Gunes Yilmaz, Tuncer Mustafa, Guntekin Unal, Ceylan Yemlihan, Simsek Hakki, Sahin Musa, Yildirim Mustafa
Cardiology Department, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey. mail:
Echocardiography. 2010 Mar;27(3):300-5. doi: 10.1111/j.1540-8175.2009.01019.x.
To improve clinical outcomes, noninvasive imaging modalities have been proposed to measure and monitor atherosclerosis. Common carotid intima-media thickness (CIMT) and brachial artery flow-mediated dilatation (FMD) have correlated with coronary atherosclerosis. Recently, the color M-mode-derived propagation velocity of descending thoracic aorta (AVP) was shown to be associated with coronary artery disease (CAD).
CIMT, FMD, and AVP were measured in 92 patients with CAD and 70 patients having normal coronary arteries (NCA) detected by coronary angiography. Patients with acute myocardial infarction, renal failure or hepatic failure, aneurysm of aorta, severe valvular heart disease, left ventricular ejection fraction <40%, atrial fibrillation, frequent premature beats, left bundle branch block, and inadequate echocardiographic image quality were excluded.
Compared to patients with normal coronary arteries, patients having CAD had significantly lower AVP (29.9 +/- 8.1 vs. 47.5 +/- 16.8 cm/sec, P < 0.001) and FMD (5.3 +/- 1.9 vs. 11.4 +/- 5.8%, P < 0.001) and higher CIMT (0.94 +/- 0.05 vs. 0.83 +/- 0.14 mm, P < 0.001) measurements. There were significant correlations between AVP and CIMT (r =-0.691, P < 0.001), AVP and FMD (r = 0.514, P < 0.001) and FMD and CIMT (r =-0.530, P < 0.001).
The transthoracic echocardiographic determination of the color M-mode propagation velocity of the descending aorta is a simple practical method and correlates well with the presence of carotid and coronary atherosclerosis and brachial endothelial function.
为改善临床预后,已提出采用无创成像方式来测量和监测动脉粥样硬化。颈总动脉内膜中层厚度(CIMT)和肱动脉血流介导的血管舒张功能(FMD)与冠状动脉粥样硬化相关。最近研究表明,经彩色M型超声测量的降主动脉传播速度(AVP)与冠状动脉疾病(CAD)相关。
对92例经冠状动脉造影确诊为CAD的患者和70例冠状动脉正常(NCA)的患者进行CIMT、FMD和AVP测量。排除急性心肌梗死、肾衰竭或肝功能衰竭、主动脉瘤、严重瓣膜性心脏病、左心室射血分数<40%、心房颤动、频发早搏、左束支传导阻滞以及超声心动图图像质量不佳的患者。
与冠状动脉正常的患者相比,CAD患者的AVP(29.9±8.1 vs. 47.5±16.8 cm/秒,P<0.001)和FMD(5.3±1.9 vs. 11.4±5.8%,P<0.001)显著降低,CIMT(0.94±0.05 vs. 0.8