Heart 1998;80:349-354 ( October )

Comparison of peripheral endothelial dysfunction and intimal media thickness in patients with suspected coronary artery disease

M-D Enderle,^a S Schroeder,^b R Ossen,^a C Meisner,^c A Baumbach,^b H U Haering,^a K R Karsch,^b M Pfohl^a

^a Department of Endocrinology, University of Tübingen, Tübingen, Germany, ^b Department of Cardiology, University of Tübingen, ^c Institute for Medical Information Processing, University of Tübingen

Correspondence to: Dr Markus-D Enderle, Eberhard-Karls-Universität Tübingen, Medizinische Klinik und Poliklinik, Abt Innere Medizin IV, Otfried-Müller-Str 10, D-72076 Tübingen, Germany.

Accepted for publication 26 June 1998

ObjectiveFlow associated dilatation (FAD%) and intimal media thickness are established markers of early atherosclerosis. This study aimed to compare the ability of the non-invasive measurements FAD% and intimal media thickness to predict coronary artery disease.
MethodsFAD% and intimal media thickness were determined using high resolution ultrasound in 122 patients with clinically suspected coronary artery disease before coronary angiography. Results are given as mean (SD).
ResultsPatients with coronary artery disease had reduced FAD% compared with those with angiographically normal coronary vessels (3.7 (4.1) v 7.0 (3.5)%, p < 0.001), whereas intimal media thickness tended to be increased in patients with coronary artery disease (0.58 (0.35) v 0.47 (0.11)mm, p = 0.054). There was a negative correlation between FAD% and intimal media thickness (R = 0.317, p = 0.0004). Receiver operating characteristic analysis showed that FAD%  4.5% predicted coronary artery disease with a sensitivity of 0.71 (95% confidence interval 0.61 to 0.80) and a specificity of 0.81 (0.58 to 0.95). In contrast, intimal media thickness showed a positive correlation with the extent of coronary artery disease (number of vessels with a lesion  50%) (R = 0.324, p = 0.0003), without a clear cut off point.
ConclusionsIn patients with clinically suspected coronary artery disease, FAD% discriminates between the presence or absence of coronary artery disease, whereas intimal media thickness is associated more with the extent of coronary artery disease.

Keywords: coronary artery disease;  endothelial dysfunction;  intimal media thickness;  flow associated dilatation

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© 1998 by Heart
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