The Study On Relationship Between Coronary Artery Disease And Peripheral Artery Elastic With Echo Tracking Technique

Background and purposeThe most common types of atherosclerosis leading to organ lesions is Coronary atherosclerotic heart disease, under the action of the common risk factors, there are similary the pathogenesis and pathophysiological basis between peripheral artery and coronary atherosclerosis. Coronary angiography is the gold standard for diagnosis of coronary artery disease, but the early and the diagnosis of subclinical disease is of no remarkable significance, and the operation of complex and demanding high technical conditions, with some traumatic, it is not suitable for people of atherosclerosis screening. As the pathogenesis of common, in-media thickness (IMT) and plaque as morphological indicators are measured to reflect and predict the extent of coronary atherosclerosis. However, as part of patients with clinical symptoms found, there is no IMT thickening, and no atherosclerotic plaque formation. On the contrary, some have atherosclerotic plaque in patients with no clinical symptoms, so purely from the structural changes in peripheral arteries to evaluate the extent of atherosclerosis has its limitations. Detection of arterial function in recent years become a hot clinical studies, more research has been focused on the carotid artery elasticity dysfunction and coronary artery disease relationships to other peripheral arterial elastic function of small. In this study, echo tracking was used to detect suspected coronary artery disease in patients with peripheral arterial elastic function of a number of cases with CAG results were compared to investigate common carotid, subclavian, brachial, femoral, popliteal artery elasticity of changes in the value of coronary artery disease prediction.Patients and methodsDecember 2008～April 2009 in our hospital during the period of Cardiology, 178 cases patients with suspected coronary heart disease were coronary angiography (CAG) technique, male 104 cases, female 74 cases, which were divided into different groups according to the results of angiography:coronary angiography showed the normal group of 58 patients, mean age (54.93±9.67) years of age, coronary heart disease group of 120 patients, of which 60 patients with single vessel disease group, mean age (52.27±9.08) years of age, multi-vessel disease group(≥2 involvement) 60 patients mean age (58.70±9.35). Applied ALOKA produced ultrasoundα10, probe frequency of 13MHz to observe the subjects right common carotid, brachial, subclavian, femoral and popliteal artery wall intima-media thickness and lumen, the sampling area were the common carotid artery bifurcation proximal 2cm, the brachial artery for the elbow joint at the top of 1.5～2.0cm, bifurcation of the subclavian artery proximal 1.5cm, the femoral artery bifurcation at the top of 1.5 cm, popliteal artery popliteal back of knee. In the image zoom mode, and to measure line and in parallel to the membrane; start ET function, equipment will automatically calculate stiffness parameter(β), elasticity modulus (Ep), compliance (AC), pulse wave velocity (PWVβ), augmentation index(AI).All ultrasound images were obtained standard data measurement, waveform image of instability when 2-3 times measurements allowed a free choice, on average, records of all inspections of different groups were above parameters. CAG evaluation criteria used Judkins method for selective left and right coronary angiography, severity of coronary lesions with luminal diameter stenosis rate of the standard. The results using the above elastic parameters associated with the CAG results were analyzed. Result1. Coronary heart disease group and control group comparison of all clinical indicatorsCoronary heart disease between the group and the control group in age, sex, total cholesterol, high-density lipoprotein and blood glucose levels were statistically significant, differences in the low-density lipoprotein, triglyceride and blood pressure was not statistically significant.2. Coronary heart disease of different group and control group comparison of peripheral arterial elastic parametersTheβ, Ep values of common carotid artery and subclavian artery between the two groups was statistically significant, as the extent of coronary artery stenosis increases, the P, Ep value were increasing. Brachial artery elastic parameters of the differences between the two groups were no statistical significance. Theβ, AC value femoral artery of the difference between the two groups was statistically significant, with the increase in the scope of coronary disease, theβvalue increased, the AC value decreased. The AC value of popliteal artery was statistically significant difference between the two groups, with the increasing range of coronary lesions, the AC value decreased.3. Elastic parameters of different peripheral arterial associated with the degree of coronary artery disease analysis and judge the resultsThe degree of coronary lesions was regativly correlated indicators include: common carotid arteryβand Ep, the subclavian arteryβand Ep, the femoral arteryβ. The degree of coronary lesions with a negative correlation of indicators include: femoral artery AC, popliteal artery AC. The relevance between theβvalue of right femoral artery and coronary artery disease degree is the most obvious, followed by theβof the right common carotid artery, the Ep of right subclavian artery. Further the elastic parameters of significant indicators were used to do stepwise discriminant, results with the femoral artery and common carotid arteryβdo judge greatly. Then discrim process do judge analysis, the results of the control group misjudgment rate of 20.68%; single-vessel disease group misjudgment rate was 35%; multi-vessel Conclusion1. Coronary heart disease group and control group, comparative study of various clinical indicators, age, sex, total cholesterol, HDL-C and fasting blood glucose difference between the two groups was statistically significant, is coronary heart disease risk factors, men with coronary heart disease incidence rates was over the high.2. Multi-vessel coronary artery disease group, theβvalue of common carotid artery,femoral artery and subclavian artery and the Ep value of subclavian and common carotid artery were higher than single-vessel disease group and control group, the difference was significant. The AC value of femoral and popliteal artery are lower than the control group and single-vessel disease group, the difference was significant.3. The relevance beween peripheral arterial elastic parameters and the degree of coronary lesions is different. the relevance between the right femoral arteryβand coronary artery disease degree is the most obvious, followed by the right common carotid arteryβ,the right subclavian artery Ep. Further use of the elastic parameters are statistically significant indicators of the extent of coronary artery disease do stepwise discriminant results with the femoral artery and common carotid arteryβdo best discrimination, with a total misjudgment rate of 23.59%. the above parameters were better correlation with extent of coronary artery disease than other indicators, could be used as indicators of severity of coronary lesions.