Predictive Value Of Flow-mediated Vasodilatation And Artery Elasticity On Coronary Heart Disease

ObjectiveTo assess the vascular elasticity and flow-mediated vasodilatation (FMD) of the brachial artery of the patients with coronary heart disease or with cardiovascular diease risk factors by echo-tracking (ET) technique, and to investigate the correlation with Framingham cardiovascular risk score, as well as the predictive value on coronary heart disease.MethodsIn this experiment,28 patients with cardiovascular diease risk factors (CRFs group),22 patients with coronary heart disease (CHD group), and 30 healthy subjects (control group) were detected by ET technique, and the following parameters were assessed respectively: pressure-strain elastic modulus (Ep), stiffness parameter (P), arterial compliance (AC), one-point pulse wave velocity (PWVβ), flow-mediated vasodilatation (FMD).Results1 Compared with control subjects,β,Ep,PWVβof brachial artery were higher in CHD and CRFs, while AC was lower, and there were significant differences ofβand Ep between control group and CRFs (P<0.05).2 Both FMD in systole period and diastole period were significantly lower in CHD and CRFs than control group (P<0.05), however, they failed to distinguish the patients with CHD from with cardiovascular diease risk factors.3 Both peak time in systole period and diastole period were lower in CHD and CRFs than control group, while there was no significant difference of peak time between CHD and CRFs.4 Framingham cardiovascular risk factor score was positively related withβ(r=0.552, P<0.05),Ep(r=0.608, P<0.05),PWVβ(r=0.434, P<0.05) and negatively related correlated with AC (r=-0.381, P<0.01), FMDs (r=-0.322, P<0.01), and FMDd (r=-0.454, P<0.01), with Pearson correlation.5 The optimal cutoff point forβ,Ep, and PWVβwas 29.9,384.5 kPa,13.25m/s respectively, while the sensitivity and specificity was 0.864,0.786; 0.864,0.75; 0.818, 0.714 seperately, as well as the under-ROC curve was 0.925,0.903 and 0.856, respectively.Conclusion1. Echo-tracking technique with flow-mediated vasodilatation pattern has high feasibility and reliability in the evaluation of vascular endothelial function and real-time detection of vascular diameter.2. Artery elasticity and flow-mediated vasodilatation based on echo-tracking technique correlated with Framingham cardiovascular risk score which could evaluate absolute risk of cardiovascular incident in ten years, would be the integration index associated to traditional risk factors as predictors of coronary heart disease.3. In this experiment, it was demonstrated that the optimal cutoff point forβ,Epβ,and PWVβin terms of sensitivity and specificity in predicting CAD was 29.9,384.5 kPa,13.25 m/s respectively.