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Published on: February 7, 2015
Carotid Artery Doppler: A Possible Non-invasive Diagnostic Approach to Assessing the Severity of Coronary Artery
Ritika Agarwal1, Jahnavi Gadupati1, Sampangi S Ramaiah1
1Radiology, M. S. Ramaiah Medical College, Bengaluru, IND.
Insights
Carotid artery ultrasound effectively predicts coronary artery disease (CAD) severity. Increased intima-media thickness and significant stenosis are linked to higher Gensini scores and multi-vessel disease, aiding early intervention.
Area of Science:
- Cardiovascular Medicine
- Diagnostic Imaging
- Vascular Ultrasound
Background:
- Coronary artery disease (CAD) poses a significant health burden.
- Non-invasive methods for assessing CAD severity are crucial for risk stratification.
- Carotid artery Doppler ultrasound is an emerging tool for cardiovascular risk evaluation.
Purpose of the Study:
- To investigate the association between carotid Doppler ultrasound parameters and CAD severity.
- To determine if carotid ultrasound can predict high Gensini scores (GS) and multi-vessel disease.
Main Methods:
- Retrospective analysis of 90 patients undergoing coronary angiography and carotid ultrasound.
- Assessment of carotid Doppler parameters including intima-media thickness (IMT) and stenosis.
- Bivariate and multivariable analyses to correlate carotid findings with CAD severity (GS, multi-vessel disease).
Main Results:
- Increased common carotid artery (CCA) IMT and internal carotid artery (ICA) IMT were associated with high GS and multi-vessel disease.
- Significant carotid stenosis (>50%) independently predicted CAD severity.
- Fibrocalcific plaques and higher plaque burden correlated with elevated GS and multi-vessel disease.
Conclusions:
- Carotid Doppler ultrasound parameters, specifically IMT and significant stenosis, are reliable predictors of CAD severity.
- Carotid artery assessment can enhance timely interventions and preventive strategies for CAD management.
Background And Objectives:
Carotid artery Doppler ultrasound is being explored for its potential as a non-invasive tool for evaluating coronary artery disease (CAD) severity and cardiovascular risk. This study aimed to investigate the association between carotid Doppler parameters and CAD severity, as determined by the Gensini score (GS) and multi-vessel disease presence.
Methods:
Ninety patients undergoing coronary angiography (CAG) and carotid ultrasound were retrospectively analysed. Carotid Doppler parameters and CAD severity were assessed through bivariate and multivariable analyses.
Results:
Among the patients studied, 80% were male, with a mean age of 65.24 years (±9.91). Triple vessel disease (68.9%) and dominant vessel disease (73.3%) were prevalent coronary findings, with a mean GS of 139.2 (±76.6). Increased intima-media thickness (IMT) in the common carotid artery (CCA) and internal carotid artery (ICA) showed significant associations (CCA IMT: OR = 0.312, p = 0.037; ICA IMT: OR = 0.354, p = 0.017) with high GS (>125) and multi-vessel disease. Significant carotid stenosis (>50% diameter stenosis) emerged as an independent predictor of CAD severity. Fibrocalcific plaques, detected in 62.2% of cases, correlated significantly with elevated GS. Plaque burden, especially plaques in >3 locations, indicated a higher likelihood of triple vessel disease and a higher GS.
Conclusion:
Carotid Doppler parameters, particularly IMT and significant stenosis, are robust predictors of CAD severity, including high GS and multi-vessel disease. Integrating carotid artery assessment into clinical protocols can aid in timely interventions and preventive strategies for CAD management.
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