Relation of carotid bifurcation atherosclerosis and the severity of coronary atherosclerosis
- VernacularTitle:颈动脉窦粥样硬化与冠状动脉粥样硬化程度的相关性
- Author:
Bo YANG
;
Luyue GAI
;
Guangyi WANG
;
Lian CHEN
;
Jinsong WANG
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2006;10(40):162-164
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: Carotid intima-media thickness (IMT) is the substitution index of coronary atherosclerosis, but the precise relation between IMT and coronary artery disease (CAD) is still unknown.OBJECTIVE: To investigate the role of carotid IMT in coronary atherosclerotic heart disease (CAHD).DESIGN: A case analysis.SETTING: Department of Cardiology, Chinese PLA General Hospital.PARTICIPANTS: The study was carried out in the Department of Cardiology, Chinese PLA General Hospital from January 2000 to January 2002. Totally 285 inpatients aged 33-74 years, mean (54.48±9.44)years with suspected CAHD, including 164 males and 121 females, were involved in this study. According to angiographic results, they were divided into 4 groups: 0-vessel group, 1-vessel group, 2-vessel group and 3-vessel group.METHODS: ①The weight and height of patients were measured, and body mass index (BMI) = weight (kg)/height (m)2.②In the supine position, the blood pressure of left arm were measured. ③Venous blood was sampled todetect blood lipid. ④High-resolution B-mode ultrasound and 10 MHz linear transducer was used to evaluate the common carotid artery,internal carotid artery, external carotid artery and carotid bifurcation.Carotid IMT ≥ 1.0 mm was defined as carotid atherosclerosis. The results of coronary angiography by standard Judkins technique showed that, CAHD extent (0, 1, 2 and 3) was determined by the number of diseased vessels,where luminal stenosis was ≥ 50%. Left stem stenosis ≥ 50% was defined as 2-vessel while left stem merging right coronary affection were taken as 3-vessel.MAIN OUTCOME MEASURES: ①IMT values at different detection sites of the patients with different CAHD lesions; ②The predictors of the CAHD severity;③The predictive values of IMT at different carotid sites on CAHD; ④The relationof different risk factors and IMT.RESULTS: Totally 285 patients were involved in the result analysis.①IMT values at different detection sites of CAD patients: The chi square test demonstrated that, left and right carotid bifurcations took the maximal F value among groups (left: 65.64, right: 63.24). And the IMT values of left and right carotid bifurcations were elevated with the increasing CAHD severity. ②The predictors of the CAHD severity: The regression analysis implied that male, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and IMT of left carotid bifurcation, right carotid bifurcation, right internal carotid artery and right external carotid artery were the independent predictors of CAHD severity, while left and right carotid bifurcation were the most important (t=3.61, P=0.391; t=2.58,P=0.247). ③The predictive values of IMT at different carotid sites on CAHD: The left and right carotid bifurcations also found the maximal positive predictive value for detecting CAHD (left: 89.9%, right: 88.8%).④Multivariate regression analysis revealed that age, BMI, cholesterol,triglyceride, HDL-C and LDL-C were the risk factors of left carotid bifurcation atherosclerosis.CONCLUSION: IMT in the carotid bifurcation is related significantly with the presence and extent of CAHD. They share common pathological and hemodynamic basis. Carotid bifurcation IMT may be used as a surrogate marker for CAHD.
