BACKGROUNDThe relationship between chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) remains largely unknown. This study aimed to explore the association of COPD with CAD, especially with multi-vessel disease (VD).

METHODSThe data of 354 patients who underwent multi-detector computed tomography (MDCT) for suspected CAD were analyzed. Luminal narrowing was defined as at least one lesion 50% or greater stenosis. The analysis of serum biochemistry profile and spirometry were performed on all eligible patients, and the diagnosis of COPD was defined as the criteria of Global Initiative for Chronic Obstructive Lung Disease.

RESULTSPatients with CAD had a significantly higher complication of COPD than those without CAD (11.8% vs. 3.7%, P < 0.001). Comparing with patients without COPD, those with COPD were more likely to have multi-VD, proportion of smoking and high C-reactive protein (CRP) (P < 0.001). Multivariate Logistic regression analysis revealed that the multi-VD was significantly correlated with COPD (P=0.012) and CRP (P=0.015).

CONCLUSIONSThere was a high complication of COPD in patients with CAD, and COPD may be a critical risk factor for CAD, especially for multi-VD. CAD and COPD were closely associated and the interplay of systemic inflammation might in part explain the relationship between them.

Coronary Artery Disease ; complications ; diagnostic imaging ; metabolism ; Humans ; Pulmonary Disease, Chronic Obstructive ; complications ; diagnostic imaging ; metabolism ; Radiography ; Risk Factors

OBJECTIVETo observe the relationship between the parameters of artery elasticity and coronary artery stenosis in normotensive and hypertensive patients with coronary artery disease (CAD).

METHODSSystemic vascular compliance (SVC), systemic vascular resistance (SVR), brachial artery compliance (BAC) and brachial artery resistance (BAR) were measured by Dynapulse 200M (Pulse Metric, Inc., USA) in 88 hypertensive and 41 normotensive patients with chest pain before coronary artery angiography.

RESULTS(1) The prevalence rate of severe coronary disease (> or = 2 coronary branches) was higher in hypertensives than in normotensives (64.7% vs. 27.1%, P < 0.05); (2) the peripheral artery buffering function was significantly lower in hypertensives than in normotensives [SVC: (0.85 +/- 0.10) ml/mm Hg (1 mm Hg = 0.133 kPa) vs. (1.17 +/- 0.11) ml/mm Hg; BAC: (0.047 +/- 0.011) ml/mm Hg vs. (0.063 +/- 0.010) ml/mm Hg, all P < 0.05]; (3) Lower arterial elasticity was associated with severe coronary artery stenosis.

CONCLUSIONThe non-invasive obtained artery elasticity is associated with the degree of coronary artery stenosis in hypertensive patients with CAD.

Aged ; Blood Pressure ; Coronary Angiography ; Coronary Artery Disease ; complications ; diagnostic imaging ; physiopathology ; Coronary Stenosis ; complications ; diagnostic imaging ; physiopathology ; Female ; Humans ; Hypertension ; complications ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Prevalence ; Pulse

OBJECTIVETo identify the potential predictors of restenosis after bare mental stent (BMS) deployment in diabetic patients in Chinese diabetic patients.

METHODSWe retrospectively analyzed all patients implanted with BMS (n = 1126 with 2376 lesions) in our department from 2002 to 2004. The multivariate logistic regression analysis was made to compare the clinical and angiographic characteristics between diabetic patients with and without restenosis. Restenosis was defined as > or = 50% diameter stenosis within the stent and 5 mm in adjacent.

RESULTSThe 6-month follow-up angiograms were available in 889 out of 1126 patients (78.9%) and 151 out of 889 patients (17%) were diabetic patients. Restenosis rate in nondiabetic patients group was 21.2% and 35.9% in diabetic patients (P < 0.001). The predictors of restenosis in diabetics were reference vessel diameter (< or = 3.0 mm), length of lesion (> 15 mm) and insulin use (P < 0.05). The restenosis predicting model showed that reference vessel caliber was the paramount predictor for restenosis in diabetic patients.

CONCLUSIONSRestenosis rate post BMS implantation is significantly higher in diabetic patients compared to non-diabetic patients. Vessel caliber, lesion length and insulin use are predictors of restenosis in diabetic patients. Diabetic patients with reference vessel diameter of > 3.0 mm combined with lesion length < 15 mm and non-diabetic patients with lesion length < 15 mm regardless of the vessel caliber could be treated with BMS since the predicted restenosis rate is lower than 15% in these patients, otherwise DES would be a better choice.

Angioplasty, Balloon, Coronary ; Coronary Angiography ; Coronary Artery Disease ; complications ; diagnostic imaging ; therapy ; Coronary Restenosis ; diagnostic imaging ; etiology ; Diabetic Angiopathies ; complications ; Drug Delivery Systems ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stents

OBJECTIVETo understand the prevalence of sleep disordered breathing (SDB) in elderly patients with coronary artery disease (CAD) and explore the relations between SDB and CAD.

METHODSSixty-two elderly patients with and 18 without CAD identified by coronary angiography underwent examinations by polysomnography (PSG). Left ventricular ejection fraction (LVEF) was measured by 99Tc equilibrium radionuclide angiography.

RESULTSIn the 62 elderly patients with CAD, 53.2% had SDB, a rate significantly higher that (22.2%) in the 18 non-CAD patients. The CAD patients with SDB had higher respiratory disturbance index (RDI) and body mass index (BMI) and lower arterial saturation of oxygen (SaO2) during sleep, with longer duration of low SPO2 (less that 90%). The incidence of hypertension was higher in CAD patients with SDB than in those without SDB. No significant correlation was found between the severity of coronary artery disease and RDI (r=-0.16, P>0.05).

CONCLUSIONThe elderly patients with CAD have higher incidence of SDB, and appropriate interventions should be administered in those with severe SDB.

Aged ; Aged, 80 and over ; China ; epidemiology ; Coronary Angiography ; Coronary Artery Disease ; complications ; diagnostic imaging ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Polysomnography ; Prevalence ; Sleep Apnea Syndromes ; complications ; epidemiology ; physiopathology

Coronary Angiography ; Coronary Artery Disease ; complications ; diagnosis ; diagnostic imaging ; Diabetes Mellitus, Type 2 ; blood ; complications ; Glycated Hemoglobin A ; metabolism ; Humans ; Mass Screening

BACKGROUND/AIMS: The CHADS2 score, used to predict the risk of ischemic stroke in atrial fibrillation (AF) patients, has been reported recently to predict ischemic stroke in patients with coronary heart disease, regardless of the presence of AF. However, little data are available regarding the relationship between the CHADS2 score and cardiovascular outcomes. METHODS: This was a retrospective study on 104 patients admitted for acute coronary syndrome (ACS) who underwent coronary angiography, carotid ultrasound, and transthoracic echocardiography. RESULTS: The mean age of the subjects was 60.1 +/- 12.6 years. The CHADS2 score was as follows: 0 in 46 patients (44.2%), 1 in 31 (29.8%), 2 in 18 (17.3%), and > or = 3 in 9 patients (8.7%). The left atrial volume index (LAVi) showed a positive correlation with the CHADS2 score (20.8 +/- 5.9 for 0; 23.2 +/- 6.7 for 1; 26.6 +/- 10.8 for 2; and 30.3 +/- 8.3 mL/m2 for > or =3; p = 0.001). The average carotid total plaque area was significantly increased with CHADS2 scores > or = 2 (4.97 +/- 7.17 mm2 vs. 15.52 +/- 14.61 mm2; p = 0.002). Eight patients experienced cardiovascular or cerebrovascular (CCV) events during a mean evaluation period of 662 days. A CHADS2 score > or = 3 was related to an increase in the risk of CCV events (hazard ratio, 14.31; 95% confidence interval, 3.53 to 58.06). Furthermore, LAVi and the severity of coronary artery obstructive disease were also associated with an increased risk of CCV events. CONCLUSIONS: The CHADS2 score may be a useful prognostic tool for predicting CCV events in ACS patients with documented coronary artery disease.
Acute Coronary Syndrome/complications/*diagnostic imaging ; Aged ; Carotid Arteries/*diagnostic imaging ; Carotid Artery Diseases/complications/*diagnostic imaging ; Cerebrovascular Disorders/diagnosis/*etiology ; *Coronary Angiography ; Coronary Artery Disease/complications/*diagnostic imaging ; *Decision Support Techniques ; *Echocardiography ; Female ; Humans ; Male ; Middle Aged ; Plaque, Atherosclerotic ; Predictive Value of Tests ; Prognosis ; Republic of Korea ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Time Factors

BACKGROUND: Right ventricular (RV)-arterial uncoupling is a powerful independent predictor of prognosis in heart failure with preserved ejection fraction (HFpEF). Coronary artery disease (CAD) can contribute to the pathophysiological characteristics of HFpEF. This study aimed to evaluate the prognostic value of RV-arterial uncoupling in acute HFpEF patients with CAD. METHODS: This prospective study included 250 consecutive acute HFpEF patients with CAD. Patients were divided into RV-arterial uncoupling and coupling groups by the optimal cutoff value, based on a receiver operating characteristic curve of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP). The primary endpoint was a composite of all-cause death, recurrent ischemic events, and HF hospitalizations. RESULTS: TAPSE/PASP ≤0.43 provided good accuracy in identifying patients with RV-arterial uncoupling (area under the curve, 0.731; sensitivity, 61.4%; and specificity, 76.6%). Of the 250 patients, 150 and 100 patients could be grouped into the RV-arterial coupling (TAPSE/PASP >0.43) and uncoupling (TAPSE/PASP ≤0.43) groups, respectively. Revascularization strategies were slightly different between groups; the RV-arterial uncoupling group had a lower rate of complete revascularization (37.0% [37/100] vs . 52.7% [79/150], P <0.001) and a higher rate of no revascularization (18.0% [18/100] vs . 4.7% [7/150], P <0.001) compared to the RV-arterial coupling group. The cohort with TAPSE/PASP ≤0.43 had a significantly worse prognosis than the cohort with TAPSE/PASP >0.43. Multivariate Cox analysis showed TAPSE/PASP ≤0.43 as an independent associated factor for the primary endpoint, all-cause death, and recurrent HF hospitalization (hazard ratios [HR]: 2.21, 95% confidence interval [CI]: 1.44-3.39, P <0.001; HR: 3.32, 95% CI: 1.30-8.47, P = 0.012; and HR: 1.93, 95% CI: 1.10-3.37, P = 0.021, respectively), but not for recurrent ischemic events (HR: 1.48, 95% CI: 0.75-2.90, P = 0.257). CONCLUSION RV-arterial uncoupling, based on TAPSE/PASP, is independently associated with adverse outcomes in acute HFpEF patients with CAD.
Humans ; Prognosis ; Prospective Studies ; Stroke Volume/physiology* ; Echocardiography, Doppler/adverse effects* ; Coronary Artery Disease/complications* ; Heart Failure ; Pulmonary Artery/diagnostic imaging* ; Ventricular Function, Right/physiology* ; Ventricular Dysfunction, Right

UNLABELLEDTo evaluate the detection rate of myocardial bridging by 64-slice spiral CT coronary angiography.

METHODSThe data of 3011 patients with suspected coronary artery disease undergoing 64-slice spiral CT coronary angiography were collected and analyzed retrospectively.

RESULTSA total of 174 cases (5.8%) with myocardial bridging were detected by 64-slice spiral CT coronary angiography, among which 168 (96.6%) had single foci of involvement and 6 (3.4%) had were multiple foci. Involvement of the left anterior descending coronary artery (LAD) was detected in 167 out of the 174 cases (96.0%). The length of the myocardial bridge varied between 5 and 120 mm (mean of 30.5 mm), and the depth of the tunneled artery ranged between 1.3 and 2.8 mm (mean 2.3 mm). Seventy-nine of the cases (45.4%) had uncomplicated myocardial bridging and 95 (54.6%) had myocardial bridging complicated by coronary atherosclerosis.

CONCLUSIONMulti-slice spiral CT coronary angiography is a reliable and noninvasive modality for diagnosis of myocardial bridging to allow direct measurement of the length and depth of the myocardial bridge and detection of concurrent coronary and cardiac lesions.

Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Coronary Angiography ; methods ; Coronary Artery Disease ; complications ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Myocardial Bridging ; complications ; diagnostic imaging ; epidemiology ; Retrospective Studies ; Tomography, Spiral Computed ; methods

BACKGROUNDDoppler color echocardiography is a common method for detecting coronary artery lesions in patients with Kawasaki disease (KD). However, the diagnostic accuracy for the whole coronary artery lesions is limited. The purpose of this study was to compare the diagnostic value of dual-source computed tomography (DSCT) and Doppler color echocardiography for the assessment of coronary artery lesions caused by KD.

METHODSSixteen patients, 12 with typical KD and 4 with atypical KD, underwent DSCT and Doppler color echocardiography. The position and internal diameter of each coronary artery lesion was measured. Correlation analysis was used to compare the diagnostic value of the two imaging modalities.

RESULTSIn the typical KD group, seven patients did not have any coronary artery lesion as confirmed by both DSCT scans and Doppler color echocardiography; in four patients proximal coronary artery injuries were identified by both modalities; in one patient an aneurysm in the middle and distal segments of the coronary artery was detected by DSCT but was negative in Doppler color echocardiography. In the atypical KD group, three cases showed the same results with both modalities, while one case with coronary artery stenosis in the middle segment was identified by DSCT but not detected by Doppler color echocardiography. There was a good correlation between the two imaging modalities (Kappa value, 0.768 (>or= 0.75)).

CONCLUSIONDSCT coronary artery angiography is an accurate, non-invasive, and valuable technique for detecting and following up coronary artery lesions in patients with KD.

Adolescent ; Child ; Child, Preschool ; Coronary Angiography ; methods ; Coronary Artery Disease ; diagnostic imaging ; Echocardiography, Doppler, Color ; Female ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

OBJECTIVETo investigate the association of the traditional and newly emerged cardiovascular risk factors with the severity of coronary artery lesion in female patients with coronary artery disease (CAD).

METHODSThis study involved 235 female in-patients undergoing coronary angiography, including 156 with confirmed coronary artery disease (CAD) and 76 non-CAD patients. Univariate and multivariate analysis of the cardiovascular risk factors and the severity of coronary artery lesion were carried out in these patients.

RESULTSUnivariate analysis showed that in the CAD patients of different severities, increased number of compromised arteries and total Gensini scores for the lesions were associated with increased incidences of the such risk factors including hypertension, type 2 diabetes, high triglycerides, high total cholesterol, low high-density lipoprotein cholesterol (HDL-C) level, high low density lipoprotein cholesterol (LDL-C) level, high uric acid level and high fibrinogen level. Multivariate regression analysis showed that high LDL-C level was the most significant independent risk factor for CAD, followed by diabetes, triglycerides, high uric acid, low HDL-C, high blood pressure and age.

CONCLUSIONSFemale CAD patients are exposed to multiple risk factors, among which high LDL-C level is the most significant independent risk factor, but the other risk factors, especially the newly emerged factor uric acid, should be given due attention in the patients.

Aged ; Cholesterol, LDL ; blood ; Coronary Angiography ; Coronary Artery Disease ; diagnostic imaging ; etiology ; pathology ; Diabetes Mellitus, Type 2 ; complications ; Female ; Humans ; Middle Aged ; Multivariate Analysis ; Risk Factors ; Sex Factors ; Triglycerides ; blood