Carotid intima-media thickness and plaque as a predictor for ischemic etiology in patients with severe left
Soon Yong Suh1, Seong Woo Han, Sung Hea Kim
1Cardiovascular Center, Konkuk University Hospital, Seoul, Korea.
Insights
In patients with severe left ventricular systolic dysfunction (LVSD), common carotid artery intima-media thickness (IMT) and bulb plaque are valuable predictors for diagnosing coronary artery disease (CAD). These non-invasive markers aid in identifying significant CAD.
Area of Science:
- Cardiology
- Vascular Ultrasound
- Diagnostic Imaging
Background:
- Coronary artery disease (CAD) is a primary cause of heart failure with left ventricular systolic dysfunction (LVSD).
- Differentiating CAD from other heart failure etiologies is crucial for prognosis.
- Carotid intima-media thickness (IMT) and plaque predict cardiovascular events, including CAD.
Purpose of the Study:
- To assess the predictive value of carotid IMT and plaque for diagnosing CAD in patients with LVSD.
- To determine if carotid ultrasound findings can aid in identifying significant CAD in this population.
Main Methods:
- Retrospective analysis of 73 patients with severe LVSD.
- Coronary angiography used to assess CAD severity (Duke Jeopardy Score).
- Carotid IMT and plaque measured using the Mannheim Carotid IMT Consensus.
Main Results:
- Significant CAD identified in 56.1% of patients.
- Higher mean common carotid artery (CCA) IMT in the CAD group (p<0.01).
- Increased prevalence of CCA plaque and bulb plaque in the CAD group (p<0.01, p<0.001).
- CCA IMT and bulb plaque were significant independent predictors of CAD (p<0.01).
Conclusions:
- Mean CCA IMT and bulb plaque are useful additional predictors for CAD diagnosis in severe LVSD patients.
- Carotid ultrasound may offer a non-invasive method to support CAD diagnosis in this cohort.
Background And Objectives:
Coronary artery disease (CAD) is a major cause of heart failure associated with left ventricular systolic dysfunction (LVSD). The prognosis of LVSD is significantly influenced by the etiology of heart failure and therefore, differentiation of significant CAD from other etiologies is important. Carotid intima-media thickness (IMT) and plaque are useful predictors for cardiovascular events, including stroke and CAD. The purpose of this study was to evaluate the predictive value of carotid IMT and plaque for the diagnosis of CAD in LVSD patients.
Subjects And Methods:
Seventy-three (n= 73, 47 male, 67.6±12.4 years) patients hospitalized for heart failure with severe LVSD were retrospectively enrolled. The severity of CAD was analyzed by the Duke Jeopardy Score system, and carotid IMT and plaque were measured according to the Mannheim Carotid IMT Consensus.
Results:
Significant CAD was found in 41 patients (56.1%, CAD group) on coronary angiography. Mean common carotid artery (CCA) IMT (0.74±0.05 mm vs. 1.04±0.04 mm, p<0.01) was significantly higher in the CAD group. Plaque in CCA (6.25% vs. 19.5%, p<0.01) and plaque in bulb (25.0% vs. 60.9%, p<0.001) were significantly higher in the CAD group. Mean CCA IMT {odds ratio (OR) 2.61, 95% confidence interval (CI) 1.134-4.469, p<0.01} and plaque in bulb (OR 4.69, 95% CI 1.702-12.965, p<0.01) were significant predictors for the diagnosis of CAD according to multivariate logistic regression analysis.
Conclusion:
In patients with severe LVSD, mean CCA IMT and bulb plaque can be useful additional predictors for the diagnosis of CAD.
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