Korean Circ J.  2010 Dec;40(12):665-670. 10.4070/kcj.2010.40.12.665.

Carotid Intima-Media Thickness and Plaque as a Predictor for Ischemic Etiology in Patients With Severe Left Ventricular Systolic Dysfunction

• Suh SY
• Han SW
• Kim SH
• Kim HJ
• Chung SM
• Ryu KH

• KMID: 2225166
• DOI: http://doi.org/10.4070/kcj.2010.40.12.665

Abstract

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.

Keyword

Plaque; Intima-media thickness; Coronary artery disease

MeSH Terms

Carotid Artery, Common
Carotid Intima-Media Thickness
Coronary Angiography
Coronary Artery Disease
Heart Failure
Humans
Logistic Models
Male
Prognosis
Retrospective Studies
Stroke

Figure

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  Fig. 1 Representative image of carotid intima-media thickness, and coronary angiography in severe left ventricular systolic dysfunction patients. A and B: non-CAD patient. C and D: CAD patient. CAD: coronary artery disease.

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  Fig. 2 Mean common carotid artery intima-media thickness (CCA-IMT) in CAD and Non-CAD group (A) and mild, moderate, severe CAD patients (B). CAD: coronary artery disease.

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  Fig. 3 Receiver operating characteristic curve for mean CCA IMT versus CAD. CCA: common carotid artery, IMT: intima-media thickness, CAD: coronary artery disease.

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