Zhang Yan, Li Jian-ping
Department of Cardiology, Peking University First Hospital, Beijing 100034, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2011 Oct 18;43(5):749-52.
Ankle brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV), well-established non-invasive techniques for evaluating obstruction and stiffness of peripheral artery respectively, are considered for the purposes of cardiovascular risk assessment. The objective of this study was to evaluate the impacts of ABI and baPWV on the extent of coronary heart disease (CHD).
Patients were enrolled consecutively from wards of Cardiovascular Department, Peking University First Hospital from March 2008 to March 2009. They had both coronary angiography (CAG), ABI and baPWV data available. ABI and baPWV were measured using an automatic device (BP-203PRE II, Colin, Japan). Patients were stratified into three groups based on CAG results: non-CHD group, single-vessel group, multiple-vessel group. Multivariate linear regression was performed in a total of 216 patients to evaluate the associations of ABI, baPWV and the extent of CHD measured by numbers of coronary arteries diseased.
Patients with multiple-vessel disease (n=113) had a lower ABI value (1.05±0.18 vs. 1.12±0.11, P=0.002) than non-CHD patients (n=49). Moreover, the results remained statistically significant after adjustment for age, gender, body mass index (BMI), smoking status, history of hypertension, diabetes and hyperlipidemia (β=-0.06±0.03 and P=0.029). There had no significant differences of ABI value between single-vessel disease group (n=54) and non-CHD group. In addition, no significant results were observed when comparing baPWV value and disease severity among these three groups.
Our study suggests that ABI value may predict the extent of CHD. The more coronary arteries are involved, the lower ABI value is observed.
踝臂指数（ABI）和臂踝脉搏波速度（baPWV）分别是用于评估外周动脉阻塞和僵硬度的成熟无创技术，被用于心血管风险评估。本研究的目的是评估ABI和baPWV对冠心病（CHD）程度的影响。
2008年3月至2009年3月期间，连续纳入北京大学第一医院心血管内科病房的患者。他们同时拥有冠状动脉造影（CAG）、ABI和baPWV数据。使用自动设备（BP - 203PRE II，日本 Colin公司）测量ABI和baPWV。根据CAG结果将患者分为三组：非冠心病组、单支血管病变组、多支血管病变组。对总共216例患者进行多变量线性回归，以评估ABI、baPWV与通过病变冠状动脉数量衡量的冠心病程度之间的关联。
多支血管病变患者（n = 113）的ABI值（1.05±0.18 vs. 1.12±0.11，P = 0.002）低于非冠心病患者（n = 49）。此外，在调整年龄、性别、体重指数（BMI）、吸烟状况、高血压病史、糖尿病和高脂血症后，结果仍具有统计学意义（β = -0.06±0.03，P = 0.029）。单支血管病变组（n = 54）和非冠心病组之间的ABI值无显著差异。此外，比较这三组之间的baPWV值和疾病严重程度时未观察到显著结果。
我们的研究表明ABI值可能预测冠心病的程度。涉及的冠状动脉越多，观察到的ABI值越低。
