Evaluation Of Carotid Artery In Patients With Coronary Heart Disease Byvelocity Vector Imaging

Objective To evaluate the diagnostic value of carotid velocity vector imaging for coronary atherosclerotic heart disease and find new indicators for early clinical diagnosis and observatioa Methods A total of 164 cases (95 males,69 females), mean age (56.1±5.1),of coronary atherosclerotic heart disease admitted to Department of Cardiology were enrolled. All patients were divided into SA (45 cases),UA(65 cases) and AMI(54 cases) group, and 58 healthy subjects (33 males, 25 females), mean age (53.8±8.4), were severed as control. The serum levels of hs-CRPs, c-TnT were detected in all subjects. The averages values (maximum radial velocity (Vmax), maximum tangential strain (Smax), maximum tangential strain rate (SRmax)) of common carotid and the maximum strain value of plaque (base, shoulder, top) were obtained and analyzed by VVI technique. All values were taken the average of three cardiac cycles image,and analysed by SPSS19.0 statistical software, P<0.05 was considered statistically significant.Results1 The difference of serum hs-CRP levels was found in four groups (P<0.01),AMI> UA>SA> Control. The difference of serum c-TnT levels in four groups:AMI,UA,SA>Control; AMI >UA, SA(P<0.01).2 The segments average Vmax, Smax, SRmax of carotid:AMI<SA,Control; UA< SA, Control; SA<Control (P<0.01). The Smax of plaque (shoulder, top):AMI>UA,SA (P<0.01).3 The Smax of carotid walls is correlated with serum hs-CRP, c-TnT level negatively, the correlation coefficient is-0.323, p<0.01;-0.200, p<0.05. The Smax of carotid plaque (shoulder, top) is correlated with serum hs-CRP, the correlation coefficient is 0.279,0.266,p<0.05;and is correlated with serum c-TnT, the correlation coefficient is 0.235,0.252, p<0.05.4 ROC curve analysis Area under the curve(AUC) of combined prediction (CRP, cTnT and wall Smax) is 0.982 (0.966-0.998),higher than any other individual detection markers, diagnostic cutoff value is determined based on the maximum Youden index, sensitivity 93.6%, specificity 93.1%; The AUC of Carotid wall Smax is 0.913 (0.871-0.955), slightly higher than hs-CRP, cTnT, sensitivity 77.3%, specificity 91.4%.Conclusion VVI detection for carotid artery has guiding significance to predict and monitor coronary heart disease.1. The mechanical parameters of carotid’s smooth walls can react artery lesions in patients with coronary heart disease, and which have predictive value in distinguishing the low risk of coronary heart disease (stable angina) from relatively high-risk of coronary heart disease (unstable angina, acute myocardial infarction).2. The mechanical parameters of Carotid plaque have potential significance for judging plaque stability. The strain value of regular shape and Soft plaques (shoulder, top)have diagnostic value for acute myocardial infarction, which may become a new indicator for the early prediction of acute myocardial infarction.3. The strain value of carotid (artery wall and the shoulder,top of plaque) is closely related to hs-CRP, c-TnT. VVI examination for carotid is expected to be a quantitative measurement of coronary lesions. VVI detection joint with hs-CRP, c-TnT has important clinical value for assessing coronary heart disease.