Dissertation
Dissertation > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Coronary arteries ( atherosclerosis ),heart disease (CHD)

Study on Relationship Between Non-invasive Vascular Measurement Indicators and Coronary Artery Lesions

Author LuoLingLi
Tutor ZhuLiGuang
School Guangxi Medical University
Course Department of Cardiology
Keywords coronary artery disease blood pressure pulse pressureankle-brachial index carotid intima-media thickness
CLC R541.4
Type Master's thesis
Year 2012
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OBJECTIVE:Explore the association between non-invasive peripheral vascular indexes and coronary artery lesions, to provide a theoretical basis and effective detection methods for the screening of early atherosclerosis, coronary heart disease early prevention and treatment.METHODS:Collected from March2011to October2011, in the Department of Cardiology, the first Affiliated Hospital of Guangxi medical University inpatient159cases suspected with coronary heart disease(CHD), underwent selective coronary angiography. Positive coronary angiography in104cases of CHD group;55cases of normal coronary angiography as the control group. Gensini score calculated in accordance with the number of coronary arteries and the degree of stenosis of coronary artery in the CHD group. According to the Gensini score, CHD group were divided into non-severe lesions group (≤30points) and severe lesions group (≥30points).All subjects were measured blood pressure, pulse pressure (PP), ankle-brachial index (ABI), carotid intima-media thickness (IMT) and plaque ultrasonic testing. At last, we compared the difference of the non-invasive indicators between the CHD group and control group, and analyzed the correlation between these indicators and the degree of coronary lesions of CHD group.RESULTS:1.Blood pressure, pulse pressure:The pulse pressure was equal to the difference of systolic blood pressure minus diastolic blood pressure. The boundaries of blood pressure was≥140/90mmHg as hypertension;The reference range of pulse pressure was30~50mmHg.SBP in the control group was129.96±16.89mmHg;in the CHD group was134.47±17.13mmHg;SBP in the non-severe lesions group was125.73±11.94mmHg; in the severe lesions group was138.01±17.69mmHg. DBP in the control group was79.45±10.64mmHg; in the CHD group was78.55±10.07mmHg; in the non-severe lesions group was77.47±8.93mmHg; in the severe lesions group was78.99±10.53mmHg. PP in the control group was50.76±12.93mmHg; in the CHD group was55.63±14.40mmHg; in the non-severe lesions group was48.26±12.02mmHg; in the severe lesions group was58.62±14.27mmHg. The results showed that:PP in the control group and CHD group, there was significant difference (P<0.05); SBP and PP, There was significant difference between the non-severe disease group and severe lesions group (P<0.05). PP in the CHD group was higher than that in the control group; SBP、PP in the severe lesions group was higher than that in the non-severe lesions group.2. The reference range of ABI was1.0~1.3. In this study, the ABI≤0.9for the lower cutoff values. The results showed that:the mean of ABI in the control group was1.13±0.07and in the CHD group was1.07±0.11, the mean of ABI in the non-severe lesion group of the CHD group was1.14±0.65;and in the severe lesion group was1.04±0.12. No cases decreased in the control group (the abnormal incidence rate was (0%);22cases decreased in the CHD group (21.15%); No cases decreased in the non-severe lesions group(0%);22cases decreased in the severe lesions group (21.15%); Statistical analysis:There was significant difference between the control group and the CHD group, There was statistical difference between the non-severe lesions group and severe lesions group in ABI (P<0.05). The value of ABI in the CHD group was less than the control group, and in the severe lesions group was less than non-severe lesions group.Abnormal ABI occurred in the severe lesions group.3. The reference range of IMT was0.40~1.00mm, in this study IMT≥1.0mm as a thickening of the boundary values, IMT>1.2mm as the value of the plaque. The results showed that:IMT in control group was0.84+0.26mm, and3cases were detected atherosclerotic plaque (5.45%); IMT in CHD group was1.47±0.62mm, and61cases were detected atherosclerotic plaque (58.65%). IMT in non-severe lesions group was1.07±0.42mm,9cases were detected atherosclerotic plaque (30%); IMT in severe lesions group was1.63±0.62mm,52cases were detected plaque (70.27%). Statistical study showed that:There was significant difference between control group and CHD group(P<0.05). Both the IMT value and the incidence rate of plaque in CHD group were higher than those in control group. There was statistical difference between the non-severe lesions group and severe lesions group in IMT and the plaque (P<0.05), IMT values and the incidence rate of plaque were higher than non-severe lesions group.Either an abnormal ABI, IMT or plaque, as the occurrence of peripheral atherosclerotic lesions. The results showed that:In the group without CHD, the incidence rate of peripheral atherosclerotic lesions was21.82%; In the group with CHD, the incidence rate of peripheral atherosclerotic lesions was95.19%. There were significant differences between the two groups (P<0.05). Gensini score of coronary artery as the dependent variable, all other indicators as independent variables, variable selection using binary logistic regression analysis. Logistic regression analysis showed that coronary artery disease was associated with SBP,ABI and IMT, in which the SBP OR1.063,95%CI(1.012,1.117); ABI OR1.063,95%CI(1.527E-08,0.016); IMT OR5.884,95%CI(1.558,22.214); There were significant differences (P<0.05).CONCLUSIONS:1. Age, PP, LDL and diabetes are major risk factors for coronary heart disease.2. A higher incidence of peripheral atherosclerotic lesions in CHD group, and coronary artery disease is more severe, the higher probability of peripheral artery involvement.3.The level of SBP、ABI and IMT were related to the severity of coronary lesions, SBP and IMT were positively correlated with coronary lesions,ABI was inversely and significantly correlated with the extent of coronary stenosis.4. Joint a variety of non-invasive indicators might be more helpful to assess CHD and the severity of coronary artery disease,and to provide a simple and feasible detection method for early diagnosis and treatment and follow-up.

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