Morphologic rather than functional or mechanical sonographic parameters of the brachial artery are related to angiographically evident coronary atherosclerosis

• Published in: Journal of the American College of Cardiology Vol. 40; no. 10; pp. 1825 - 1830
• Main Authors: Frick, Matthias, Schwarzacher, Severin P, Alber, Hannes F, Rinner, Alexander, Ulmer, Hanno, Pachinger, Otmar, Weidinger, Franz
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 20-11-2002; Elsevier Science; Elsevier Limited
• Subjects: Adult; Age; Aged; Atherosclerosis; Biological and medical sciences; Blood pressure; Body mass index; Brachial Artery - diagnostic imaging; Brachial Artery - pathology; Cardiology; Cardiovascular disease; Cardiovascular system; Cholesterol; Confidence intervals; Coronary Angiography; Coronary Artery Disease - diagnosis; Coronary Artery Disease - epidemiology; Coronary Artery Disease - pathology; Coronary vessels; Diabetes; Family medical history; Hard disks; Humans; Hypertension; Investigative techniques, diagnostic techniques (general aspects); Low density lipoprotein; Male; Mechanical properties; Medical imaging; Medical sciences; Middle Aged; Patients; Regression Analysis; Risk Factors; Statistics as Topic; Studies; Triglycerides; Tunica Intima - diagnostic imaging; Tunica Intima - pathology; Ultrasonic investigative techniques; Ultrasonography, Interventional; Vasodilation - physiology; CD; IMT; WCSA; NMD; LDL; CAD; Einc; FMD; BP; BA; Sonography; Human; Regional blood flow; High resolution; Coronary artery; Brachial artery; Cardiovascular disease; Exploration; Coronary heart disease; Vascular disease; Thickness; Morphological analysis; Atherosclerosis; Diagnosis; Hemodynamics; Vascular wall
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/S0735-1097(02)02480-4

The purpose of this study was to determine the relationship among coronary atherosclerosis and functional, morphologic, and mechanical parameters assessed noninvasively within the brachial artery (BA).
Flow-mediated vasodilation (FMD) of the BA, intima-media thickness (IMT) of the carotid artery, and distensibility of the aorta have been correlated with the presence of coronary artery disease (CAD).
The BA was examined with high-resolution ultrasound (13 MHz) in 117 male patients, in whom coronary angiography was performed. Coronary artery disease (≥30% diameter stenosis in ≥1 major branch) was found in 84 patients, and 33 patients had smooth coronary arteries (non-CAD). Wall cross-sectional area (WCSA) was calculated from resting diameter and IMT.
The BA-WCSA (5.3 ± 1.5 mm2vs. 4.4 ± 1.4 mm2, p = 0.002) and IMT (0.37 ± 0.07 mm vs. 0.31 ± 0.07 mm, p < 0.001) were significantly greater in patients with CAD compared with non-CAD patients. Flow-mediated vasodilation and distensibility were similar among groups. Using logistic regression analyses adjusting for age, positive family history, hypertension, hypercholesterolemia, smoking, FMD, and distensibility, only WCSA (p < 0.01) and IMT (p < 0.001) correlated independently with the presence of CAD.
Morphologic but not functional and mechanical parameters of the BA are associated with the presence of CAD. Among BA sonographic parameters, IMT and WCSA seem to be the most accurate ones for the estimation of coronary atherosclerotic risk.