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ȣ - 520061 266 |
| Relationship between Noninvasive Predictors of Atherosclerosis: Endothelial Function, Carotid Artery Intima-Media Thickness, Pulse Wave Velocity and Nitroglycerin-Induced Headache in Patients with Chest Pain |
| 전남대학교병원 심장센터¹ , 전남대학교 간호대학² , 전남대학교의과대학 예방의학교실³ |
| 조숙희¹, 정명호¹ , 임상춘¹ , 최영자¹ , 박인혜² , 최진수³ , 윤현주¹ , 김계훈¹ , 홍영준¹ , 김주한¹ , 안영근¹ , 조정관¹ , 박종춘¹ , 강정채¹ , 박옥규¹ |
Background and Objectives: The aim of this study is to evaluate whether nitroglycerin (NTG)-induced headache is associated with the level of endothelial function, carotid artery intima-media thickness (IMT), pulse wave velocity (PWV) severity are related to atherosclerosis and can be assessed non-invasive methods. Methods: This study population was 120 patients (Group I: 58.9±8.6 years, 79 males) with angiographically diagnosed coronary heart disease (CAD), and 134 patients (Group II: 54.6±9.6 years, 70 males) with normal coronary arteries or minimal CAD and new onset of chest pain. The prevalence of NTG-induced headache was 0.09% (11/120) in Group I and 61.9% (83/134) in Group II. Patients were excluded if they had a history of chronic headache, long term nitrates use, and coronary artery procedures. Coronary angiography was performed within one month after nitroglycerin administration. Results: The NMD was significantly decreased in Group I than in Group II (18.3±8.5% vs. 22.2±8.0%, p=0.001). The flow-mediated dilation (FMD) was significantly decreased in Group I than in Group II (6.9±3.3% vs. 8.7±4.0%, p<0.001). Triglyceride level was increased in Group I than in Group II (115.5±61.9mg/dL vs. 96.6±57.2mg/dL, p=0.013). The heart-carotid PWV (hcPWV) was significantly increased in Group I than in Group II (930.0±154.8 cm/s vs. 769.7±163.4 cm/s, p<0.001). The heart-femoral PWV (hfPWV) was increased in Group I than in Group II (1141.7±233.4 cm/s vs. 901.8±128.3 cm/s, p<0.001). NMD was positively associated with the FMD (r=0.364, p<0.001), but the level of total cholesterol (r= -0.149, p=0.012), homocysteine (r= -0.167, p=0.012), hcPWV (r= -0.271, p=0.011), hfPWV (r= -0.347, p=0.001), common carotid IMT (r= -0.331, p=0.001) were negatively associated with FMD. In multiple regression analysis, the NTG-induced headache was independent factor of CAD [odds ratio (OR), 0.062, 95% confidence interval (CI), 0.30-0.126: p<0.001, respectively]. Conclusion: NTG-induced headache and endothelial function plays an important role in patients with chest pain. More NTG-induced headache developed in patients with normal coronary arteries or minimal CAD than in patients with obstructive CAD.
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