Carotid Artery Intima-Media Thickness in Patients With CAD
Carotid Artery Intima-Media Thickness in Patients With CAD
Thirty- one patients took part in the study. Two patients were excluded due to poor echocardiographic image quality. Strain analyses were therefore performed in 29 patients.
The age of the patients ranged from 53 to 75 years. There were 81% males in the study. Baseline characteristics of the patients are shown in Table 1.
A total of 20 (65%) patients had significant CAD (≥50% stenosis). Eight of these patients had an occlusion of a major coronary artery) and 11 (35%) had a non-significant CAD (<50% stenosis). There was a significant difference in endocardial and mid-myocardial LVGLS between the patients with significant coronary stenosis and the patients with non-significant coronary stenosis. Layer-specific LVGLS compared to the coronary angiography findings are shown in Table 2.
Left ventricular Ejection Fraction (LVEF) was: mean ± SD; 61% ± 6% for the total group of patients. Patients with normal endocardial strain had EF values of: mean ± SD; 62% ± 6.0% and patients with reduced endocardial strain mean ± SD; 58% ± 4.8%. This difference was not significant (p = 0.091).
Figures 4a-d shows ROC analyses of layer specific strain parameters and the ability of IMT measurements to identify patients with significant CAD. Maximum carotid IMT ranged between 1 mm and 2.88 mm for the whole group of patients including carotid plaques in the IMT measurements. For the group with normal endocardial strain values, defined by the cut-off strain value of -16.7, carotid IMT was 1.2 mm ± 0.2 (mean ± SD) and for the group with reduced endocardial strain values the carotid IMT value was 1.7 mm ± 0.5 (mean ± SD). Independent samples t-test comparing the two groups was statistically significant (p = 0.006). There was significant correlation between endocardial LVGLS and maximum carotid IMT (p = 0.006). The results of linear regression analyses which incorporated adjustment for known risk factors of atherosclerosis (hypertension, smoking, hyperlipidemia, diabetes and BMI) were made and showed significant results (p = 0.02).
(Enlarge Image)
Figure 4.
ROC curves for coronary angiography and carotid IMT versus ventricular strain. a: Coronary angiography versus endocardial 2D-STE. b: Coronary angiography versus mid-myocardial 2D-STE. c: Coronary angiography versus epicardial 2D-STE. d: Average maximum Carotid IMT versus endocardial 2D-STE.
Results
Thirty- one patients took part in the study. Two patients were excluded due to poor echocardiographic image quality. Strain analyses were therefore performed in 29 patients.
The age of the patients ranged from 53 to 75 years. There were 81% males in the study. Baseline characteristics of the patients are shown in Table 1.
A total of 20 (65%) patients had significant CAD (≥50% stenosis). Eight of these patients had an occlusion of a major coronary artery) and 11 (35%) had a non-significant CAD (<50% stenosis). There was a significant difference in endocardial and mid-myocardial LVGLS between the patients with significant coronary stenosis and the patients with non-significant coronary stenosis. Layer-specific LVGLS compared to the coronary angiography findings are shown in Table 2.
Left ventricular Ejection Fraction (LVEF) was: mean ± SD; 61% ± 6% for the total group of patients. Patients with normal endocardial strain had EF values of: mean ± SD; 62% ± 6.0% and patients with reduced endocardial strain mean ± SD; 58% ± 4.8%. This difference was not significant (p = 0.091).
Figures 4a-d shows ROC analyses of layer specific strain parameters and the ability of IMT measurements to identify patients with significant CAD. Maximum carotid IMT ranged between 1 mm and 2.88 mm for the whole group of patients including carotid plaques in the IMT measurements. For the group with normal endocardial strain values, defined by the cut-off strain value of -16.7, carotid IMT was 1.2 mm ± 0.2 (mean ± SD) and for the group with reduced endocardial strain values the carotid IMT value was 1.7 mm ± 0.5 (mean ± SD). Independent samples t-test comparing the two groups was statistically significant (p = 0.006). There was significant correlation between endocardial LVGLS and maximum carotid IMT (p = 0.006). The results of linear regression analyses which incorporated adjustment for known risk factors of atherosclerosis (hypertension, smoking, hyperlipidemia, diabetes and BMI) were made and showed significant results (p = 0.02).
(Enlarge Image)
Figure 4.
ROC curves for coronary angiography and carotid IMT versus ventricular strain. a: Coronary angiography versus endocardial 2D-STE. b: Coronary angiography versus mid-myocardial 2D-STE. c: Coronary angiography versus epicardial 2D-STE. d: Average maximum Carotid IMT versus endocardial 2D-STE.
Source...