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Comparison of peripheral endothelial dysfunction and intimal media thickness in patients with suspected coronary
M D Enderle1, S Schroeder, R Ossen
1Department of Endocrinology, University of Tübingen, Germany.
Insights
Flow associated dilatation (FAD%) effectively distinguishes coronary artery disease presence, while intimal media thickness correlates with disease extent. Both are non-invasive markers for atherosclerosis assessment.
Area of Science:
- Cardiovascular Medicine
- Diagnostic Imaging
- Vascular Biology
Background:
- Flow associated dilatation (FAD%) and intimal media thickness are recognized indicators of early atherosclerosis.
- Non-invasive assessment of these markers is crucial for early disease detection.
Purpose of the Study:
- To compare the predictive capabilities of FAD% and intimal media thickness for coronary artery disease (CAD).
- To evaluate FAD% and intimal media thickness as non-invasive biomarkers for CAD detection.
Main Methods:
- High-resolution ultrasound was used to measure FAD% and intimal media thickness in 122 patients with suspected CAD.
- Measurements were taken prior to coronary angiography for definitive diagnosis.
Main Results:
- Patients with CAD exhibited significantly reduced FAD% compared to those without (3.7% vs. 7.0%, p < 0.001).
- Intimal media thickness showed a trend towards increase in CAD patients (0.58mm vs. 0.47mm, p = 0.054).
- FAD% < or = 4.5% predicted CAD with 71% sensitivity and 81% specificity; intimal media thickness correlated with CAD extent (R = 0.324, p = 0.0003).
Conclusions:
- FAD% serves as a reliable discriminator for the presence or absence of CAD.
- Intimal media thickness is more indicative of the extent of coronary artery disease rather than its presence alone.
Objective:
Flow associated dilatation (FAD%) and intimal media thickness are established markers of early atherosclerosis. This study aimed to compare the ability of the non-invasive measurements FAD% and intimal media thickness to predict coronary artery disease.
Methods:
FAD% and intimal media thickness were determined using high resolution ultrasound in 122 patients with clinically suspected coronary artery disease before coronary angiography. Results are given as mean (SD).
Results:
Patients with coronary artery disease had reduced FAD% compared with those with angiographically normal coronary vessels (3.7 (4.1) v 7.0 (3.5)%, p < 0.001), whereas intimal media thickness tended to be increased in patients with coronary artery disease (0.58 (0.35) v 0.47 (0.11)mm, p = 0.054). There was a negative correlation between FAD% and intimal media thickness (R = -0.317, p = 0.0004). Receiver operating characteristic analysis showed that FAD% < or = 4.5% predicted coronary artery disease with a sensitivity of 0.71 (95% confidence interval 0.61 to 0.80) and a specificity of 0.81 (0.58 to 0.95). In contrast, intimal media thickness showed a positive correlation with the extent of coronary artery disease (number of vessels with a lesion > or = 50%) (R = 0.324, p = 0.0003), without a clear cut off point.
Conclusions:
In patients with clinically suspected coronary artery disease, FAD% discriminates between the presence or absence of coronary artery disease, whereas intimal media thickness is associated more with the extent of coronary artery disease.