A Study on Usefulness of Flow Mediated Vasodilatation of Brachial Artery in Assessing the Severity of Coronary Artery Disease and its Correlation with Coronary Angiogram

ABSTRACT

Introduction: The endothelium is a special tissue that releasesnumerous substance that moderates tone of the vascular bed,growth of cells, platelet and WBC interactions. Significantly,the evolution of atherosclerosis occurs much early in life, andendothelial dysfunction accelerates atherosclerosis and occursmuch before the development of morphological changes inthe vascular bed. Hence; the present study was undertakenfor assessing the usefulness of flow mediated vasodilatationof brachial artery in assessing the severity of coronary arterydisease and its correlation with coronary angiogram.Material and methods: A total of 75 subjects were enrolled.Group A included 18 subjects with non-critical CAD, Group Bincluded 33 subjects with SVD, Group C included 8 subjectswith DVD and Group D included 16 subjects with TVD.Complete demographic and clinical details were obtained.All patients who have been diagnosed having coronary arterydisease which includes chronic stable angina, ST elevation MI,non ST elevation MI, unstable angina within the last 1monthand have undergone CAG. Patients were subjected to symptomanalysis, clinical examination, laboratory investigations andflow mediated vasodilation studies of brachial artery. All theresults were analysed by SPSS software.Results: By conventional criteria the association between thestudy groups and smoking is considered to be not statisticallysignificant since p > 0.05. There was meaningfully realincrease in severity of CAD as duration of smoking increasesin our study subjects. By conventional criteria the associationbetween the study groups and alcoholism is considered tobe not statistically significant since p > 0.05. The diabeticstatus in non-critical CAD group is meaningfully less thanDVD group by 1.15 times with a mean difference of 8percentage points. By conventional criteria the associationbetween the study groups and brachial artery resting diameterstatus is considered to be not statistically significant sincep > 0.05. There was meaningfully real increase in severityof CAD as Increase in FMD % decreases in our studysubjects.Conclusion: Apart from assessing the traditionalcardiovascular risk factors, it is also important to assessthe endothelial function of the patient by methods likeFMD.