| Objectives To discuss the correlation between aortic elasticity and coronary artery stenosis,coronary artery calcification and stenosis,aortic elasticity and coronary artery calcification by 256-MSCT.Methods Totally 142 patients underwent CCTA and were diagnosed of coronary artery disease in North China university of science and technology affiliated hospital.The images were qualified for aortic elasticity measurement.According to the CCTA examination result,all patients were divided into stenosis group（n=87）and non-stenosis group（n=55）.The stenosis group was further divided into light,medium,and serious groups according to their degree of coronary artery stenosis.According to whether coronary artery calcification existed or not,all patients were also divided into calcification negative group（n=74）and calcification positive group（n=68）.The calcification positive group was further divided into light,medium,and serious groups according to the calcification scores.The negative group was further divided into non-calcified plaque group and normal group according to CCTA examination result.Reconstructed the 5%-99.9% ascending aortic images every two 5% R-R intervals.The cross-sectional areas and diameters of aortic in each R-R interval were measured automatically and diameter variation rate（%A0）,aortic distensibility（A0D）,aortic compliance（A0C）,and aortic stiffness β（A0SI）were calculated to evaluate aortic elasticity.At the same time,the plaques locations were recorded,the number of stenosed coronary vessel was counted,Gensini Score was evaluated according to coronary artery stenosis degree.Correlation between aortic elasticity and coronary artery stenosis,coronary artery stenosis and calcification,aortic elasticity and and coronary artery calcification were analyzed.Results 1 In the no stenosis group,%A0,A0 D,A0C,A0 SI respectively were 17.70±4.28,2.82±1.32 mm Hg-1,2.16±0.84 mm2/mm Hg,3.05±1.12.In the stenosis group,%A0,A0 D,A0C,A0 SI respectively were 13.29±3.96,1.55±0.66 mm Hg-1,1.34±0.47mm2/mm Hg,4.79±1.93.There were significant difference in the two groups（all P>0.05）.In the light stenosis group,%A0,A0 D,A0C,A0 SI respectively were 14.77±4.56,1.73±0.75 mm Hg-1,1.45±0.45 mm2/mm Hg,4.29±1.89.In the middle stenosis group,%A0,A0 D,A0C,A0 SI respectively were 12.02±2.44,1.44±0.53 mm Hg-1,1.34±0.50 mm2/mm Hg,5.24±1.93.In the serious stenosis group,%A0,A0 D,A0C,A0 SI respectively were 11.27±2.25,1.27±0.43 mm Hg-1,1.06±0.35 mm2/mm Hg,5.43±1.80.There was significant differences in the four reference indexes between light and serious coronary artery stenosis groups（P <0.05）.%A0 was lower and A0 SI was higher in coronary artery stenosis medium group than those in light group（P<0.05）,but there were no significant differences in A0 D,A0C（P>0.05）.There was no significant differences in the four reference indexes between medium and serious coronary artery stenosis groups（P>0.05）.Correlation analysis demonstrated a negative correlation between %A0,A0 D,A0C and the Gensini score（r respectively were-0.428,-0.361,-0.394,P<0.05）,and a positive correlation between A0 SI and the Gensini scores（r=0.404,P<0.05）.In muiltiple regression analysis,age,pulse pressure and Gensini score were independently associated with A0 SI.2 The mean calcification score in coronary artery normal,light,medium,serious groups respectively were 0,97.68±158.15,372.47±367.88,463.09±451.71,and there were significant difference among them.Correlation analysis demonstrated a posititive correlation between Gensini score,the number of stenosed coronary vessel and the calcification scores（r were 0.625、0.583,P<0.01）.The comparison of the four main coronary arteries calcification in different stenosis groups showed that LAD>RCA>LCX>LM,excepting LM,there were significant difference in LAD,RCA,LCX（P<0.01）.3 In the calcification negative group,%A0,A0 D,A0C,A0 SI respectively were 17.46±4.33,2.56±1.29 mm Hg-1,2.00±0.79mm2/mm Hg,3.10±1.08.In the calcification positive group,%A0,A0 D,A0C,A0 SI respectively were 12.32±3.22,1.49±0.61 mm Hg-1,1.28±0.47 mm2/mm Hg,5.21±1.93.%A0,A0 C,A0C were lower and A0 SI was higher in calcification positive group than those in calcification negative group（all P<0.05）.In the light calcification group,%A0,A0 D,A0C,A0 SI respectively were 13.33±4.16,1.64±0.78 mm Hg-1,1.34±0.48 mm2/mm Hg,4.79±1.80.In the middle calcification group,%A0,A0 D,A0C,A0 SI respectively were 11.81±2.87,1.48±0.56 mm Hg-1,1.30±0.50 mm2/mm Hg,5.57±2.11.In the serious calcification group,%A0,A0 D,A0C,A0 SI respectively were 12.05±2.44,1.33±0.45 mm Hg-1,1.17±0.42 mm2/mm Hg,5.01±1.76.There were no significant differences in the four reference indexes of aortic elasticity among light,medium,and serious groups in calcification positive group（P>0.05）.In the non-calcified plaque group,%A0,A0 D,A0C,A0 SI respectively were 16.12±4.45,2.07±0.93 mm Hg-1,1.75±0.64 mm2/mm Hg,3.39±1.12.In the normal group,%A0,A0 D,A0C,A0 SI respectively were 18.72±3.85,3.02±1.42 mm Hg-1,2.24±0.86 mm2/mm Hg,2.83±0.98.There were significant differences in the four reference indexes of aortic elasticity between coronary artery noncalcified plaque group and normal group.Correlation analysis demonstrated a negative correlation between %A0,A0 D,A0C and the calcification scores（r respectively-0.336,-0.296,-0.308,P < 0.01）,and a positive correlation between A0 SI and the calcification scores（r=0.322,P<0.01）.Conclusions 1 Aortic elasticity is correlated with the severity of coronary artery stenosis degree and can be used as independent predictor of coronary heart disease.2 The calcification score were positively correlated with the degree of coronary artery stenosis and the number of stenosed coronary vessel.Calcification score can be used as the effective indexes for evaluation of coronary heart disease.3 Aortic elasticity is correlated with coronary artery calcification,and the combination of them will be beneficial for the early diagnosis of coronary heart disease. |
PDF Full Text Request