Department of Cardiology, The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, China.
Department of Ultrasound, Shenzhen People's Hospital, 3046 Shennandong Road, Luohu District, Shenzhen, Guangdong, China.
Eur Heart J Cardiovasc Imaging. 2019 Aug 1;20(8):889-896. doi: 10.1093/ehjci/jez026.
Carotid intima-media thickness (CIMT) has been widely used to risk stratify and predict coronary artery disease (CAD) despite its significant limitations. To test whether radial artery intima thickness (RIT) is closely associated with atherosclerotic risk factors, and whether RIT has an independent and additive value for diagnosis of CAD.
One hundred and sixteen consecutive CAD patients and 79 age and gender-matched healthy controls were enrolled in this study. RIT, radial media thickness, radial intima-media thickness, and CIMT were measured with a high-resolution ultrasound biomicroscopy. Binary logistic regression was used to assess association between CAD and ultrasonic parameters, biochemical biomarkers or traditional risk factors. Receiver-operating characteristic curves were plotted to compare performances of several diagnostic models. RIT was positively associated with age, systolic blood pressure, statin administration, and hypertension. The independent value of RIT for differentiating CAD was similar to that of CIMT, but the add-on value of RIT to traditional risk factors for detecting CAD was superior to that of CIMT. Moreover, addition of RIT and CIMT to traditional risk factors increased AUC for detecting CAD from 0.724 to 0.867 significantly (P = 0.003).
RIT could detect CAD independently similarly to CIMT. The add-on value of RIT to traditional risk factors for detecting CAD was superior to CIMT and addition of RIT and CIMT to traditional risk factors markedly increased the power to diagnose CAD. Thus, RIT measured by ultrasound biomicroscopy provided a novel approach to non-invasive diagnosis of CAD.
尽管颈动脉内膜中层厚度（CIMT）存在明显局限性，但已被广泛用于对冠状动脉疾病（CAD）进行风险分层和预测。本研究旨在检验桡动脉内膜厚度（RIT）与动脉粥样硬化危险因素的密切相关性，以及 RIT 是否对 CAD 的诊断具有独立且附加的价值。
本研究纳入了 116 例连续的 CAD 患者和 79 名年龄和性别匹配的健康对照者。使用高分辨率超声生物显微镜测量 RIT、桡动脉中层厚度、桡动脉内膜中层厚度和 CIMT。采用二元逻辑回归评估 CAD 与超声参数、生化标志物或传统危险因素之间的相关性。绘制受试者工作特征曲线比较几种诊断模型的性能。RIT 与年龄、收缩压、他汀类药物治疗和高血压呈正相关。RIT 对区分 CAD 的独立价值与 CIMT 相似，但 RIT 对传统危险因素检测 CAD 的附加价值优于 CIMT。此外，将 RIT 和 CIMT 添加到传统危险因素中可使检测 CAD 的 AUC 从 0.724 显著增加至 0.867（P=0.003）。
RIT 与 CIMT 相似，可独立检测 CAD。RIT 对传统危险因素检测 CAD 的附加价值优于 CIMT，并且将 RIT 和 CIMT 添加到传统危险因素中可明显提高 CAD 的诊断能力。因此，超声生物显微镜测量的 RIT 为 CAD 的无创诊断提供了一种新方法。
