Correlation Between Subendocardial Myocardial Viability And Coronary Artery Stenosis In Patients With Coronary Heart Disease

Background: The subendocardial viability ratio(SEVR)is a pulse wave analysis parameter which reflects coronary perfusion noninvasively.In China,they were the leading cause of death in 2018,accounting for 46.66% and 43.81% of all deaths in rural and urban areas,respectively.Approximately 330 million people suffer from Cardiovascular diseases(CVD),approximately 11.39 million of whom have coronary heart disease(CHD).Coronary angiography is the gold-standard modality for assessing the involvement of the coronary artery in patients with atherosclerotic coronary heart disease(CHD).A safe,accurate,reproducible,low cost,noninvasive test is required to measure the degree of myocardial ischemia that would correlate strongly with the severity of coronary stenosis.Changes in SEVR in patients with CHD have not been elucidated.Therefore,the aim of the present study was to analyze changes in SEVR in patients with atherosclerotic CHD.Methods: We enrolled 243 patients with atherosclerotic CHD who had visited our hospital from July 1,2021,to January 30,2022.Inclusion criteria were: clinical diagnosis of atherosclerotic CHD and availability of the SYNTAX score derived by coronary angiography.The patients were further divided into the control(n = 100),low stenosis(n = 107),and high stenosis(n = 36)groups,with SYNTAX scores of 0,≤ 22,and > 22,respectively.Pressure waveforms were obtained with a high-fidelity tonometer within the outspread supply route for SEVR calculation before coronary angiography.SEVR was measured and compared among the three groups.Unless otherwise stated,the results are expressed as mean ± standard deviation.For inter-group comparisons,the one-or two-way analysis of variance was performed,followed by the Bonferroni test for the post-hoc analysis.To evaluate the association between SEVR and the SYNTAX score in patients with CHD,a Pearson’s correlation analysis was performed.A p-value < 0.05 was considered to indicate statistical significance.Results: Atherosclerosis-related data,including the ankle–brachial index(ABI),pulse pressure,heart rate(75 beats/min)-corrected aortic augmentation index(AIx@75),brachial–ankle pulse wave velocity(Ba PWV),and SEVR,differed significantly among the three groups.SEVR was significantly lower in the high stenosis group(1.02 ± 0.14)than in the control(1.13 ± 0.20)and low stenosis(1.12 ± 0.21)groups(p 0.05).However,SEVR was lower in the low stenosis group than in the control group,although without statistical significance.In patients with CHD,the SYNTAX score correlated positively with age(r = 0.375,p = 0.001)and AIx@75(r = 0.226,p = 0.007)and negatively with ABI(r =-0.255,p = 0.002)and SEVR(r =-0.18,p = 0.029).Conclusions:The results of this study suggested that in patients with typical chest pain and a significant decrease in SEVR measured by noninvasive methods,anatomical coronary stenosis can be considered,and treatment related to CHD can be started as early as possible.SEVR calculation could be used as a noninvasive method for the detection of CHD.