Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, 126-1, 5ga, Anamdong, Seongbukgu, Seoul 136-705, Republic of Korea.
Eur Heart J Cardiovasc Imaging. 2012 Jul;13(7):568-73. doi: 10.1093/ejechocard/jer259. Epub 2011 Nov 28.
Carotid intima-media thickness (CIMT) is a useful indicator of coronary artery disease (CAD). The relation between functional changes of the common carotid artery (CCA) and CAD is unclear. This study investigated the relationship between CCA strain and CIMT in the assessment of CAD.
Within a 1-month period, 121 patients underwent coronary angiography and ultrasonography of the CCA. Circumferential strain and strain rate were measured in the left CCA by 2D ultrasonography with a speckle tracking method and CIMT was measured using standard techniques. Adequate images were obtained in 104 patients (59 ± 11 years, 39 females), of which 46 had CAD. Strain and strain rate were negatively correlated with CIMT and were positively correlated with the number of risk factors. CIMT was significantly higher, and strain and strain rate were significantly lower in the CAD group (OR, 95% CI, P-value, CIMT: 23.23, 2.03-265.30, 0.011; strain: 0.51, 0.31-0.82, 0.006; strain rate: 0.01, 0.00-0.13, 0.001). However, after adjustment for cardiovascular risk factors, only strain and strain rate were significantly associated with CAD (OR, 95% CI, P-value, CIMT: 5.28, 0.28-99.84, 0.267; strain: 0.51, 0.30-0.88, 0.014; strain rate: 0.01, 0.00-0.42, 0.014). CAD severity, assessed by the number of stenosed coronary arteries, was also significantly correlated with strain and strain rate, but was not significantly correlated with CIMT.
Both CIMT and CCA strain were associated with CAD. CAD severity and extent were correlated with strain and strain rate, but were not correlated with CIMT. The evaluation of mechanical properties of CCA by ultrasonographic 2D strain imaging could therefore be more effective than that by CIMT for the assessment of CAD.
颈动脉内膜中层厚度(CIMT)是冠心病(CAD)的一个有用指标。颈总动脉(CCA)功能变化与 CAD 的关系尚不清楚。本研究旨在探讨 CCA 应变与 CIMT 在 CAD 评估中的关系。
在 1 个月内,121 例患者接受了冠状动脉造影和 CCA 超声检查。通过二维超声斑点追踪技术测量左 CCA 的周向应变和应变速率,并采用标准技术测量 CIMT。104 例患者(59±11 岁,39 例女性)获得了足够的图像,其中 46 例患有 CAD。应变和应变速率与 CIMT 呈负相关,与危险因素数量呈正相关。CAD 组的 CIMT 显著较高,应变和应变速率显著较低(OR,95%CI,P 值,CIMT:23.23,2.03-265.30,0.011;应变:0.51,0.31-0.82,0.006;应变速率:0.01,0.00-0.13,0.001)。然而,在校正心血管危险因素后,只有应变和应变速率与 CAD 显著相关(OR,95%CI,P 值,CIMT:5.28,0.28-99.84,0.267;应变:0.51,0.30-0.88,0.014;应变速率:0.01,0.00-0.42,0.014)。CAD 严重程度,由狭窄冠状动脉数量评估,也与应变和应变速率显著相关,但与 CIMT 不相关。
CIMT 和 CCA 应变均与 CAD 相关。CAD 严重程度和范围与应变和应变速率相关,与 CIMT 不相关。因此,超声二维应变成像评估 CCA 的力学特性可能比 CIMT 更有效地评估 CAD。