Correlative Study Of Peripheral Vascular Function And Coronary Artery Calcification

Background:With the great changes of modern lifestyle and the increasing degree of population aging,the incidence of coronary heart disease is increasing year by year,which is a thorny problem facing the global medical community.Coronary artery calcification(CAC)is a very important pathological feature in the occurrence and development of Coronary atherosclerosis.The occurrence of calcification aggravates Coronary artery lesions and increases the incidence of cardiovascular events.Therefore,it is necessary to evaluate the severity of CAC for the prevention and treatment of CHD.For the detection of CAC,there are also derived a variety of examination methods,including coronary CT,coronary angiography,etc.,but all of them have the disadvantages of high cost and low popularity.And peripheral vascular function as a reflection of peripheral atherosclerosis indexes,have the advantage of noninvasive,convenient,this study based on peripheral artery atherosclerosis and coronary atherosclerosis is a common risk factor and pathological mechanism,by studying the association between CAC and peripheral vascular function,provide the basis for peripheral vascular function index to assess the CAC,increase to CAC as screening simple noninvasive,good economic indicators.Objective:This research mainly focuses on patients with Chronic coronary syndrome(CCS).Based on the common risk factors and pathological mechanism between coronary atherosclerosis and peripheral atherosclerosis,changes in arterial wall elasticity and compliance are the basis for the occurrence and development of cardiovascular and cerebrovascular diseases.By exploring the correlation between peripheral vascular function and CAC,it can provide a basis for the feasibility of using peripheral vascular function correlation detection to evaluate CAC to some extent,and add non-invasive good indicators for CAC evaluation.Methods:Collected from January 2019 to January 2020 in the first people’s hospital of Yunnan province cardiovascular internal medicine in the hospital and patients with diagnosis of CCS,complete venous blood in hospital,electrocardiogram,echocardiography(UCG),door control cardiovascular spiral CT examination and peripheral arterial sclerosis patients with testing,and included in the standard,into the group of 126 patients,aged 33-79,60 cases including men,women,66 cases;According to the result of gating cardiovascular spiral CT examination CAC score,the object of study is divided into calcification group(> 0)with the calcification(= 0),non calcified group of 46 people,calcification group of 80 people,calcification group according to further Agatston score to calcium score of 1-99 points,100-399 points,400 points or more patients according to the degree of calcification were divided into mild,moderate,severe three subgroups,including mild calcification group of 22 people,moderate calcification group of 38 people,severe calcification group of 20 people.All data were processed with SPSS25.0 statistical analysis software.Logistic regression was used to analyze the risk factors affecting CAC and the correlation between peripheral vascular function and CAC.Results:1.In the comparison of general information,there were statistically significant differ ences in age,smoking,hypertension,diabetes,total cholesterol,high-density lipoprotein,ABI,BAPWV,CIMT and PP between CAC group and non-calcification group(P < 0.05).2.Multiple logistic regression analysis of age,smoking,hypertension,diabetes,tot al cholesterol,high-density lipoprotein,ABI,BAPWV,CIMT and PP showed that age,s moking,diabetes,ABI,BAPWV,CIMT and PP were independent risk factors for CAC.3.The CAC group was compared with the related indexes of peripheral vascular function,which included ABI,BAPWV,CIMT and PP.The results showed that there was statistical significance in the comparison of the indicators among the four groups(P<0.05).The histogram showed that BAPWV,PP and CIMT increased and ABI decreased with the CAC degree increasing.4.ROC curves were drawn according to the measurement results of ABI,BAPWV,CIMT and PP between calcification group and non-calcification group.The results indi cated that the four peripheral vascular function indexes had statistical significance on th e ROC curves of CAC patients,indicating that ABI,BAPWV,CIMT and PP could be us ed as screening indexes of CAC,respectively.5.Comparison of peripheral vascular function indexes between the hypertensive gr oup and the non-hypertensive group showed statistically significant differences in BAP WV,PP,and CIMT among the groups(P<0.05),indicating that compared with the nonhypertensive group,the hypertensive group had worse vascular elasticity and higher arte rial stiffness.The proportion of calcification patients in the hypertensive group was high er than that in the non-hypertensive group,and the number of abnormal patients with B APWV and PP was also higher,with statistical significance(P<0.05).The chi-square an alysis of significant BAPWV and PP in hypertensive CAC group and non-hypertensive CAC group indicated that there were statistically significant differences in BAPWV in h ypertensive CAC group and non-hypertensive CAC group(P<0.05),indicating that BA PWV could play a certain predictive value in patients with hypertension and CAC.6.Comparison of peripheral vascular function indexes between the diabetic group and the non-diabetic group showed statistically significant differences in BAPWV,PP,a nd CIMT among the groups(P<0.05),indicating that compared with the non-diabetic gr oup,the diabetic group had worse vascular elasticity and higher arterial stiffness.The pr oportion of calcification patients in the diabetic group was higher than that in the non-di abetic group,and the number of abnormal patients with BAPWV,PP and CIMT was als o higher,with statistical significance(P<0.05).Chi-square analysis of significant BAP WV,PP and CIMT was conducted in the diabetic CAC group and non-diabetic CAC gro up,and the results showed that only BAPWV and CIMT had statistically significant diff erences in the non-diabetic CAC group(P<0.05).Conclusion:1.Independent risk factors for CAC were age,smoking,diabetes,ABI,BAPWV,CIMT and PP.2.The occurrence risk of CAC was negatively correlated with ABI,and positively correlated with BAPWV,CIMT and PP,respectively,and each related index could indicate the severity of CAC to a certain extent.3.ABI,BAPWV,CIMT and PP can be used as screening indexes of CAC,respectively.4.Compared with the non-hypertensive group,the degree of vascular elasticity in the hypertensive group was worse and the degree of arterial stiffness was higher;CAC and abnormal vascular elasticity are correlated with hypertension.BAPWV can play a certain predictive value in patients with hypertension complicated with CAC.5.Compared with the non-diabetic group,the vascular elasticity of the diabetic group was worse,and the arterial stiffness was higher;Abnormal CAC and vascular elasticity are associated with diabetes mellitus.