Study On The Correlation Between Lipids Combined With Echocardiography And The Degree Of Vascular Lesions In Coronary Heart Disease

ObjectiveAccording to the results of coronary angiography in patients with coronary heart disease,the SYNTAX score was calculated to explore the value of blood lipids combined with echocardiography in evaluating the severity of coronary artery disease,so as to provide a basis for early diagnosis and treatment of coronary heart disease with complex coronary artery disease.Methods182 patients were admitted to the Second Affiliated Hospital of Shenyang Medical College from November 2020 to February 2022 and underwent coronary angiography.According to the results of coronary angiography,the coronary artery stenosis < 50%group was non-coronary heart disease group,and the coronary artery stenosis ≥ 50%group was coronary heart disease group.According to SYNTAX score,the coronary heart disease group was divided into mild disease group（< 23 points）,moderate disease group（23-32 points）and severe disease group（> 32 points）.The baseline demographic characteristics of all subjects（sex,age,history of hypertension and diabetes,etc.）were collected,body mass index（BMI）was calculated,and fasting blood glucose and blood lipids,such as total cholesterol（TC）,triglyceride（TG）,low-density lipoprotein cholesterol（LDL-C）,high-density lipoprotein cholesterol（HDL-C）,lipoprotein（a）[LP（a）].LDL-C/HDL-C was calculated and echocardiographic parameters such as left ventricular end-diastolic dimension（LVEDD）,left ventricular end-diastolic volume（LVEDV）,left ventricular end-systolic volume（LVESV）and e ’velocity of septal annulus by pulsed wave tissue Doppler imaging（Septal-e’）,e ’velocity of lateral annulus by pulsed wave tissue Doppler imaging（Lateral-e’）,etc.Ordered Logistic regression analysis was used to evaluate the independent risk factors of coronary heart disease,and Spearmen correlation analysis was used to determine the correlation among the risk factors.The receiver operating characteristic（ROC）curve was used to analyze the significance of various factors in predicting severe coronary artery disease.Result1.A total of 182 patients were enrolled in the study,with an average age of 59.4 ±10.6 years,including 89 males（48.9%）.According to the results of coronary angiography,patients were divided into coronary heart disease group（n = 133）and non-coronary heart disease group（n = 49）.According to SYNTAX score,coronary heart disease group was divided into mild lesion group（n = 72）,moderate lesion group（n = 26）and moderate lesion group（n = 35）.The results showed that there were no significant differences in sex ratio and age distribution,BMI,hypertension,diabetes,smoking and drinking among the four groups.2.There were significant statistical differences between TG,HDL-C,LDL-C/HDLC and LP（a）between the four groups（P<0.05）.However,TC and LDL-C were not statistically significant（P>0.05）.3.There were significant differences in LVEF,LVEDV,LVESV,Septal-e’ and LVEDD among the four groups,but there was no significant difference in LVSV,E/A,Lateral-e’,E/e ’among the four groups.4.Ordered logistic regression analysis of statistically significant indicators in the study group showed that LDL-C/HDL-C,LP（a）and Septal-e’ were independent predictors of coronary heart disease with complex coronary lesions.5.LDL-C/HDL-C was positively correlated with LP（a）,the number of coronary lesion branches,and the maximum degree of stenosis of coronary artery lesions（r was0.162,0.297,0.245,P<0.05,respectively）,and was inversely correlated with Septal-e’（r value-0.417,P<0.01）.Septal-e’ was inversely correlated with the number of lesions and the degree of lesion stenosis（-0.459 and-0.445,respectively,P <0.01）,while no significant correlation was found between LP（a）and Vital-e’,the number of lesion ranches,and the degree of lesion stenosis.6.The ROC curve was analyzed by LDL-C/HDL-C,LP（a）and Septal-e’.The results showed that when the echocardiographic Septal-e’ was 3.95cm/s,the sensitivity and specificity of predicting high SYNTAX score were 60% and 76.9%,respectively.When LDL-C/HDL-C is 3.12,the sensitivity of predicting high SYNTAX score is 48.6%,and the specificity is 83.7%（AUC=0.646,P < 0.001）.When LP（a）is 242.44mg/d L,the sensitivity of predicting high SYNTAX score is 54.3%,and the specificity is 72.1%（AUC=0.632,P < 0.01）.Septal-e’,LDL-C/HDL-C and LP（a）combined to predict the area under the ROC curve of patients with high SYNTAX score was 0.771,the sensitivity was 71.4%,and the specificity was 71.4%.Conclusion1.Serum LDL-C/HDL-C and LP（a）were significantly higher and he parameters of Septal-e’ were significantly lower in patients with complex coronary artery disease than those with mild coronary artery disease.2.Serum LDL-C/HDL-C was positively correlated with LP（a）,the number of coronary lesions and the degree of the most severe stenosis,there was a negative correlation between the parameters of Septal-e’,the parameters of Septal-e’ and the number and degree of coronary artery stenosis,but there was no significant correlation between LP（a）and the parameters of Septal-e’,the number and degree of coronary artery stenosis.3.The combination of Septal-e’,LDL-C/HDL-C and LP（a）may be helpful for early diagnosis and treatment of patients with complicated coronary artery disease.