Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea.
Clin Exp Hypertens. 2011;33(8):501-5. doi: 10.3109/10641963.2011.601376. Epub 2011 Oct 3.
Pulse wave analysis and intima-media thickness (IMT) of carotid artery are the non-invasive indicators of subclinical atherosclerosis. Coronary artery calcification (CAC) score measured by multi-detector computed tomography (MDCT) is well known as a predictor of coronary heart disease (CHD). We investigated the association between coronary calcification assessed by MDCT and extracoronary atherosclerosis measured by pulse wave analysis and IMT of carotid artery. Arterial stiffness and carotid IMT were measured consecutively in 133 patients who underwent their first coronary MDCT angiography due to chest pain. Patients were divided into three groups according to the CAC score (group 1, score = 0, n = 62; group 2, 0 < score < 400, n = 58; group 3, score ≥ 400, n = 13). The classification of CAC score was associated with age, prevalence of hypertension and dyslipidemia, systolic blood pressure, pulse pressure, brachial-ankle pulse wave velocity, percentage of brachial mean artery pressure, upstroke time (UT), augmentation index, and carotid IMT. In a multivariate analysis, age (P = .048), hypertension (P = .007), dyslipidemia (P = .24), and mean ankle UT (P = .038) were independent variables for the classification of CAC score. The UT of pulse wave was significantly associated with the CAC score. The increased UT of pulse wave might provide incremental risk prediction in addition to that defined by conventional CHD risk assessment.
脉搏波分析和颈动脉内膜中层厚度(IMT)是亚临床动脉粥样硬化的非侵入性指标。多排螺旋 CT(MDCT)测量的冠状动脉钙化(CAC)评分是冠心病(CHD)的预测指标。我们研究了 MDCT 评估的冠状动脉钙化与脉搏波分析和颈动脉 IMT 测量的冠状动脉外动脉粥样硬化之间的关系。因胸痛而首次接受冠状动脉 MDCT 血管造影的 133 例患者连续测量了动脉僵硬度和颈动脉 IMT。根据 CAC 评分将患者分为三组(组 1,评分=0,n=62;组 2,0<评分<400,n=58;组 3,评分≥400,n=13)。CAC 评分的分类与年龄、高血压和血脂异常的患病率、收缩压、脉压、肱踝脉搏波速度、肱动脉平均压百分比、上升时间(UT)、增强指数和颈动脉 IMT 相关。在多变量分析中,年龄(P=0.048)、高血压(P=0.007)、血脂异常(P=0.24)和平均踝 UT(P=0.038)是 CAC 评分分类的独立变量。脉搏波的 UT 与 CAC 评分显著相关。脉搏波 UT 的增加除了传统 CHD 风险评估定义的风险外,可能还提供了额外的风险预测。