El-Naggar Heba M, Anwar Helen S, Helmy Hatem A, Demitry Salwa R
Department of Cardiovascular Medicine, Assiut University Heart Hospital, Assiut, Egypt.
J Cardiovasc Echogr. 2021 Oct-Dec;31(4):234-241. doi: 10.4103/jcecho.jcecho_31_21. Epub 2022 Jan 24.
Aortic elastic properties have been related to coronary artery disease (CAD) morbidity and mortality. We aimed to assess the relation of aortic elasticity indices to the severity and complexity of CAD assessed using the SYNTAX Score (SS), evaluating which of these indices have better predictivity for CAD severity.
We prospectively enrolled 150 individuals who underwent elective coronary angiography for suspected CAD, out of them 29 (19.3%) had normal or nonsignificant angiographic findings (Group I), whereas 121 (80.7%) had significant CAD (Group II) for whom the SS was calculated. Echo-derived aortic elasticity indices were performed for all patients.
Logistic regression analyses showed that each of aortic distensibility, stiffness index, elastic modulus, aortic strain, and aortic peak early diastolic velocity were predictors for significant CAD and further for more complex CAD as indicated by intermediate-high SS. Receiver operator characteristic curves-derived cutoff points were performed for each of the aortic elasticity indices. Along with diabetes, decreased aortic strain ≤10.2% was the only independent predictor of intermediate-high SS (odds ratio = 4.31, 95% confidence interval = 1.38-13.50, = 0.01).
Simple M-mode derived aortic elasticity indices, particularly aortic strain ≤10.2%, might predict patients with more severe and complex CAD.
主动脉弹性特性与冠状动脉疾病(CAD)的发病率和死亡率相关。我们旨在评估主动脉弹性指数与使用SYNTAX评分(SS)评估的CAD严重程度和复杂性之间的关系,以评估这些指数中哪些对CAD严重程度具有更好的预测性。
我们前瞻性纳入了150例因疑似CAD接受选择性冠状动脉造影的患者,其中29例(19.3%)血管造影结果正常或无显著异常(I组),而121例(80.7%)患有显著CAD(II组),并为其计算了SS。对所有患者进行了超声心动图衍生的主动脉弹性指数检测。
逻辑回归分析表明,主动脉扩张性、硬度指数、弹性模量、主动脉应变和主动脉舒张早期峰值速度中的每一项都是显著CAD的预测指标,对于中高SS所表明的更复杂CAD也是如此。对每个主动脉弹性指数进行了受试者工作特征曲线衍生的截断点分析。与糖尿病一起,主动脉应变降低≤10.2%是中高SS的唯一独立预测指标(比值比 = 4.31,95%置信区间 = 1.38 - 13.50,P = 0.01)。
简单的M型衍生主动脉弹性指数,特别是主动脉应变≤10.2%,可能预测患有更严重和复杂CAD的患者。