Noninvasive tests for arterial structure, function, and compliance: Do they identify risk or diagnose disease? - 24/08/11
, Robert Fathi, MB,BS a, Leanne Jeffriess, BS a, Rodel Leano, BS a, Stephane G Carlier, MD, PhD a, Thomas H Marwick, MD, PhD aAbstract |
Background |
Brachial artery reactivity (BAR), carotid intima-media thickness (IMT), and applanation tonometry for evaluation of total arterial compliance may provide information about preclinical vascular disease. We sought to determine whether these tests could be used to identify patients with coronary artery disease (CAD) without being influenced by their ability to identify those at risk for CAD developing.
Methods |
We studied 100 patients and compared 3 groups: 35 patients with known CAD; 34 patients with symptoms and risk factors but no CAD identified by stress echocardiography (risk group); and 31 control subjects. BAR and IMT were measured using standard methods, and total arterial compliance was calculated by the pulse-pressure method from simultaneous radial applanation tonometry and pulsed wave Doppler of the left ventricular outflow. Ischemia was identified as a new or worsening wall-motion abnormality induced by stress.
Results |
In a comparison between the control subjects and patients either at risk for developing CAD or with CAD, the predictors of risk for CAD were: age (P = .01); smoking history (P = .002); hypercholesterolemia (P = .002); and hypertension (P = .004) (model R = 0.82; P = .0001). The independent predictors of CAD were: IMT (P = .001); BAR (P = .04); sex (P = .005); and hypertension (P = .005) (model R = 0.80; P = .0001).
Conclusion |
IMT, BAR, and traditional cardiovascular risk factors appear to identify patients at risk for CAD developing. However, only IMT was significantly different between patients at risk for developing CAD and those with overt CAD.
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 | CME Statement The American Society of Echocardiography (ASE) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians. The ASE designated this educational activity for 1 hour of Category 1 credit of the AMA Physicians' Recognition Award. The ASE adheres to ACCME Standards regarding industry support of continuing medical education. Disclosures of faculty and commercial sponsor relationships, if any, have been indicated. ASE certificates are recognized by ARDMS and CCI as appropriate towards their registry requirements for sonographers. Target Audience: Participation should include persons from the fields of cardiac sonography, cardiovascular anesthesiology, cardiovascular medicine, cardiovascular surgery, pediatric cardiology, neurology, and nursing, as well as medical residents/fellows, and students. Educational Objective:After reading this article, the participant should be able to do the following:
The estimated time for this CME activity is approximately 1 hour. Supported in part by a Clinical Centers of Research Excellence Award, National Health and Medical Research Council, Australia. |
Vol 17 - N° 2
P. 195-202 - février 2004 Retour au numéro
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