| Background and Objective:Endothelial dysfunction is the initiating aspects of cardiovascular disease.It is present in the atherosclerotic process,and promotes the development of clinical cardiovascular disease. If you can give early diagnosis and intervention to prevent the endothelial dysfunction initiating link,it is expected to change the course of coronary heart disease.So looking for a more simple, fast, reproducible, inexpensive method of detecting endothelial function has important clinical significance.The present study is to use a new measuring method which is fingertip photoplethysmogram analysis fingertip pulse volume(PAV) to investigate endothelial function change clinical predictive value in diagnosing coronary artery disease and cardiovascular risk factors in relations.Methods:Choose from September in 2014 to September in 2015 into cardiology department of China-Japan Union Hospital with chest pain Cardiology patients undergoing coronary angiography for the study of 409 cases, 185 cases were male,female 224 cases, aged 27 to 86 years old(Average58.56±9.68).Admission records of all patients with coronary heart disease family history, personal history of cardiovascular disease, smoking and hypertension, history of diabetes and other details recorded total cholesterol(CHOL), triglyceride(TG), high density lipoprotein cholesterol(HDL- C), low-density lipoprotein cholesterol(LDL-C), non-high-density lipoprotein cholesterol(non-HDL-C) and other indicators.With the endothelial function diagnostic application, before and after the pressure ratio and amplitude ratio obtained after running PAV side amplitude reference value.Results:1.Comparison of the two groups PAV level: PAV level in patients with coronary heart disease group(1.24 ± 0.36) was significantly lower than the control group of patients(1.43 ± 0.44), P <0.0001.2.PAV sensitivity and specificity to predict coronary heart disease: ROC curve PAV expression prediction of coronary heart disease: the sensitivity(sensitivity, se) as ordinate represents true positive rate, 1- specificity(specificity, spe) for the abscissa represents the false positive rate,according to coronary heart disease group and the control group PAV measurement results calculated from different cut-off points and the corresponding sensitivity and 1-specificity, ROC curve drawing,the shortest distance from the upper left corner point to se = 0.7465, spe = 0.5537, PAV value of1.37 corresponding to a sensitivity of 74.65% and a specificity of 44.63%. Area under the curve(AUC) was 0.637, P <0.01, AUC 95% confidence interval(0.579,0.695),indicating ROC curve PAV diagnosis of coronary heart disease was statistically significant.3.Correlation between PAV and coronary angiography:409 cases of patients receiving coronary angiography,in coronary angiography positive(+) patients with coronary heart disease is determined, according to PAV value <1.37 to predict the presence or absence of coronary artery disease, the positive predictive value of76.24%, negative predictive value of 42.52%, accuracy was 65.77%.4.Logistics regression analysis of PAV and risk factors for coronary heart disease:the PAV = 1.37 as the critical point,in PAV whether <1.37 diagnosis of coronary heart disease as the dependent variable,PAV will analyze the two different levels of risk factors according to sex, age, presence or absence of hypertension, diabetes, smoking,family history of coronary heart disease, with or without hyperlipidemia Logistic Regression..Logistic regression analysis showed that: PAV showed a significant decrease and associated high blood pressure, smoking history, hypertriglyceridemia(P<0.01).Conclusion:PAV associates with coronary heart disease and its risk factors,the reference of PAV to predict coronary heart disease is 1.37. |
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