Evaluation Of Carotid Artery Elasticity And Its Influencing Factors In Coronary Artery Disease By Ultrafast Pulse Wave Velocity Technique

ObjectiveThe main pathological basis of coronary artery disease are the changes of vascular elastic function and wall structure.This research intends to explore the risk factors and analyze the carotid artery elasticity by Ultrafast pulse wave velocity technique in patients with coronary artery disease.Methods247 patients who received coronary angiography?CAG?and carotid artery ultrasound were selected randomly.Those patients were to excluded carotid intima-media thickness thickening and carotid plaque.According to the results of CAG,those subjects were further divided as Normal group,Mild stenosis group and Moderate-Severe stenosis group.Patients in three groups were matched for gender,age and heart rate in order to avoid selection bias.The following parameters were measured using Ultrafast pulse wave velocity technique,including pulse wave velocity at beginning of systolic period(PWV_BS)and pulse wave velocity at end of systolic period(PWV_ES).Compare PWV_BSS and PWV_ESS between three groups,analyze the correlations between the risk factors of arteriosclerosis and the elastic parameters,including PWV_BSS and PWV_ES;and explore the related factors which influencing PWVBS and PWVES.IBM SPSS Statistics 20.0 was used to process the data,a two tailed P<0.05demonstrated statistical significance.Results1.Comparison of baseline clinical data of each groupThe gender,age,heart rate and high-density lipoprotein cholesterol between the three groups had no obvious difference?P>0.05?.There was significant difference in systolic blood pressure,diastolic blood pressure,fasting plasma glucose,triglyceride and low-density lipoprotein cholesterol?P<0.05?.2.Comparison of bilateral PWV_BS and PWV_ES in three group?1?Comparison of bilateral PWV_BS:comparison of the Normal group on both sides of PWV_BS,there was no statistically significant difference?P>0.05?;the Mild stenosis group and Moderate-Severe stenosis on both sides of PWV_BS,the differences were statistically significant?P<0.05?;?2?Comparison of bilateral PWV_ES:comparison of the normal group on both sides of PWV_ES,there was no statistically significant difference?P>0.05?;the Mild stenosis group and Moderate-Severe stenosis on both sides of PWV_ES,the difference was statistically significant?P<0.05?;3.Comparison of PWV_BS and PWV_ES between different gender?1?There was no significant difference in the PWV_BS of the common carotid artery between different gender?P>0.05?.?2?There was no significant difference in the PWV_ES of the common carotid artery between different gender?P>0.05?.4.Comparison of the elastic parameters of the carotid artery PWV_BS and PWV_ES:?1?The normal group and Mild stenosis group:comparison of PWV_BSS between the two groups,Mild stenosis group is higher than normal group,the difference was statistically significant?P<0.05?;comparison of PWV_ES between the two groups,Mild stenosis group is higher than normal group,the difference was statistically significant?P<0.05?;?2?The normal group and Moderate-Severe stenosis group:comparison of PWV_BSS between the two groups,Moderate-Severe stenosis group was significantly higher than normal group,the difference was statistically significant?P<0.01?;the PWV_ES between the two groups,Moderate-Severe stenosis group was significantly higher than normal group,the difference was statistically significant?P<0.01?;?3?Mild stenosis group and Moderate-Severe stenosis group:the comparison between the two groups in PWV_BS,Moderate-Severe stenosis group was higher than Mild group,the difference was statistically significant?P<0.05?;the PWV_ES between the two groups,Moderate-Severe stenosiss group was higher than the Mild stenosis group,the difference was statistically significant difference?P<0.05?;5.Sensitivity and specificity of PWV_BS and PWV_ES?1?The critical value of PWV_BS is 6.19m/s,its sensitivity is 67.7%and the specificity is 87.0%.?2?The critical value of PWV_ES is 7.97m/s,its sensitivity is 86.5%and the specificity is 83.8%.6.Analysis of correlation between each index and the elastic parameters of PWV_BS and PWV_ES?1?There is a positive correlation factors between PWV_BS and systolic blood pressure,diastolic blood pressure,triglyceride,fasting plasma glucose,age,low density lipoprotein cholesterol,r value were 0.838?0.708?0.429?0.412?0.233?0.231 respectively,P<0.05;The negative correlation between PWV_BS and high density lipoprotein cholesterol was found,r value was-0.278,P<0.05.?2?There is a positive correlation factors between PWV_ES and systolic blood pressure,diastolic blood pressure,triglyceride,fasting plasma glucose,age,low density lipoprotein cholesterol,r value were 0.700?0.658?0.451?0.416?0.292?0.239 respectively,P<0.05;The negative correlation between PWV_ES and high density lipoprotein cholesterol was found,r value was-0.212,P<0.05.7.Analysis of the influencing factors of PWV_BS and PWV_ES?1?The influencing factors of PWV_BS were systolic blood pressure,diastolic blood pressure,fasting plasma glucose,low density lipoprotein cholesterol and triglyceride,and the beta coefficients were 0.620,0.203,0.099,0.088 and 0.080,respectively.?2?The influencing factors of PWV_ES were systolic blood pressure,diastolic blood pressure,triglyceride,fasting plasma glucose and low density lipoprotein cholesterol,and the beta coefficients were 0.399?0.252?0.158?0.143 and 0.113respectively.Conclusions1.When coronary artery stenosis occurred,PWVBS and PWVES of left common carotid artery were faster than that in right common carotid artery,suggesting that left common carotid artery atherosclerosis involved earlier than right side.2.There was no significant difference in PWV_BS and PWV_ES between different gender.3.The UFPWV technique can detect the carotid artery elasticity changes in the early stage,and estimate the coronary artery elasticity indirectly,then carry out early screening for coronary artery stenosis disease.4.Carotid elastic parameters(PWV_BS and PWV_ES)were correlated well with the predisposing factors of arteriosclerosis and were affected by related factors.