Clinical Significance Of Cervical Femoral Pulse Wave Velocity(cfPWV) In Diagnosis Of Aortic Disease

ObjectiveIn this study,the value of cf PWV in patients with suspected aortic disease was studied by measuring the cervical femoral pulse wave conduction velocity(cf PWV).In order to guide,improve,clinical diagnosis and treatment level,reduce the rate of misdiagnosis and missed diagnosis.MethodsA total of 120 patients with suspected aortic disease were admitted to the second affiliated hospital of shenyang medical college from November 2018 to November2019,of which 60(test group)were diagnosed with aortic CTA as the main artery disease,including 20 patients in the aortic aneurysm group,20 patients in the aortic dissection group and 20 patients in the aortic ulcer group.Aortic CTA examination was performed in 60 healthy patients(control group).Measuring instrument measuring spots with arteriosclerosis carotid pulse wave conduction velocity(cf PWV),and record to be included in the general clinical data(gender,age,smoking,obesity(BMI = mass(kg)/height(m2))history,history of hypertension and diabetes mellitus,the determination of D-dimer,homocysteine),D-dimer,homocysteine test results from our laboratory.Statistical software was used for analysis to compare the general clinical data of the selected patients in each group,and the differences of cf PWV between the control group and the experimental group.The differences of cf PWV in the aorticaneurysm group,aortic dissection group and aortic ulcer group were respectively compared in the experimental group.ROC curve was used to calculate the area under the curve(AUC)of cf PWV level for the occurrence of aortic disease,and the sensitivity,specificity and Jordan index were calculated.Pearman rank correlation was used to analyze the correlation between cf PWV and D-dimer and homocysteine in patients with aortic dilation.Results1.There was no statistically significant difference between the experimental group and the control group in gender,age,smoking,obesity,history of hypertension,history of diabetes and other general clinical data(all P >0.05).2.Independent sample t test was used to determine the difference of cervical femoral pulse wave conduction velocity in patients with aortic dilation disease and the general population.Results showed that the cf PWV value of aortic dilatation was8.67±1.61,higher than 7.68±1.51 in the normal aortic population,with a difference of0.99(95% confidence interval of 0.36-1.61).The independent sample t test results suggested that t= 3.15,p=0.002,indicating that there was a statistical difference in cervical femoral pulse wave conduction velocity between patients with aortic dilatation disease and those with normal aorta.3.One-way analysis of variance was used to determine whether cf PWV was different in different aortic diseases.They were divided into four groups: aortic aneurysm group(n=20),aortic dissection group(n=20),aortic ulcer group(n=20),and aortic normal group(n=60).According to the boxplot,the abnormal values were removed.According to shapiro-wilk test,the values in each group were normally distributed(P > 0.05).According to Levenes test of homogeneity of variance,the data in each group were homogeneous(P=0.246).The differences in cf PWV betweendifferent groups were statistically significant(F=8.73,P=0.000).The aortic aneurysm group(7.60±1.72),aortic dissection group(9.37±1.31),aortic ulcer group(9.36±1.04),and normal aorta group(7.68±1.51).Tukey test results showed that the cf PWV in the aortic ulcer group increased on average 1.76(95% CI: 0.47-3.05)compared with that in the aortic aneurysm group,and the difference was statistically significant(P=0.003).The cf PWV in the aortic ulcer group increased on average 1.68(95%CI:0.65-2.71)compared with the normal aortic group,and the difference was statistically significant(P=0.000).Cf PWV in the aortic dissection group increased on average 1.69(95%CI: 0.25-3.13)compared with that in the normal aortic group,and the difference was statistically significant(P=0.015).The mean increase of cf PWV in the aortic dissection group was 1.77(95%CI: 0.13-3.41)compared with that in the aortic aneurysm group,and the difference was statistically significant(P=0.029).There was no significant difference between the aortic ulcer group and the aortic dissection group(P=1.000).4.Draw ROC curve to evaluate the predictive value of cf PWV in aortic disease with AUC.It can be concluded that the area under the ROC curve of cf PWV is0.684(95%CI: 0.570-0.798,P<0.05),the sensitivity is 61.1,and the specificity is 73.7.AUC was used to evaluate the predictive value of cf PWV for ulce-rative aortic disease.The area under the ROC curve of cf PWV was 0.826(95%CI: 0.721-0.931,P<0.05),the sensitivity was 77.8,and the specificity was 80.7.AUC was used to evaluate the predictive value of cf PWV in aortic dissection.The area under the ROC curve of cf PWV was 0.796(95%CI: 0.636-0.957,P<0.05),the sensitivity was 75.0,and the specificity was 77.2.5.According to correlation analysis,cf PWV level was positively correlated with D-dimer concentration(r=0.581,P<0.001).Cf PWV level was positively correlatedwith Hcy concentration(r=0.475,<0.001).ConclusionAs the "gold standard" for evaluating aortic stiffness,cervical femoral pulse wave velocity has a definite correlation in the diagnosis of aortic ulcer and aortic dissection.