Evaluation Of Relationship Between Carotid Arterial Disease And Coronary Arterial Disease Of Younger CAD

Coronary artery angiography (CAG) is the golden standard for diagnosing coronary artery stenosis. But there is no significant meaning for early and sub-clinical events. Carotid artery intima-media thickness(IMT) and plaque could be used to reflect the extent of coronary artery atherosclerosis. Some studies showed there were positive correlations between the extent of coronary artery and carotid artery atherosclerosis, whereas other studies showed opposite results. Recently, detection of arterial function become hot in atherosclerosis studies. The precision of e-Tracking (ET) technique can reach 0.007—0.013mm as a method for checking and evaluating the artery elasticity. ET technique had been used to evaluate the elastic changes of hypertension, diabetes, hyperlipidemia and perimenopausal women, but now it was no related studies on the relation between carotid elasticity and the extent of coronary artery atherosclerosis in younger coronary artery disease (CAD) patients.Objective:To assess the relationship between carotid arterial elasticity and the extent of coronary arterial atherosclerosis in younger(<45y) CAD patients using ET technique and to discuss the value of ET technique for early stage CAD patients.Methods:137 young CAD patients who were established coronary artery stenosis by CAG were enrolled in our study. Before or after 1 week of CAG, carotid artery ultrasound was performed to recording the IMT, numbers and size of plaques in all CAD patients. According with or without IMT abnormality and plaques, all CAD patients were divided into two groups (patient group I, 62 cases; (patient group II, 75 cases). After that, both the patient groups were divided respectively into sub-group Ia (32 cases), sub-group Ib (30 cases) and sub-group IIa (39 cases), sub-group IIb (36 cases) according to single or multi-vessels stenosis in coronary artery. All patients characteristics such as hypertension, hyperlipidemia, diabetes and smoking were collected. Seventy-five normal subjects were selected as control group and matched with patients groups (control group I, 33 cases, control group II, 42 cases,). ET technique was used to detect the stiffness parameter (β), pressure-strain elasticity modulus (Ep), arterial compliance (AC), one-point pulse wave velocity (PWVβ) in control group II and patients group II.Results:IMT was increased gradually in control group I and patients sub-group Ia and Ib and had significant differences. Also, there were significant differences between sub-group Ia and Ib and sub-group Ib had higher carotid artery plaque occurrence than sub-group Ia. The arterial elastical parameters were significant differences between control group II and sub-group IIa and IIb.β,Ep,PWVβincreased and AC decreased gradually.Conclusions:1. Arterial elasticity is a sensitive parameter to evaluating the early stage of artery atherosclerosis.2. There have good correlation between the extent of carotid artery and coronary artery atherosclerosis. When carotid artery IMT increasing and carotid artery plaque appear, it has nice correlation with coronary artery atherosclerosis. When carotid artery IMT was normal or without plaque, there are good correlation between carotid artery elastical parameters and coronary artery atherosclerosis. So it suggested that arterial elasticity could be a sensitive parameter to assess CAD.3. Smoking and gender are independent risk factors of effecting carotid artery and coronary artery atherosclerosis in young patients.4. The risk factors effecting coronary artery disease could also be the risk factors which affect carotid arterial elasticity.5. ET technique is an invasive method for detecting arterial elasticity with higher accuracy, sensitivity and repeatability. It is possible to become an useful method for evaluating early stage CAD, and for assessing the curative effect of anti-atherosclerosis medicine.