The Diagnostic Effect Of Carotid Intima-media Thickness, IBS And Brachial Artery Endothelial Dependent Vasodilation On Coronary Artery Disease And Coronary Risk Factors

Objective: 1. To determine the clinical value of Integrated backscatter (IBS) in evaluation of carotid intima-media alteration in patients with coronary artery disease and coronary risk factors 2.To investigate the diagnostic effect of carotid IMT, IBS and brachial EDV on coronary artery disease(CAD) and coronary risk factors by observing the changes and relations of carotid IMT, IBS and brachial EDV in these patients. Methods: 1. The subjects were divided into six groups: CAD, hypertensive associated with diabetes mellitus(DM), hypertensive, DM, normal control and normal young subjects, with every group including fifty subjects. 2. using SONOS HP5500 equipped with IBS software and 7.5MHz linear array transducer, we got the common carotid image, IMT was measured in 5 consecutive regions every 5mm from the bifurcation of the common carotid artery, A total of ten regions were examined in each person, IBS data were also sampled in the same regions in which IMT was measured. The normal range of C-IBS was defined as C-IBS of young healthy subjects +2SD. C-IBS lower than normal range was fatty alteration, higher than normal range was fibrosis alteration. The percent of fatty alteration and fibrosis alteration was calculated in the six groups. 3. the brachial artery was scanned in a longitudinal view above the elbow, the baseline artery diameter was measured, then the reactive hyperemia diameter, at last the diameter after nitroglycerin was measured, EDV is expressed as the percent change in diameter after reactive hyperemia relative to the baseline value. We observed the change and difference of IMT, C-IBS and EDV in the six groups. Multivariate logistic regression was used to analysis the risk factor for the detection of CAD. Results: 1.The percent of regions diagnosed as fatty alteration was 9% in hypertensive, 10%in DM, 30% in hypertensive associated with DM, 61% in CAD. There was no significant difference between hypertensive and DM group, but these two groups had significant difference with CAD and hypertensive associated DM...