Intravascular Ultrasound Study On The Patients With Normal Coronary Artery Angiography And Positive Exercise Test

Intravascular Ultrasound Study on the Patients With Normal Coronary Artery Angiography and Positive Exercise TestObjective:The purpose of this study was to investigate the main course of normal coronary artery angiography and positive exercise test,we examined the degrees of atherosclerosis on these patients,using intravascular ultrasound(IVUS),Methods:Exercise test and coronary artery angiography were conducted for the patients with possible diagnosis of CHD,then intravascular ultrasound(IVUS) was conducted among 98 patients with positive exercise test and normal coronary artery angiography.Results:(1) According to IVUS,7(7.2%) cases are normal,68(69.4%) cases with light-midrange affection and 23(23.2%) cases with CHD.Among 26 atherosclerotic plaques of 26 spots of 32 patients,there were 16 eccentric plaques and 10 concentric plaques; 13 fibrous plaque,9 fatty plaque,4 calcific plaque,and 1 vulnerable plaque.(2) Comparing CHD and normal patients,the former with male(73.9%),chestache(73.9%),≥2 risk factor(87%) showed high proportion.Among light-midrange CHD patients,91.2% presented 1-2 risk factors,45.5%typical chestache.While,in CHD patients,100%presented risk factors and 73.9%typical chestache.(3) Patient without risk factors and with only positive changes inⅡ,Ⅲ,avF ST-T of EST showed low possibility for CHD.Positive lead of EST inⅡ,Ⅲ,avF and V_4-6 showed 74.7%vascular lesion of different degree.(4)The incident of CHD in group A1 is significantly lower than in group BI(0 vs 35%P＜0.05),and the incident of CHD in group A2 is significantly lower than in group B2(10%vs 45% P＜0.01).Conclusions:(1)Among the patients with positive exercise test and normal coronary artery angiography.,the incident of CHD by coronary artery angiography is significantly lower than by IVUS(0 vs 23.2%).(2)IVUS for CHD surpassed coronary artery angiography,and IVUS may get the message of narrow degree of CA,plaque nature,characteristics.(3)For the patients with negative or almost negative coronary artery angiography and positive exercise test,we should make comprehensive decision with risk factors for degree of CHD.