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ȣ - 520062 70 |
| Increased Carotid Artery Intima-Media Thickness, Pulse Wave Velocity and Decreased Endothelial Function Are Associated with Variant Angina |
| 전남대학교병원 심장센터¹ , 전남대학교 간호대학² , 전남대학교 의과대학 예방의학교실³ |
| 조숙희¹, 정명호¹ , 임상춘¹ , 이숙자¹ , 최영자¹ , 박인혜² , 최진수³ , 윤현주¹ , 김계훈¹ , 홍영준¹ , 박형욱¹ , 김주한¹ , 안영근¹ , 조정관¹ , 박종춘¹ , 강정채¹ , 박옥규¹ |
Background: Endothelial dysfunction and vascular inflammation may be associated with variant angina (VA). Carotid artery IMT, Pulse wave velocity (PWV) and flow-mediated vasodilation (FMD) are widely used as noninvasive modalities for evaluating atherosclerosis. However, it is not known whether carotid IMT, PWV are related to FMD in patients with VA. Therefore, the present study was designed to investigate the difference in carotid IMT, PWV and endothelial function in patients with VA. FMD, IMT, PWV, and inflammatory markers were measured in the morning before CAG with ergonovine provocation test. Methods and Results: A total of 254 patients with chest pain were divided into three groups according to coronary angiogram (CAG) finding with or without ergonovine provocation test. The 58 patients (Control group: 56.1±8.7years, 30 males) with normal CAG with negative ergonovine provocation test, 76 patients (VA group: 53.5±10.2years, 41 males) with normal CAG with positive ergonovine provocation test, and 120 patients with angiographically diagnosed coronary heart disease (CAD group: 58.9±8.6years, 79 males). Carotid IMT was significantly increased in VA group than in control group (0.57±0.1mm vs. 0.54±0.1mm, p<0.001). The right brachial-ankle PWV (baPWV) was significantly increased in VA group than in control group (1446.2± 256.7 cm/s vs. 1431.3±.176.0 cm/s, p = 0.049). The left brachia-ankle PWV (baPWV) was significantly increased in VA group than in control group (1440.3± 214.8 cm/s vs. 1362.7 ± 404.5 cm/s, p = 0.002). The level of FMD was significantly decreased in VA group than in control group (8.2±.1% vs. 9.4±3.8%, p=0.001). The levels of white blood cell count and monocyte counts were higher in VA group than control group (7515.8±2611.1/㎣ vs. 6548.2±2156.4/㎣, p=0.015; 657.2±261.1/㎣ vs. 442.5±219.3/㎣, p=0.025, respectively). Conclusion: VA is associated with increased carotid IMT, baPWV, inflammatory markers, and decreased endothelial function. Therefore, vascular events which might have clinical implications for the assessment and management of cardiovascular risks in VA patients.
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