Evaluation of the Severity of Coronary Atherosclerotic Lesions by Integrated Cervical Cerebral Ultrasound Combined with Hcy and hs-CRP

doi:10.7517/issn.1674-0475.221020

Abstract

Abstract: This study investigated the value of intracranial and extracranial integrated cervical cerebral ultrasound features combined with homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) in evaluating the degree of coronary atherosclerosis. 120 patients with suspected coronary heart disease were selected, and 82 patients were diagnosed with coronary heart disease by coronary angiography (CAG), including 45 patients with mild coronary artery stenosis and 37 patients with moderate to severe coronary artery stenosis. All patients underwent transcranial Doppler ultrasound and carotid artery ultrasound examination, compared the differences in clinical data and ultrasound parameters between patients with coronary heart disease and without coronary heart disease, patients with different degrees of coronary artery disease, and analyzed the influencing factors of moderate to severe coronary artery stenosis. The results showed that the levels of Hcy and hs-CRP in CHD patients were higher than those in non-CHD patients (P<0.05). The age, total cholesterol (TC), triglyceride (TG), Hcy, hs-CRP, carotid Crouse plaque score and intima-media thickness (IMT) of patients with moderate to severe stenosis were higher than those of patients with mild stenosis (P<0.05), while the mean intracranial artery velocity, end-systolic velocity (PSV) and end-diastolic velocity (EDV) were lower than those of patients with mild stenosis (P<0.05). Carotid crouse plaque score, carotid IMT, Hcy and hs-CRP were positively correlated with Gensini score (P<0.05). The Logistic regression equation showed that Hcy, hs-CRP, carotid Crouse plaque score and carotid IMT were the influencing factors of moderate to severe coronary artery stenosis in patients with coronary heart disease (P<0.05). The area under the ROC curve of Logistic regression equation for predicting moderate to severe stenosis was 0.962 (P<0.05). The intracranial and extracranial integrated cervical cerebral ultrasound features combined with Hcy and hs-CRP have a good effect on evaluating and predicting the degree of coronary atherosclerosis.

Key words: ultrasonic characteristics, homocysteine, hypersensitive C-reactive protein, coronary atherosclerosis, severity

SHEN Jian, ZHANG Haoran, WANG Feng, LIU Yanwei, LI Sha, YANG Shaoshi. Evaluation of the Severity of Coronary Atherosclerotic Lesions by Integrated Cervical Cerebral Ultrasound Combined with Hcy and hs-CRP[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2023, 41(1): 96-101.

References

[1] Hashemi J, Patel B, Chatzizisis Y S, et al. Study of coronary atherosclerosis using blood residence time[J]. Frontiers in Physiology, 2021, 12(44):e625420.
[2] Alieva R B, Bekmetova F M, Fozilov K, et al. Correlation between the left ventricular strain and the severity of coronary atherosclerosis in patients with coronary artery disease[J]. European Heart Journal-Cardiovascular Imaging, 2022, 23(Supplement_1):jeab289.022.
[3] Cao R Y, Yang J, Zheng Y T, et al. The potential value of Copeptin and Pentraxin3 for evaluating the severity of coronary stenosis in patients with coronary artery disease[J]. Clinical Biochemistry, 2021, 87(7):32-38.
[4] Alam S, Siddique U, Khan A N, et al. Presence and severity of coronary atherosclerosis in patients with zero calcium score on computed tomography coronary angiography:Relying on calcium scoring alone may miss clinically important coronary artery disease[J]. Journal of Cardiovascular Computed Tomography, 2020, 14(3):S39-S40.
[5] 马秀华. 多层螺旋CT冠脉成像与冠脉造影对冠心病的评估分析[J]. 四川生理科学杂志, 2022, 44(8):1440-1443, 1373.
[6] 蒋薇, 闵祖良, 刘杰杰, 等. 老年冠状动脉粥样硬化性心脏病患者TBIL、HCY、Hs-CRP、UA水平与冠状动脉不稳定性斑块形成风险的关系[J]. 中国急救复苏与灾害医学杂志, 2022, 17(3):304-308.
[7] 张秋焕, 辛成德, 钟白云. 同型半胱氨酸和超敏C反应蛋白与冠状动脉粥样硬化性心脏病的相关性分析[J]. 中国现代医学杂志, 2017, 27(28):66-69.
[8] 康文慧, 汤庆, 刘淑军, 等. 颈脑一体化超声检查评估脑卒中患者的临床价值分析[J]. 中国现代药物应用, 2019, 13(11):24-26.
[9] 周敏, 陈立秀, 郎朝容, 等. 三维斑点追踪技术联合颈动脉血管超声预测冠状动脉狭窄程度的价值[J]. 临床超声医学杂志, 2021, 23(12):915-919.
[10] 包萍, 陶长生, 朱晓非, 等. 急性冠脉综合征患者aVR导联ST段变化与冠状动脉Gensini评分的相关性研究[J]. 临床军医杂志, 2015, 43(9):909-912.
[11] 贾松峰, 李建玲, 龚卉. 颈部血管超声、CT血管造影诊断颈动脉狭窄病变效能比较[J]. 中国CT和MRI杂志, 2020, 18(7):36-38,143.
[12] 李洪利, 焦力群, 王亚冰, 等. 冠状动脉合并颈动脉粥样硬化性狭窄患者同期血运重建七例临床分析[J]. 中国脑血管病杂志, 2021, 18(6):405-412.
[13] 刘天宇, 邢彩云, 张桂云, 等. 颈动脉超声与经颅多普勒超声对T2DM患者颈动脉粥样硬化性病变的评估价值研究[J]. 湖南师范大学学报(医学版), 2021, 18(5):183-186.
[14] 薛红莲, 李文君, 张品元, 等. 症状性颅内动脉粥样硬化性病变患者血管内治疗适应证筛查现状及预后分析[J]. 中风与神经疾病杂志, 2020, 37(6):523-526.
[15] 孙春喜, 任小鹏, 李建成, 等. 冠心病患者hs-CRP、DPP-4水平及其与冠状动脉病变程度的相关性[J]. 海南医学, 2020, 31(11):1397-1400.
[16] 高伟杰, 黑耀宗, 王飞. 血清神经元特异性烯醇化酶同型半胱氨酸联合检测对急性脑梗死合并冠状动脉粥样硬化性心脏病患者的诊断及病情严重程度判断的临床意义[J]. 中国药物与临床, 2022, 22(1):13-16, 97.
[17] 孔令堃, 李亚玉, 曲青霞, 等. 外周动脉斑块超声评估数据联合常规临床危险因素预测冠状动脉粥样硬化[J]. 临床超声医学杂志, 2020, 22(8):566-570.
[18] 沈健, 张皓然, 王枫, 等. 颈脑一体化超声对颅-内外动脉粥样硬化狭窄性病变患者冠状动脉狭窄的预测价值[J]. 河北医学, 2021, 27(7):1166-1169.
[19] 薛娟娟. 不同病变程度冠心病患者颈动脉粥样硬化超声相关参数变化分析[J]. 中国药物与临床, 2021, 21(21):3544-3546.
[20] 王宏宇, 凌莉萍. 血脂水平与缺血性脑血管病患者颈动脉狭窄的相关性[J]. 中国卫生工程学, 2020, 19(1):71-73.
[21] 李睿, 崔新景, 陈吉彬, 等. 超声技术综合评价颈动脉粥样硬化与冠心病病变程度的相关性研究[J]. 中国循证心血管医学杂志, 2021, 13(2):166-169.