Morphological but not functional changes of the carotid artery are associated with the extent of coronary artery disease in patients with preserved left ventricular function.

Abstract

The atherosclerotic process is associated with both morphological and functional changes in the carotid artery. We evaluated the relationship between these parameters of the carotid artery and the extent of coronary artery disease (CAD) in patients with preserved left ventricular function. The study population consisted of 104 stable patients with CAD who had preserved left ventricular function (left ventricular ejection fraction >or=45%). All patients underwent carotid ultrasound for evaluation of carotid artery plaque score defined by the sum of plaque thickness, maximum percent area stenosis, and carotid arterial stiffness index beta calculated by a combination of changes in carotid arterial diameter and blood pressure. Plaque score and percent area stenosis correlated with the extent of CAD defined as the number of diseased coronary vessels (P<0.001 and 0.002, respectively), but arterial stiffness beta did not (P=0.39). Using logistic regression analyses adjusting for confounding coronary risk factors and arterial stiffness beta, plaque score and percent area stenosis were independently correlated with multivessel CAD (P=0.001 and 0.004, respectively). Carotid artery plaque burden, but not arterial stiffness, is associated with the extent of CAD, suggesting morphological rather than functional changes in the carotid artery may be a more accurate predictor of the extent of CAD and multivessel CAD independent of left ventricular function.