Clinical value of ultrasound in evaluating carotid stenosis and left heart function in elderly patients with coronary heart disease combined with hypertension
Objective To evaluate the carotid stenosis and left heart function in elderly patients with coronary heart disease(CHD)combined with hypertension(EH)by carotid ultrasound and three-dimensional speckle tracking echocardiography(3D-STE),and to explore their clinical application value.Methods A total of 60 elderly patients with CHD combined with EH and 60 patients with single CHD in our hospital were enrolled as combination group and CHD group,respectively.The intima-media thickness(IMT)of common carotid artery,stenosis degree and carotid plaques(Crouse)score were obtained by carotid ultrasound.The left atrial minimal and maximal volume(LAVmin,LAVmax),left atrial pre-systolic volume index(LAVIp),left atrial minimal and maximal volume index(LAVImin,LAVImax),left atrial active ejection fraction(LAAEF),left atrial total ejection fraction(LATEF),left ventricular ejection fraction(LVEF),global area strain(GAS),global circumferential strain(GCS),global radial strain(GRS),global longitudinal strain(GLS),left atrial peak atrial longitudinal strain(PALS)and left atrial peak atrial contraction strain(PACS)were obtained by 3D-STE,the differences of the above parameters between the two groups were compared.The correlation between carotid ultrasound parameters and 3D-STE parameters was analyzed.The independent influencing factors for predicting carotid stenosis and left ventricular function changes in elderly patients with CHD combined with EH were screened by multivariate Logistic regression analysis.Results There were significant differences in IMT of common carotid artery,stenosis degree and Crouse score between combination group and CHD group(all P<0.001).LAVmin,LAVmax,LAVIp,LAVImin,LAVImax and LAAEF in combination group were higher than those in CHD group,while LATEF,LVEF,GAS,GCS,GRS,GLS,PALS and PACS were lower than those in CHD group(all P<0.001).Correlation analysis showed that IMT of common carotid artery,stenosis degree and Crouse score were positively correlated with LAVmin,LAVmax,LAVIp,LAVImin,LAVImax,LAAEF,LATEF and LVEF(all P<0.05),while negatively correlated with GAS,GCS,GRS,GLS,PALS and PACS(all P<0.05).Multivariate Logistic regression analysis showed that IMT of common carotid artery,stenosis degree,Crouse score were independent influencing factors for predicting carotid stenosis in elderly patients with CHD combined with EH(all P<0.05),and LAAEF,GAS,PALS,PACS were independent influencing factors for predicting left heart function changes(all P<0.05).Conclusion Carotid ultrasound and 3D-STE can evaluate carotid stenosis and left heart function changes in elderly patients with CHD and EH,which has a certain clinical value.
Echocardiography,three-dimensionalUltrasonography,carotidCoronary heart diseaseHypertensionCarotid stenosisLeft heart function
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