Ultrasound Detection Of Carotid Atherosclerosis And Branchial Artery Flow Mediated Vasodilation In Patients With Coronary Heart Disease

Objective (1) To investigate the carotid atherosclerosis( the intima-media thickness on carotid artery and plaques ) and the brachial artery flow-mediated dilation (FMD) in patients with coronary heart disease ( CHD ) and evaluate the relation between CHD and carotid artery atherosclerosis. (2) To investigate the diagnostic value of peripheral artery ultrasonography for CHD. Methods Intima-media thickness(IMT) and plaques in the carotid arteries were assessed with high-resolution B-mode ultrasonography and the brachial artery FMD were measured in 86 patients with coronary heart disease and 46 healthy control subjects. Results (1) The intima-media thickness of coronary heart disease group [(0.87 0.16)mm] was significantly thicker than those of the control group [(0.72 0.13)mm, p<0.01]. Atherosclerotic plaques were found mostly in the carotid bifurcation and common carotid artery segments especially in the left side. The prevanlence rate of plaques were 77.9% and 17.4%, Carotid atherosclerosis was more prevalent in CHD patients as compared with Control(p<0.01). (2) The mIMTc of single vessel group [ (0.85 0.15) mm] was significantly higher than those of multivessel group[(0.99 0.17)mm, P<0.01] and significant differences of carotid plaque score were found between the single vessel group and the multivessel subjects [ (2.68 1.82 vs. 1.60 1.27), P<0.05 ]. Intima-media thickness in the carotid artery was correlated with coronary atherosclerotic severity. (3) An mIMTc 0.85mm could predict the presence of coronary heart disease with a specifity of 75%, a sensitivity of 72.3% .(4) The FMD in CHD patients[(6.21 1.92)% ] was significantly impaired when compared with those in control group[(9.04 3.03)%, P<0.01 ]. (5) FMD was inversely correlated with mIMTcin 132 subjects ( r =-0.497 , P<0.01) ,but there was no significant correlation between FMD and mIMTc in the patients with coronary heart disease( r =-0.163 , P>0.05 ).?Multiple analyses showed that CHD was closely associated with age, carotid artery plaque ,sex, hypertension and hypercholesterolemia. The mIMTc increased while the FMD decreased with aging. Conclutions The CHD patients are accompanied with severe carotid atherosclerosis and vasodilation dysfunction. CHD is associated with a higher incidence of and more extensive atherosclerosis in carotid artery.There are close relationship between carotid and coronary artery atherosclerosis. Carotid ultrasound examination could help to predict the presence of coronary artery disease.