Ultrasonographic Assessments Of Correlativity About Carotid Artery Elasticity And Brachial Artery Endothelial Function In Patients With Coronary Heart Disease

Objective:To discuss the value of brachial artery endothelial dependent dilation and Echo-tracking in the early stage's diagnosis of atherosclerosis;To investigate the value of assessing the artery endothelial function about the carotid elastic modulus measured by Echo-tracking.Methods:The study comprised 30 subjects with CHD and 28 subjects with coronary atherosclerosis according to coronary angiography and 40 healthy control subjects.The endothelial dependent dilation was reflected by flow-mediated dilation(FMD)in the brachial artery evaluated with high resolution ultrasound.Newly Echo-tracking was used to evaluate the carotid elastic modulus,such as the pressure-strain elastic modulus(Ep),stiffness parameter (β),arterial compliance(AC),pulse wave conducting velocity(PWVβ)and augment index (AI).Respectively analyse the correlativity about brachial artery endothelial dependent dilation and the modulus of carotid artery elasticity such as the Ep,β,AC,PWVβ,AI.Results:(1)FMD reduced obviously in CHD group(-0.73±5.76 vs 8.54±4.66,P<0.01) and coronary atherosclerosis group(4.10±4.87vs8.54±4.66,P<0.01)compared with the normal subjects.FMD reduced obviously in CHD group compared with coronary atherosclerosis group (-0.73±5.76 vs4.10±4.87,P<0.01).(2)Ep,βand PWVβincreased significantly in CHD group (174.02±44.35vs84.67±18.49,12.71±2.53 vs 6.99±1.86 and 7.84±0.89 vs 5.65±0.82 respectively,P<0.01)and coronary atherosclerosis group(156.08±42.18 vs 84.67±18.49, 11.56±2.79 vs 6.99±1.86 and 7.44±0.99vs5.65±0.82 respectively,P<0.01)compared with the normal subjects,but AC reduced obviously(0.65±0.24 vs 1.02±0.32 and 0.66±0.22 vs 1.02±0.32,P<0.01).(3)Ep,βand PWVβincreased slightly in CHD group compared with coronary atherosclerosis group(174.02±44.35 vs 156.08±42.18,12.71±2.53 vs 11.56±2.79 and 7.84±0.89 vs 7.44±0.99 respectively,P>0.05),and AC reduced(0.65±0.24 vs0.66±0.22,P>0.05). However,there was no statistic difference between two groups.(4)AI increased slightly in CHD group and coronary atherosclerosis group compared with the normal subjects(22.05±14.75 vs 14.86±11.17 and 16.93±14.67vs14.86±11.17 respectively,P>0.05),AI increased slightly in CHD group compared with coronary atherosclerosis group(22.05±14.75 vs16.93±14.67,P>0.05).However,there was no statistic difference in three groups.(5) Respectively there were negative correlativity between Ep(r=-.596,-.688,-.932,-.971 respectively,P<0.01),β(r=-.582,-.497,-.863,-.825 respectively,P<0.01),PWVβ (r=-.491,-.559,-.624,-.832 respectively,P＜0.01)and FMD,positive correlativity between AC and FMD(r=.514,.873,.890,.597 respectively,P＜0.01),while there was no correlation between AI and FMD(r=-.172,-.005,-.070,-.033 respectively,P＞0.05)to all subjects,the control subjects,the CHD group and coronary atherosclerosis group.Conclusions:(1)FMD of the brachial artery could assess the endothelial function about coronary atherosclerosis with varying degree.(2)The modulus of carotid artery elasticity such as the Ep,β,AC,PWVβmeasured by Echo-tracking could assess the early stage of coronary atherosclerosis,but these modulus didn't sensitively reflect the severe degree of coronary atherosclerosis.(3)The brachial artery endothelial dependent dilation and the modulus of carotid artery elasticity such as Ep,β,AC,PWVβhad a high linear correlativity respectively. It meant Ep,β,AC and PWVβmight be used as a novel index for assessing the arterial endothelial function.So ET technology could be a new way to early and quantitatively reflect the vascular changes and be a convenient and practical modality to evaluate vascular endothelial function.