Ulgen M S, Bilici A, Acar M, Onder H, Sucu M, Toprak N
Dicle Universitesi Tip Fakültesi Kardiyoloji.
Anadolu Kardiyol Derg. 2001 Mar;1(1):5-9, AXII.
Atherosclerosis causes functional vasomotor changes as well as well as atheromatous carotid plaques and luminal stenosis resulting in mechanical effect. The relation between functional vasomotor changes in carotid arteries and extent of coronary artery disease is unknown. In our study, the probable relationship between carotid arterial flow velocities and resistance indexes (RI) with the extent of coronary artery disease (CAD) in patients who do not have significant carotid luminal stenosis was evaluated.
One hundred and fourteen patients (74 males, mean age 53+/-10 years, range 33-72 years) were studied. All patients underwent color Doppler sonography before coronary angiography. Peak systolic flow velocity, end-diastolic flow velocity and resistance index (RI) of right and left common carotid and internal carotid and internal carotid arteries were measured by color Doppler sonographic technique. Doppler parameters were correlated with the extent of CAD and left ventricular ejection fraction.
Patients were classified on the basis of presence of significant CAD and the number of affected coronary arteries. Thirty-three patients did not have (normal group) and 81 patients had significant coronary arterial stenosis (22 patients with one-vessel disease, 27, with two-vessel disease and 32 patients with three-vessel disease). Flow velocities were the highest in normal group but the lowest in CAD patients, especially when 3 coronary arteries were affected. Correlation analysis demonstrated negative relationship of age, ejection fraction and number of affected coronary arteries with end-diastolic flow velocity, but positive and significant correlation with RI value.
Our study is the first on this object. The results suggest that presence and extent of CAD changes flow velocities and RI values of common and internal carotid arteries. However, further investigations are required before these parameters can be applied as diagnostic criteria.
动脉粥样硬化会导致功能性血管舒缩变化,以及动脉粥样硬化性颈动脉斑块和管腔狭窄,从而产生机械效应。颈动脉功能性血管舒缩变化与冠状动脉疾病程度之间的关系尚不清楚。在我们的研究中,评估了无明显颈动脉管腔狭窄患者的颈动脉血流速度和阻力指数(RI)与冠状动脉疾病(CAD)程度之间可能存在的关系。
研究了114例患者(74例男性,平均年龄53±10岁,范围33 - 72岁)。所有患者在冠状动脉造影前均接受了彩色多普勒超声检查。采用彩色多普勒超声技术测量左右颈总动脉、颈内动脉的收缩期峰值流速、舒张末期流速和阻力指数(RI)。将多普勒参数与CAD程度和左心室射血分数进行关联分析。
根据是否存在明显CAD以及受累冠状动脉的数量对患者进行分类。33例患者无CAD(正常组),81例患者存在明显冠状动脉狭窄(22例单支血管病变,27例双支血管病变,32例三支血管病变)。流速在正常组中最高,而在CAD患者中最低,尤其是当三支冠状动脉受累时。相关性分析表明,年龄、射血分数和受累冠状动脉数量与舒张末期流速呈负相关,但与RI值呈正相关且具有显著性。
我们的研究是关于该主题的首例研究。结果表明,CAD的存在和程度会改变颈总动脉和颈内动脉的流速和RI值。然而,在这些参数可作为诊断标准应用之前,还需要进一步的研究。