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ȣ - 530077 126 |
| Effect of Fat Distribution on Endothelial Function And Carotid Artery Intima-Media Thickness in Patients with Chest Pain |
| 전남대학교병원 심장센터, 간호부, 보건복지부 심장질환 특성화 연구센터 |
| 조숙희, 정명호, 이지선, 김혜숙, 임상춘, 심재연, 채임순, 최영자, 윤현주, 김계훈, 홍영준, 박형욱, 김주한, 안영근, 조정관, 박종춘, 강정채 |
Background and Objectives: The aim of this study is to evaluate whether morphometric assessment [body mass index (BMI), waist circumference (WC)] is associated with the level of endothelial function in patients with chest pain. Methods: This study population was 99 patients (Group I: 59.2±9.1years, 68 males) with angiographically diagnosed coronary heart disease (CAD), and 113 patients (Group II: 54.1±9.1years, 63 males) with normal coronary arteries or minimal CAD and new onset of chest pain. All patients underwent assessment of conduit artery endothelial-dependent vasodilation by using flow-mediated vasodilation (FMD) of the brachial artery, carotid artery intima-media thickness (IMT), pulse wave velocity (PWV). They had blood taken for measurement of plasma marker of glucose homeostasis (Hb A1c), homocysteine, high sensitivity C-reactive protein and lipids. BMI, WC, systolic and diastolic arterial pressure were also measured. Results: The AC was significantly increased in Group I than in Group II (89.8±7.6cm vs. 86.7±10.0cm, p=0.020). The level of FMD was significantly decreased in Group I than in Group II (6.9±3.5% vs. 8.4±4.0%, p=0.002). The heart-carotid PWV (hcPWV) was significantly increased in Group I than in Group II (903.4±205.6cm/s vs. 797.8±171.1cm/s, p=0.008). The heart-femoral PWV (hfPWV) was significantly increased in Group I than in Group II (1107.7±233.8 cm/s vs. 917.4±192.3 cm/s, p<0.001). The brachial-ankle PWV (baPWV) was significantly increased in Group I than in Group II (1667.9±268.8 cm/s vs. 1464.5±179.2 cm/s, p<0.001). The carotid IMT was significantly increased in Group I than in Group II (0.70±0.2 mm vs. 0.57±1.5 mm, p=0.002). The level of AC (r= -0.257, p=0.003), age (r= -0.151, p=0.037), homocysteine (r= -0.167, p=0.012), HgbA1c (r= -0.176, p=0.020), hcPWV (r= -0.285, p=0.006), hfPWV (r= -0.352, p=0.001), carotid IMT(r= -0.284, p=0.004) were negatively associated with FMD. A stepwise multiple regression analysis showed that AC and carotid IMT predicted the decrease of FMD (Adjusted R2=0.309, p<0.001). Conclusion: We have shown that WC and carotid artery IMT are important markers of endothelial dysfunction in patients with chest pain.
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