The Correlation Between Vascular Endothelial Function And Severity Of Coronary Artery Stenosis In Patients With Coronary Artery Disease

Purpose:It has been found that the endothelial function of the brachial artery can be evaluated accurately and quantitatively by noninvasive ultrasound evaluation of brachial artery flow mediated dilation(FMD). The purpose of this study is to investigate the relationship between the vascular endothelial function and the degree of coronary stenosis of patients with coronary artery disease(CAD).Method:Coronary angiography(CAG) was performed in 137 patients with suspected CAD.The clinical baseline conditions were collected from all patients.High-frequency ultrasound was used to detect the flow mediate dilation(FMD) at the first day of operation. Thus, the patients can be devided into two groups: CAD group(with more than 50% degree of coronary stenosis) and Non-CAD group(with less than 50% degree of cornonary stenosis).The Gensini score of the CAD group was assessed to detect the degree of stenosis of blood vessels. Then the relationship between FMD and coronary artery stenosis was analyzed.Results: According to the results of CAG,106 patients were enrolled into the CAD group with 52 patients into the Non-CAD group. Firstly,by comparing the clinical factors between CAD group and Non-CAD,we found that there issignificant difference(P < 0.05) in sex ratio,smoking,hypertension,diabetes, HDL-C, LDL-C, and Hcy factors between these two groups, while there no difference in other factors;Secondly,the Gensini score is positively correlated to the severity of coronary artery disease change. And there is significant difference between each Gensini score of single branch lesion, double vessel lesion and three branch lesions disease(P < 0.05);Thirdly,the FMD values of the coronary heart disease group are significantly lower than Non-CAD group( 4.83±2.57% vs 9.75±2.27%, P < 0.001). Coronary heart disease group analysis showed that with the increase in the number of diseased coronary artery,the FMD values gradually decline. The difference is statistically significant(P < 0.05). Lastly,we found that the FMD value and Gensini score are negatively correlated(r2=0.650, P<0.001). ROC curve analysis showed that the area under the ROC curve of FMD was larger than other clinical factors, and it was more valuable in the diagnosis and prediction of coronary stenosis for CAD patients.Conclusion:FMD has a good value of diagnosis and prediction for patients with coronary artery disease, and it is closely related to the severity of degree coronary artery stenosis.