Key result
Maximum carotid wall elastic modulus measured using shear wave elastography independently identified obstructive coronary artery disease (AUC 0.70; P = 0.003) in patients without carotid plaque.
Why the study?
Whether carotid wall elastic modulus measured by shear wave elastography can predict obstructive CAD is not well known.
Does carotid wall elastic modulus measured using shear wave elastography identify obstructive coronary artery disease in patients without carotid plaque?
Cross-Sectional (n=61)
Does carotid wall elastic modulus measured using shear wave elastography identify obstructive coronary artery disease in patients without carotid plaque?
Answers are grounded in this paper and cite their sources.
Carotid wall elastic modulus measured by shear wave elastography provides independent and incremental value over clinical risk factors and other imaging markers for identifying obstructive CAD in patients without carotid plaque.
BACKGROUND: Shear wave elastography (SWE) directly quantifies the local arterial wall stiffness by calculating the elastic modulus. However, whether carotid wall elastic modulus can predict obstructive coronary artery disease (CAD) is not well known. We aimed to investigate the value of carotid wall elastic modulus measured using SWE in identifying obstructive CAD. MATERIALS AND METHODS: We prospectively enrolled 61 patients without carotid plaque referred for clinically indicated coronary angiography. Twenty-seven (44.3%) patients were diagnosed with obstructive CAD (≥50% coronary stenosis). The elastic modulus of common carotid artery was quantified using SWE. Ankle--brachial index (ABI) and echocardiographic global cardiac calcium score (GCCS) were measured. RESULTS: Patients with obstructive CAD had significantly higher elastic modulus than those without obstructive CAD. The maximum elastic modulus (EMmax) was independently associated with obstructive CAD after adjusting for the Framingham risk score, ABI, and GCCS. EMmax had the highest area under the curve (AUC) to identify obstructive CAD (AUC 0.70; P = 0.003). In the nested models, the model based on the Framingham risk score and ABI (χ2 = 3.74) improved by adding GCCS (χ2 = 9.95) and further improved by adding EMmax (χ2 = 15.86). Adding EMmax to the combined ABI and GCCS model increased integrated discrimination index from 0.10 to 0.19. CONCLUSION: Carotid wall elastic modulus measured using SWE is a useful predictor of obstructive CAD in patients without carotid plaque. We demonstrated the incremental and independent value of carotid wall elastic modulus in identifying obstructive CAD compared with clinical risk factors and other imaging predictors, including ABI and GCCS. VIDEO ABSTRACT: Please see the video, in Supplemental Digital Content 1, http://links.lww.com/HJH/B551 for more insights from the authors.
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Wang et al. (2020) conducted a cross-sectional in Suspected coronary artery disease (n=61). Maximum carotid wall elastic modulus (EMmax) using shear wave elastography vs. Clinical risk factors, ABI, and GCCS was evaluated on Obstructive coronary artery disease (≥50% coronary stenosis) (AUC 0.70, p=0.003). Maximum carotid wall elastic modulus measured using shear wave elastography independently identified obstructive coronary artery disease (AUC 0.70; P = 0.003) in patients without carotid plaque.
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