Usability of Achilles tendon strain elastography for the diagnosis of coronary artery disease

• Published in: Journal of medical ultrasonics (2001) Vol. 46; no. 3; pp. 343 - 351
• Main Authors: Koc, Ayse Selcan, Pekoz, Burcak Cakir, Donmez, Yurdaer, Yasar, Simge, Ardic, Mustafa, Gorgulu, Feride Fatma, Icen, Yahya Kemal, Sumbul, Hilmi Erdem, Koc, Mevlut
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01-07-2019; Springer; Springer Nature B.V
• Subjects: Angiography; Body fat; Cardiac patients; Cardiovascular disease; Cholesterol; Coronary artery disease; Coronary heart disease; Coronary vessels; Creatinine; Diabetes; Diabetes mellitus; Diagnosis; Glucose; Hyperlipidemia; Imaging; Injuries; Laboratories; Laboratory tests; Medical imaging; Medicine; Medicine & Public Health; Original Article; Patients; Radiology; Regression analysis; Risk factors; Statistical analysis; Tendons; Ultrasonic imaging; Ultrasound; Ultrasound imaging; Vein & artery diseases; United States > US; Achilles tendon thickness; Achilles tendon strain ratio; Coronary artery disease; Strain elastography
• ISSN: 1346-4523; 1613-2254
• DOI: 10.1007/s10396-019-00931-9

Purpose
There are close relationships between major coronary artery disease (CAD) risk factors and Achilles tendon thickness (AT-T) and AT strain ratio (AT-SR). Our aim was to evaluate the diagnostic importance of AT-T and AT-SR as obtained by ultrasonography (USG) and strain elastography (SE) for predicting CAD.
Materials and methods
One hundred and eighty-four patients scheduled to undergo coronary angiography were included in the study. Achilles tendon USG (B-mode and SE) and laboratory tests were performed on all patients. The patients were divided into two groups, i.e., patients with and without CAD.
Results
The patients with CAD (72.8%) were more likely to be male, exhibited higher frequencies of diabetes mellitus (DM) and hyperlipidemia, exhibited higher levels of basal creatinine and glucose, and had higher AT-T and AT-SR values (
p
 < 0.05 for all). Age, DM, AT-T, and AT-SR independently predicted the probability of CAD in a logistic regression analysis (
p
 < 0.05 for all). Age (each year), DM (presence), AT-T (each 1 mm), and AT-SR (each 0.1) increased the CAD risk by 3.4%, 2.9 times, 47.1%, and 16.0%, respectively. ROC analysis revealed AUCs of 0.665 and 0.730 for the AT-T and AT-SR values, respectively (
p
 < 0.05). The AT-SR cutoff value of 1.2 predicted the presence of CAD with 75.4% sensitivity and 72.7% specificity.
Conclusions
AT-SR is a simple, inexpensive, noninvasive, reproducible, and objective parameter for the prediction of CAD. We think that AT-SR evaluation should become a part of conventional USG assessments in patients who are at a high risk of CAD.