)Patients in CHD group were divided into two subgroups according to whether they had hypertension or not: they are CHD uncomplicated hypertension group(CHD-non-HP group)and CHD complicated hypertension group(CHD-HP group).(2)The two subgroups were divided into groups with different severity of coronary artery disease according to the coronary artery disease count and Gensini scores.(3)Kruskal-wallis test was used to compare the differences of LVMI between groups with different severity of coronary artery disease;Spearman correlation analysis was used to explore the correlation between LVMI and Gensini integral;ROC curve was used to evaluate the predictive value of LVMI in the severity of coronary artery disease;Multiple linear regression analysis was used to control the confounding factors.Results(1)Comparison of baseline data between the control group and the CHD group:The proportion of male in CHD group,proportion of smoking history,TG,LDL-C,SUA and LVMI were all higher than those in the control group(P< 0.05).High-density lipoprotein was lower than that of the control group(P< 0.05).There were no significant differences in total bilirubin,total cholesterol and body mass index between the two groups(P > 0.05).(2)Comparison of LVMI between CHD-HP group and CHD-non-HP group: LVMI = 92.29(79.86,107.06)in the CHD-HP group and 87.98(74.67,106.22)in the CHD-non-HP group.LVMI in CHD-HP group> CHD-non-HP group(P < 0.05).(3)Comparison of LVMI in CHD-HP group:(1)Different lesion number groups: LVMI was 80.25(67.30,94.09),87.42(76.64,98.28),89.62(77.40,105.67),100.79(86.55,116.86)in the no-lesion group,single,double,and three-lesions group.Patients in the group without lesions and hypertension had lower LVMI than those in the group with single,double or triple lesions(P< 0.05).LVMI in the three-vessel lesion group was higher than that in the double-vessel lesion group and single-vessel lesion group(P < 0.05).There was no significant difference in LVMI between the two groups and the single group(P > 0.05).(2)Different Gensini scores groups: LVMI was 80.25(67.30,94.09),86.89(75.68,96.47),92.34(78.23,106.19)and 103.81(86.83,118.56),respectively,in the group without lesions and with hypertension,in the group with mild,moderate and severe lesions.LVMIn the group without lesions and with hypertension <mild lesion group < moderate lesion group < severe lesion group(P < 0.05).(3)Spearman correlation analysis of LVMI and severity of coronary artery disease: correlation coefficient=0.409,P = 0.001.(4)LVMI multiple linear regression analysis: non-standardized coefficient B=0.208,standard error =0.024,standard coefficient =0.360,T value =8.812,P <0.001.(5)Analysis of the predictive value of LVMI for the severity of coronary artery lesions in CHD-HP patients: ROC curve analysis shows: AUC = 0.643(95% confidence interval0.584～0.702),and the critical value was 90.52g/m2(P < 0.001).The sensitivity and specificity of LVMI in predicting the aggravation of coronary artery lesions in THE CHD-HPgroup were 57.20% and 72.60%.(4)Comparison of LVMI in CHD-non-HP group:(1)Different lesion number groups: LVMI was 80.00(70.26,94.31),88.80(73.46,102.13),85.92(72.32,106.46)and 89.24(77.04,109.72),respectively,in the group without lesions and without hypertension,in the group with single,double and three-vessel lesions.Patients in the non-hypertensive group with no lesions had lower LVMI than those in the single,double and triple lesions groups(P< 0.05).There was no significant difference in LVMI between the single,double and triple lesion groups(P > 0.05).(2)Different Gensini scores group: LVMI was 80.00(70.26,94.31),82.87(73.53,100.62),88.04(73.78,106.42),91.15(76.86,112.71)in the non-diseased group,mild,moderate and severe coronary artery disease group.Patients in the group without lesions and without hypertension had lower LVMI than those in the mild,moderate and severe groups(P < 0.05).There was no significant difference in LVMI between mild,moderate and severe lesion groups(P> 0.05).(3)Spearman correlation analysis of LVMI and severity of coronary artery disease: correlation coefficient=0.221,P < 0.001.(4)The multivariate linear regression analysis results of LVMI influencing factors were as follows: non-standardized coefficient B=0.101,standard error=0.033,standard coefficient =0.153,t value =3.062,P = 0.002.(5)Analysis of the predictive value of LVMI for the severity of coronary artery disease in the CHD-non-HP group: ROC curve analysis showed that LVMI was not statistically significant for the severity of coronary artery disease in the CHD-non-HP group(P= 0.383).Conclusion(1)LVMI was positively correlated with the severity of coronary artery disease.(2)LVMI has a certain predictive value for the severity of coronary artery in patients with CHD and hypertension.(3)LVMI had no predictive value for the severity of coronary artery disease in non-hypertensive patients with CHD.