Assessment of the intima-media thickness and pulse-wave velocity in peripheral arteries in patients with angiographically confirmed coronary artery disease

摘要

Background: Non-invasive methods of assessment of the vascular wall have become of significant interest in recent years. They allow better prediction of cardiovascular lesions when combined with evaluation of established cardiovascular risk factors. The aim of the study was to evaluate whether the combination of ultrasonographic assessment of intima-media thickness (IMT) and pulse-wave velocity (PWV) measurement in peripheral arteries results in an increased predictive value for the presence of atherosclerotic coronary lesions. In addition, selected established risk factors for atherosclerosis were analysed for their association with IMT and PWV. Methods: Fifty patients with angiographically confirmed coronary artery disease were included in the study. In all patients ultrasonographic assessment of IMT was performed in the common carotid artery (CCA), the carotid artery bulb (CB) and the common femoral artery (CFA). Simultaneously PWV was recorded between CCA and the brachial and femoral arteries. Results: A higher IMT was noted both in CB and CFA as compared to CCA. Carotid-brachial PWV was higher compared to carotid-femoral PWV. Carotid-femoral PWV correlated with IMT (p = 0.015) and the presence of atherosclerotic plaques (p = 0.04) in CB. No similar relation was found for carotid-brachial PWV. IMT in CCA, CB, and CFA was significantly higher in subjects with triple-vessel disease compared to patients with single-vessel or doublevessel disease. We also found a trend for higher PWV values in patients with multivessel disease but these differences did not reach statistical significance. Conclusions: Combining ultrasonographic assessment of IMT and PWV measurements in peripheral arteries results in an increased predictive value for the presence of atherosclerotic coronary lesions. Isolated PWV measurements are less useful for non-invasive coronary risk assessment than IMT measurements.