Enderle M D, Schroeder S, Ossen R, Meisner C, Baumbach A, Haering H U, Karsch K R, Pfohl M
Department of Endocrinology, University of Tübingen, Germany.
Heart. 1998 Oct;80(4):349-54. doi: 10.1136/hrt.80.4.349.
Flow associated dilatation (FAD%) and intimal media thickness are established markers of early atherosclerosis. This study aimed to compare the ability of the non-invasive measurements FAD% and intimal media thickness to predict coronary artery disease.
FAD% and intimal media thickness were determined using high resolution ultrasound in 122 patients with clinically suspected coronary artery disease before coronary angiography. Results are given as mean (SD).
Patients with coronary artery disease had reduced FAD% compared with those with angiographically normal coronary vessels (3.7 (4.1) v 7.0 (3.5)%, p < 0.001), whereas intimal media thickness tended to be increased in patients with coronary artery disease (0.58 (0.35) v 0.47 (0.11)mm, p = 0.054). There was a negative correlation between FAD% and intimal media thickness (R = -0.317, p = 0.0004). Receiver operating characteristic analysis showed that FAD% < or = 4.5% predicted coronary artery disease with a sensitivity of 0.71 (95% confidence interval 0.61 to 0.80) and a specificity of 0.81 (0.58 to 0.95). In contrast, intimal media thickness showed a positive correlation with the extent of coronary artery disease (number of vessels with a lesion > or = 50%) (R = 0.324, p = 0.0003), without a clear cut off point.
In patients with clinically suspected coronary artery disease, FAD% discriminates between the presence or absence of coronary artery disease, whereas intimal media thickness is associated more with the extent of coronary artery disease.
血流相关扩张（FAD%）和内膜中层厚度是早期动脉粥样硬化的确立标志物。本研究旨在比较无创测量指标FAD%和内膜中层厚度预测冠状动脉疾病的能力。
在122例临床怀疑患有冠状动脉疾病的患者进行冠状动脉造影前，使用高分辨率超声测定FAD%和内膜中层厚度。结果以均值（标准差）表示。
与冠状动脉血管造影正常的患者相比，冠状动脉疾病患者的FAD%降低（3.7（4.1）对7.0（3.5）%，p<0.001），而冠状动脉疾病患者的内膜中层厚度有增加趋势（0.58（0.35）对0.47（0.11）mm，p = 0.054）。FAD%与内膜中层厚度呈负相关（R = -0.317，p = 0.0004）。受试者工作特征分析表明，FAD%≤4.5%预测冠状动脉疾病的敏感性为0.71（95%置信区间0.61至0.80），特异性为0.81（0.58至0.95）。相比之下，内膜中层厚度与冠状动脉疾病的程度（病变血管数≥50%）呈正相关（R = 0.324，p = 0.0003），但没有明确的截断点。
在临床怀疑患有冠状动脉疾病的患者中，FAD%可区分冠状动脉疾病的有无，而内膜中层厚度与冠状动脉疾病的程度关联更大。
