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CLINICAL STUDY: CARIOVASCULAR ULTRASOUND STUDIES

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

Matthias Frick, MD^*, Severin P. Schwarzacher, MD, FACC^*, Hannes F. Alber, MD^*, Alexander Rinner, MD^*, Hanno Ulmer, PhD, Otmar Pachinger, MD^* and Franz Weidinger, MD^*,*

^* Division of Cardiology, Department of Medicine, University of Innsbruck, Innsbruck, Austria
Institute for Biostatistics, University of Innsbruck, Innsbruck, Austria

Manuscript received March 20, 2002; revised manuscript received June 7, 2002, accepted July 11, 2002.

^* Reprint requests and correspondence: Dr. Franz Weidinger, Cardiology Division, Department of Medicine, University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
F.Weidinger{at}uibk.ac.at

OBJECTIVES: 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).

BACKGROUND: 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).

METHODS: 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.

RESULTS: The BA-WCSA (5.3 ± 1.5 mm² vs. 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.

CONCLUSIONS: 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.

Abbreviations and Acronyms   BA   brachial artery   BP   blood pressure   CAD   coronary artery disease   CD   cross-sectional distensibility   Einc   incremental elastic modulus   FMD   flow-mediated vasodilation   IMT   intima-media thickness   LDL   low-density lipoprotein   NMD   nitroglycerin-mediated vasodilation   WCSA   wall cross-sectional area

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