Clinical Study Of Aortic Elasticity In Coronary Heart Disease Evaluated By Pulsed Wave Doppler Tissue Imaging.

Objective: to determine clinical value of pulsed wave Doppler tissue imaging(PW-DTI)in evaluating aortic elasticity in coronary heart disease. Methods:M-mode echocardiography and pulsed wave Doppler tissue imaging(PW-DTI) were applied to examine 34 patients with coronary heart disease(mean age 62 + 10 years, 20 male, 14 female), and 30 patients without coronary heart disease(mean age 60 + 7 years, 14 male, 16 female) evaluated by angiography, and patients with any one coronary artery lesion of at least 50% lesion were classified as the patients with coronary heart disease. Aortic upper wall velocities (including S wave, E wave and A wave cm/sec), aortic stiffness index and aortic distensibility were determined that reflect aortic elasticity. Aortic systolic diameter(Ds) and diastolic diameter(Dd) were measured by M-mode echocardiography and aortic upper wall tissue velocities were measured by PW-DTI 3cm above the aortic valve. Lateral mitral annulus tissue velocities(including S wave,E wave and A wave) were also measured by PW-DTI.Formula for aortic stiffness index is: (InSBP-lnDBP) X Dd/(Ds-Dd), formula for aortic root distensibility is:2 X(Ds-Dd)/PP X Dd (cm2dynes-1) ,and PP stands for pulse pressure. Results: Aorticupper wall S wave velocity was lower in coronary heart disease patients 8.2 + 2.4(cm/sec) vs 11.7 + 3.6(cm/sec), P<0.05; aortic stiffness index was higher in coronary heart disease patients 14.99+11.05 vs 11.22 + 7.01, P<0.05. Logistic analysis results demonstrated the differences of aortic upper wall S wave velocity,aortic stiffness index between the two groups were significant after adjusted for coronary heart disease risk factors and the factors which affected by heart function. (OR=0.92 ,P=0.001 ; OR=1.11 ,P=0.000 ; respectively). After adjusted for coronary heart disease risk factors and the factors which affected by heart function, aortic upper wall S wave velocity remained negative correlation with aortic stiffness index (r=-0.343, P=0.026 ) .Paired T-TEST results demonstrated PW-DTI could measureaortic upper wall S wave velocity repeatedly(t=1.238,P=0.236). Conclusions:(l)Aortic stiffness index correlated with coronary heart disease negatively; Aortic upper wall S wave velocity measured by PW-DTI correlated positively with coronary heart disease. (2)Decreased aortic upper wall S wave velocity measured by PW-DTI had negative correlation with increased aortic stiffness index significantly; (3) Aortic upper wall S wave velocity measured by Pulsed Wave Doppler Tissue Imaging might be used as one index to evaluate aortic elasticity of patients with coronary heart disease. It could reflect aortic movement quantitatively and repeatedly.