The Predictive Value Of Peripheral Ultrasound In Coronary Artery Disease

Objective:To investigate the flow mediated dilation(FMD)of brachial artery and the intima-media thickness(IMT)of carotid artery in patients with suspected coronary artery disease(CAD)by two-dimensional ultrasonography.To study the relationship between FMD and IMT of the patients with CAD.To investigate FMD and IMT changes in patients of CAD by ultrasonography,and evaluate the diagnostic value of peripheral artery ultrasonography for CAD.Methods:IMT of the carotid artery and FMD of the brachial artery were measured in 100 subjects suspected coronary artery disease.All of the subjects had accepted coronary angiography.Among them,47 were confirmed with CAD with at least a stenosis over 50% in one or more main branches of coronary artery,53 were negative.Risk factors of CAD, such as age,sex,postprandial blood glucose,hypertension,smoking,TG,TC,LDL and HDL cholesterol levels were investigated.The differences of IMI and FMD between the patients with and without CAD were analyzed.The relationship of IMT and FMD with the risk factors were tested.And the CAD was predicted with IMT and FMD.Resuits:(1)The FMD in CAD patients(10.78±2.76%)was significantly lower than that in control group(12.5±3.62)%,p=0.009.FMD was inversely correlated with IMT in all of the subjects(r=-0.360,p＜0.01),but was not significantly correlated in the patients of CAD(r=-0.050,p＞0.740).(2)The predictive sensitivity and specificity to CAD with FMD＜10%were 65.9%and 71.7%,respectively.The positive prediction was 76%and negative prediction was 59.3%.The area under cure(AUC)of ROC was 0.770.At peak point of the ROC curve of the FMD was 10%.(3)The IMT of CAD group(0.85±0.08)was significantly thicker than those of the control group(0.68±0.09),p＜0.05.(4)An IMT≥0.8mm could predict CAD with a sensitivity of 76.6%,a specificity of 92.4%,a positive prediction of 90%,and a negative prediction of 81.7%The area under curve(AUC)of ROC was0.913,p＜0.001.At peak point of the ROC curve the IMT was 0.8mm.(5)CAD was closely related with age,male,FMD,IMT,TC,LDL which was confirmed by binary Logistic regression.Conclusions:Two-dimensional ultrasonography with high resolution has such outstanding features as convenience,noninvasion,good repition and so on.FMD decreased and IMT increased in CAD.The artery FMD＜10%and IMT≥0.8mm have the definite veracity in diagnosis of CAD.The artery FMD＜10%and IMT≥0.8mm as the diagnostic critical value of CAD were proved to be better in sensitivity and specificity.The detection of IMT and FMD are sensitive predictor of CAD.CAD was closely related with FMD,IMT,age,and so on risk factors.