목적 : 관상동맥 경화증이 있는 환자군에서 관상동맥 경화의 정도와 비침습적 동맥 경화 지표와의 사이에 상관관계가 있는지 알아보고, 이들 지표들간의 상관관계가 있는지 알아보고자 이 연구를 시행하였다. 방법 : 관상동맥 조영술상 병변이 확인되고 비침습적 동맥경화 지표(경동맥 내중막 두께, 동맥 경직도, 내피세포 기능)를 동시에 시행한 연속적인 275명의 환자(평균 연령; 60세, 남자; 140명)를 대상으로 하였다. 관상동맥 경화의 정도는 50% 이상의 협착이 있는 주요 관상동맥 수에 따라 0, 1, 2, 3으로 분류하여 동맥 경화지표에 따른 상관관계를 비교하였다. 관상동맥의 협착이 10% 이상 50% 미만인 경우를 0으로 하였다. 경동맥 내중막 두께는 고해상도 초음파와 MATH software를 이용하여 반자동으로 측정하였고, 내피세포 기능은 상완 동맥 혈류의존 확장능(FMD, %)을 구하여 측정하였고, 동맥 경직도는 맥파속도를 대동맥, 하지 동맥, 상지 동맥에서 각각 측정하여 분석했다. 결과 : 경동맥 내중막 두께는 0군(n=125), 1군(n=75), 2군(n=38), 3군(n=21)에서 각각 0.85±0.16 mm, 0.88±0.15 mm, 0.91±0.19 mm, 0.98±0.18 mm로 관상동맥 경화의 정도에 따라 유의하게(r=0.211, p=0.001) 증가되는 경향을 보였다. 동맥 경직도와 내피세포 기능은 관상동맥 경화 정도에 따른 유의한 변화가 관찰되지 않았다. 경동맥 내중막 두께는 이들 지표들 중 대동맥의 경직도와만 서로 유의한 상관관계를 보였고(r=0.179, p=0.004), 대동맥 경직도는 하지와 상지의 동맥 경직도와 유의한 상관관계를 보였으나 다른 지표들과는 상관관계가 없었다. 내피 세포 기능과 상관관계는 이들 지표들 중에는 관찰되지 않았다. 결론 : 관상동맥 경화가 있는 환자군에서 관상동맥 경화의 정도와 상관이 있는 비침습적 지표로는 경동맥 내중막 두께였으나 독립적 인자는 아니었고, 이들 환자군에서 경동맥 내중막 두께는 대동맥 경직도와 유의한 상관관계가 관찰되었다.

Background : We performed this study to evaluate the association between the extent of coronary atherosclerosis and the noninvasive atherosclerosis surrogates such as carotid intima-media thickness (IMT), endothelial function, and arterial stiffness in patients with coronary atherosclerosis. Methods : The study population was consisted of 275 consecutive patients (mean age; 60 yrs, 140 males), who had coronary atherosclerosis by coronary angiography. The extent of coronary atherosclerosis was classified to 0 (n=125), 1 (n=75), 2 (n=38), 3 (n=21) according to the vessel number narrowed by more than 50%. Carotid IMT was semi-automatically measured using MATH software and high-resolution ultrasound. Endothelial function was measured by flow-mediated brachial artery dilation (FMD, %). Arterial stiffness was measured by obtaining pulse wave velocity in the aorta, upper and lower extremities. Results : Carotid IMT was significantly (r=0.211, p=0.001) increased according to the extent of coronary atherosclerosis (0.85±0.16 mm, 0.88±0.15 mm, 0.91±0.19 mm, 0.98±0.18 mm, respectively). However, there was no significant association between the other surrogates and the extent of coronary atherosclerosis. Carotid IMT also showed the significant association with the aortic stiffness (r=0.179, p=0.004). There was not any more significant association among the other surrogates in this study. Conclusions : The extent of coronary atherosclerosis is associated with carotid IMT but not independently, only out of several noninvasive atherosclerosis surrogates in patients with coronary atherosclerosis. And carotid IMT is also associated with the aortic stiffness in this study population.

Background : We performed this study to evaluate the association between the extent of coronary atherosclerosis and the noninvasive atherosclerosis surrogates such as carotid intima-media thickness (IMT), endothelial function, and arterial stiffness in patients with coronary atherosclerosis. Methods : The study population was consisted of 275 consecutive patients (mean age; 60 yrs, 140 males), who had coronary atherosclerosis by coronary angiography. The extent of coronary atherosclerosis was classified to 0 (n=125), 1 (n=75), 2 (n=38), 3 (n=21) according to the vessel number narrowed by more than 50%. Carotid IMT was semi-automatically measured using MATH software and high-resolution ultrasound. Endothelial function was measured by flow-mediated brachial artery dilation (FMD, %). Arterial stiffness was measured by obtaining pulse wave velocity in the aorta, upper and lower extremities. Results : Carotid IMT was significantly (r=0.211, p=0.001) increased according to the extent of coronary atherosclerosis (0.85±0.16 mm, 0.88±0.15 mm, 0.91±0.19 mm, 0.98±0.18 mm, respectively). However, there was no significant association between the other surrogates and the extent of coronary atherosclerosis. Carotid IMT also showed the significant association with the aortic stiffness (r=0.179, p=0.004). There was not any more significant association among the other surrogates in this study. Conclusions : The extent of coronary atherosclerosis is associated with carotid IMT but not independently, only out of several noninvasive atherosclerosis surrogates in patients with coronary atherosclerosis. And carotid IMT is also associated with the aortic stiffness in this study population.

Atherosclerosis, Surrogate, Coronary artery disease