Kiuchi Shunsuke, Hisatake Shinji, Kabuki Takayuki, Oka Takashi, Dobashi Shintaro, Fujii Takahiro, Ikeda Takanori
Department of Cardiovascular Medicine, Toho University Graduate School of Medicine, Tokyo, Japan.
J Clin Med Res. 2017 May;9(5):439-445. doi: 10.14740/jocmr2994w. Epub 2017 Apr 1.
The most common cause of heart failure (HF) is ischemic heart disease (IHD). Evaluation of IHD with non-invasive examinations is useful for the treatment of HF, and cardio-ankle vascular index (CAVI) is a good parameter for detecting systemic arteriosclerosis. However, the relationship between IHD and CAVI in acute HF (AHF) patients is still unclear. Therefore, we investigated the effect of non-invasive examinations, including CAVI to detect IHD.
We studied 53 consecutive patients (average age of 66.5 ± 10.9 years old, 36 males) with AHF from January 2009 to December 2012. These patients were classified into the IHD group (n = 19) and non-IHD group (n = 34) according to the coronary artery angiography results. We evaluated the vital signs, laboratory findings and CAVI.
According to the laboratory findings, the C-reactive protein (CRP) in IHD group was significantly higher than non-IHD group (1.5 ± 2.1 mg/dL vs. 0.4 ± 0.4 mg/dL, P = 0.002). CAVI in IHD group was significantly higher than non-IHD group (9.58 ± 1.73 vs. 7.83 ± 1.86, P < 0.001). In the receiver operating characteristic (ROC) curve for discriminating the probability of IHD, the cut-off point of the CRP plus CAVI was 9.00. At that cut-off point, the sensitivity and the specificity were 69.7% and 89.5%, respectively. The mean area under the ROC curve (AUC) defined by the CRP plus CAVI was the greatest at all parameters.
The CRP and CAVI were useful parameters for the identification of IHD in patients with AHF.
心力衰竭(HF)最常见的病因是缺血性心脏病(IHD)。采用非侵入性检查评估IHD对HF的治疗很有用,而心踝血管指数(CAVI)是检测全身动脉硬化的一个良好参数。然而,急性心力衰竭(AHF)患者中IHD与CAVI之间的关系仍不清楚。因此,我们研究了包括CAVI在内的非侵入性检查对检测IHD的作用。
我们研究了2009年1月至2012年12月期间连续收治的53例AHF患者(平均年龄66.5±10.9岁,男性36例)。根据冠状动脉造影结果,将这些患者分为IHD组(n = 19)和非IHD组(n = 34)。我们评估了生命体征、实验室检查结果和CAVI。
根据实验室检查结果,IHD组的C反应蛋白(CRP)显著高于非IHD组(1.5±2.1mg/dL对0.4±0.4mg/dL,P = 0.002)。IHD组的CAVI显著高于非IHD组(9.58±l.73对7.83±1.86,P<0.001)。在用于鉴别IHD可能性的受试者工作特征(ROC)曲线中,CRP加CAVI的切点为9.00。在该切点时,敏感性和特异性分别为69.7%和89.5%。由CRP加CAVI定义的ROC曲线下平均面积(AUC)在所有参数中最大。
CRP和CAVI是AHF患者识别IHD的有用参数。