Volume elastic modulus of the brachial artery and coronary artery stenosis in patients with suspected stable coronary artery disease

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• 作者：Ryo Munakata ; Toshiaki Otsuka ; Saori Uchiyama ; Tetsuro Shimura…
• 关键词：Brachial artery stiffness ; Coronary artery disease ; Framingham risk score ; Oscillometric measurement ; Risk prediction
• 刊名：Heart and Vessels
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：31
• 期：9
• 页码：1467-1475
• 全文大小：524 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  Cardiac Surgery
  Vascular Surgery
  Biomedical Engineering
  Interventional Radiology
  Ultrasound
  
• 出版者：Springer Japan
• ISSN：1615-2573
• 卷排序：31

文摘

This study aimed to examine the association between the non-invasive measurement of the brachial artery volume elastic modulus (V_E), an index of arterial stiffness, and the presence of coronary artery stenosis in patients with suspected stable coronary artery disease (CAD). A total of 135 patients with suspected stable CAD (87 men, mean age, 64 ± 12 years) underwent oscillometric measurement of the brachial artery to obtain V_E. Coronary angiography was thereafter carried out to diagnose CAD, defined as having ≥75 % stenosis in the epicardial coronary arteries. V_E was significantly higher in patients with CAD (1.94 ± 0.34 mmHg/%) than in those without CAD (1.71 ± 0.35 mmHg/%, P < 0.001). In multiple logistic regression analysis, V_E was an independent predictor for the presence of CAD (odds ratio 1.19 per 0.1 mmHg/% increase, 95 % CI 1.04–1.51) even after adjusting for multiple potential confounders including the Framingham risk score (FRS). The area under the curve of the receiver operating characteristic curve analysis for discriminating CAD increased significantly after the addition of V_E to the FRS (from 0.75 to 0.81, P = 0.034). The category-free net reclassification improvement and the integrated discrimination improvement by adding V_E to the FRS were 0.476 (95 % CI 0.146–0.806) and 0.086 (95 % CI 0.041–0.132), respectively. In conclusion, the brachial V_E was significantly associated with the presence of coronary artery stenosis. The additional measurement of V_E to the FRS improved the ability to identify patients with coronary artery stenosis among those with suspected stable CAD.