Clinical Study To Predict Coronary Atherosclerosis By Real-Time Shear Wave Elastography And Pulse Wave Velocity To Evaluate Carotid Elasticity

Objective:Real-time shear wave elastography(SWE)and pulse wave velocity(PWV)were applied to measure the carotid elasticity in patients with coronary atherosclerosis,to explore whether the changes of carotid elasticity have a certain correlation with the degree of luminal stenosis caused by coronary atherosclerosis,and to evaluate whether the two ultrasonic detection methods have a certain predictive diagnostic value for coronary atherosclerosis.Methods:Seventy-five patients who were hospitalized in the Department of Cardiology of Yibin First People’s Hospital and underwent coronary angiography from September 2020 to October 2021 were selected and grouped according to the degree of coronary artery stenosis(25 cases in the mild group,31 cases in the moderate group and 19 cases in the severe group).Thirty outpatients with no history of coronary heart disease were used as the normal control group.The pulse wave velocity(PWV-BS,PWV-ES)of his carotid artery and the Young’s modulus(Min,Mean,Max)of the anterior intima-media of his carotid artery were measured respectively,and statistical inference was made after statistical data processing and analysis.Results:1.Pulsewave velocity(PWV)of carotid arterywill increase with the severity of coronary artery disease.The pulse wave velocity(PWV-BS,PWV-ES)of the control group and the mild group<moderate group<severe group(P<0.05).2.Young’s modulus values(Min,Mean and Max)of carotid anterior intima-media became larger with the aggravation of coronary artery lesion.The values in the control group and mild group<moderate group<severe group(P<0.05).3.There is a positive correlation between the degree of coronary atherosclerotic stenosis and the mean values of carotid anterior intima-media Young’s modulus(Emean)and PWV(PWV-BS and PWV-ES),with the correlation coefficients rs of 0.814,0.761 and 0.768,respectively(P<0.05).4.ROC curve was drawn for the prediction value of mean value of carotid intima-media young’s modulus(Emean)and carotid pulse wave velocity(PWV-BS and PWV-ES)on coronary heart disease(coronary stenosis ≥50%).The AUC and the corresponding 95%CI were 0.798(0.731,0.882)and 0.820(0.741,0.899)and 0.816(0.735,0.896),Emean’s threshold was 44.05KPa,PWV-BS’s threshold was 6.60m/s,and PWV-ES’s threshold was 8.73m/s,with sensitivities of 94.5%,96.5%,and 89.7%,and specificities of 77.1%,74.3%,and 85.8%,respectively.The ROC curve of mean value of carotid anterior intima-media Young’s modulus(Emean)and carotid pulse wave velocity(PWV-BS and PWV-ES)on the prediction value of severe coronary artery stenosis(coronary artery stenosis ≥75%)was drawn,and the AUC and the corresponding 95%CI were 0.880(0.805,0.955),0.833(0.744,0.921),0.844(0.756,0.931),Emean’s threshold was 57.56KPa,PWV-BS’s threshold was 7.66m/s,and PWV-ES’s threshold was 10.15m/s,with sensitivities of 89.5%,94.7%,94.7%,and 80.4%,67.9%,and 62.5%,respectively.Conclusion:Pulse wave velocity and real-time shear wave elastography can evaluate the elastic function of carotid artery circumferentially and longitudinally respectively,and the mean value of carotid anterior intima-media Young’s modulus(Emean)and carotid pulse wave velocity(PWV-BS and PWV-ES)have positive correlation with the degree of coronary artery stenosis caused by coronary atherosclerosis,which can be used as a window to indirectly reflect and predict whether there is coronary heart disease and the severity of coronary arteriosclerosis,and can better predict the degree of coronary artery stenosis,with certain application value in clinical practice.