The Relationship Of Non-invasive Subendocardial Viability Ratio And The Severity Of Coronary Artery Lesion

Objective: To compare non-invasive central artery parameters of the normal group and the coronary artery lesion group,and to explore the relationship between non-invasive subendocardial viability ratio and the severity of coronary artery lesion?Methods: After rigorous selection criteria and exclusion criteria,122 hospitalized patients who had accepted coronary angiography(CAG)from August 2016 to March 2017 in the Department of Cardiology of the Second Affiliated Hospital of Nanchang University were continuously enrolled.We accurately recorded their basic characteristics such as sex,age,height and weight through the detailed history of disease.Elbow venous blood was extracted with fasting state in the morning after admission in order to test blood biochemical indices.Color doppler echocardiography was used to measure cardiac structure and function,including atrial size,ventricular size,left ventricular ejection fraction and other parameters.The peripheral arterial blood pressure(right upper arm brachial artery blood pressure)was measured by electronic sphygmomanometer,and the pulse pressure and mean arterial pressure were calculated.These parameters including systolic blood pressure,diastolic blood pressure,pulse pressure,augmentation pressure,augmentation index,cardiac cycle parameters and subendocardial viability ratio were detected by the Sphygmo Cor pulse wave analyzer.According to these results of CAG,all patients were divided into two groups: normal control group(Gensini score=0,n=15)and coronary artery lesion group(Gensini score >0,n=107).And then according to the Gensini score integral value of the ternary pitch,the lesion group was divided into three subgroups: mild lesion group(0<Gensini score?8,n=37),moderate lesion group(8<Gensini score?40,n=28),severe lesion group(Gensini score >40,n=42).These general datas,biochemical datas,left ventricular ejection fraction,peripheral arterial pressure,central arterial pressure and other parameters were compared between normal control group,lesion group and lesion subgroup,then the correlation analysis was carried out.Results: 1.Sex(male: 40% vs 68.22%,female: 60% vs 31.78%),Left ventricular ejection fraction(0.64 ± 0.07 vs 0.59 ± 0.09),diabets(0% vs 26.2%),smoking(6.7% vs 49.5%),peripheral arterial pusle pressure(51.20 ± 8.81 vs 61.58 ± 14.97)were different between normal control group and the coronary artery lesion group(P<0.05),and central artery pusle pressure(39.13 ± 11.15 vs 48.36 ± 15.16),the augmentation pressure(9.07 ± 3.24 vs 21.22 ± 7.46),augmentation index(0.23 ± 0.04 vs 0.44 ± 0.07),systolic time(266.87 ± 38.97 vs 325.05 ± 37.01),systolic time ratio(0.27±0.01 vs 0.35±0.03),diastolic time(707.33 ± 87.91 vs 617.48 ± 90.46),diastolic-systolic time ratio(2.66 ± 0.18 vs 1.91 ± 0.29),subendocardial viability ratio(2.30 ± 0.10 vs 1.62 ± 0.24)were significant different(P <0.01).2.For peripheral arterial blood pressure parameters,the peripheral systolic pressure and pulse pressure in the severe lesion group were higher than that in the moderate lesion group,mild lesion group and normal group(P <0.05).The mean arterial pressure in the severe lesion group was higher than that in the normal group(P <0.05),the mean arterial diastolic pressure-systolic blood pressure ratio was lower than that in the normal group(P <0.05).There was no significant difference in the diastolic blood pressure between the two groups(P> 0.05).Compared with the mild lesion group and the moderate lesion group,the heart rate in the severe lesion group was faster than that of the mild lesion group(P <0.05).For the parameters of central arterial pressure,the systolic blood pressure,arterial pressure,mean systolic blood pressure and systolic time were higher in the severe lesion than those in moderate lesion group,mild lesion group and normal group(P <0.05).Diastolic time,diastolic-systolic time ratio,subendocardial viability ratio were lower than the moderate lesion group,mild lesion group and normal group,and the central arterial diastolic blood pressure between these groups were not statistically different(P> 0.05).The central arterial pulse pressure and augmentation index in the severe lesion group were higher than those of the normal group and mild lesion group(P <0.05).3.The Spearman correlation analysis displayed that Gensini score was positively related to fasting blood glucose(r=0.18,P <0.05),Hb A1C(r=0.219,P<0.05),HCY(r= 0.316,P <0.01),BUN(r = 0.221,P <0.05),serum creatinine(r = 0.291,P <0.01),UA(r = 0.236,P <0.05),and negatively related with LVEF(r =-0.328,P <0.01).Heart rate(r=0.314,P<0.01)?central artery systolic pressure(r=0.292,P<0.01),the mean arterial pressure(r = 0.22,P <0.05),the central arterial pusle pressure(r = 0.306,P <0.01),augmentation pressure(r = 0.686,P <0.01),augmentation index(r = 0.201,P <0.01),mean diastolic blood pressure(r = 0.221,P <0.05),systolic time(r = 0.565,P <0.01)were positively related to the Gensini score.However the mean diastolic blood pressure-mean systolic ratio(r=-0.232,P<0.05)?cardiac cycle(r =-0.241,P <0.05),diastolic time(r =-0.604,P <0.01),diastolic time ratio(r =-0.945,P <0.01),diastolic time-contraction time ratio(r =-0.946,P <0.01)and the subendocardial viability ratio(r =-0.985,P <0.01)were negatively related to the Gensini score.Conclusion: 1.There is a highly negative correlation between non-invasive subendocardial viability ratio and the severity of coronary artery lesion.The lower the SEVR is,the higher the Gensini score is,which is reflecting the greater severity of coronary artery lesion.2.Detection of non-invasive subendocardial viability ratio may contribute to early screening and diagnosis of high-risk patients with coronary heart disease.