Detection Of The Texture Of Carotid Plaques In Patients With Acute Coronary Syndrome Using Virtual Touch Tissue Quantification

Objectives:Through the observation and the analysis of the ultrasound result of carotid artery athersclerosis in coronary heart disease patients evaluated by coronary angiography for suspected CAD,this study aims to explore:(1) the predictive value of carotid mIMT and plaque for the diagnosis of CAD;(2) To evaluate the relationship between the texture of carotid plaques and acute coronary syndrome(ACS) using virtual touch tissue quantification.Methods:(1) the first part:There are107patients who were divided into two groups. The carotid atherosclersis was observed. The severity of CAD was analyzed by the ACC/AHA system. Analyze the relationship between carotid atherosclersis and coronary artery disease. Using logistic regress analysis analyze the risk factors. Choose20soft plaques which are in carotid posterior wall, VTQ was used to measure the shear wave velocities(SWV) of each soft plaque with two methods and compare the results between the two groups.(2)the second part:The study population consisted of105patients with coronary heart disease associated carotid plaques, including ACS group and sCAD group.VTQ was used to measure the shear wave velocities(SWV) of each soft plaque of the two groups. The results of two groups were compared. Receiver operating characteristic(ROC) curve was drawn to assess the diagnostic accuracy.Results:(1) the first part:Mean common carotid artery IMT (1.04±0.14mm vs.0.79±0.08mm,P=0.001) and plaque score(6.23±4.12mm vs.2.04±1.49mm,P=0.016) was significantly higher in the CAD group. Plaque in CCA (21.3%vs.8.33%,P=0.027) and plaque in bulb(73.8%vs.29.1%,P=0.007) were significantly hiher in the CAD group. Carotid plaques integral and coronary angiography integral coefficients of the relationship between for r=0.743, P<0.01. Hypertension (OR7.65395%CI1.112-12.675P=0.039), CCA mIMT (OR2.61395%CI1.134-4.469P=0.002) and plaque in bulb (OR5.72995%CI1.817-14.965P=0.028) were significant predictors for the diagnosis of CAD according to logistic regression analysis. The results of two methods using VTQ have no statistical significance.(2) the second part:Of the95carotid plaques,65were in ACS group,30were in sCAD, with mean VTQ values±SD of0.85±0.18and1.29±0.13. The value of SWV between two groups were significantly different (t=2.36, P=0.02). The sensitivity and specificity of SWV(AUC=0.837, cut-off value=1.205m/s) in predicting ACS was76.7%and62.9%respectively, with the positive predictive value60.2%and negative predictive value74.5%.Conclusions:(1) The carotid artery athersclerosis is related to the coronary artery disease. The mean carotid IMT and plaques in the bulb can be the dispensable predictive factor of the coronary heart disease, and ultrasound can indirectly reflect the degree of coronary athersclerosis.(2) VTQ is a feasible method to detect the SWV of plaques with different thickness.The texture of carotid soft plaques can be evaluated quantitatively using VTQ which was strongly related with the risk of ACS.(3) Ultrasound, as an effective screening method, can help doctors discover the CAD patients and prevent them from acute coronary events.