Impact of Left Ventricular Ejection Fraction on Endothelial Function and Carotid Intima-Media Thickness in Patients with Coronary Artery Disease

Background and Objectives：The endothelial function and carotid arteries intima-media thickness (IMT) are abnormal in patients with coronary artery disease (CAD).We performed this study to evaluate the impact of the ejection fraction on the endothelial function and carotid IMT in patients with CAD. Subjects and Methods：The study population consisted of 283 patients who had undergone coronary angiography (mean age; 59 years, 176 males).The endothelial function and the carotid IMT were assessed by measuring the flow-mediated vasodilation (FMD) of the brachial artery and semi-automatically using high-resolution ultrasound, respectively.Results： Patients (n=236) with an ejection fraction (EF) (55% on routine echocardiogram were younger (mean age; 58 vs. 62 years), showed a lower prevalence of diabetes (15 vs. 38%) and myocardial infarction (13 vs. 66%), a higher FMD (4.8±2.4 vs. 4.0±2.0%,p<0.05) and a lower carotid IMT (0.85±0.15 vs. 0.91±0.17mm, p<0.05) than patients (n=47) with an EF <55%.The correlation coefficients between the EF and FMD, and the EF and the carotid IMT were 0.149 (p<0.02) and -0.156 (p<0.02),respectively, in the entire study population.However, there was no significant correlation between the FMD and carotid IMT in the study patients.A multivariate analysis showed the EF still to be an independent factor of the FMD, but not of the carotid IMT.Conclusion：The EF was the only significant independent factor of the endothelial function, although it was associated with the FMD and carotid IMT in patients with CAD.These results support the view that the endothelial function is an important prognostic factor in patients with CAD.(Korean Circulation J 2005;35:375-381) KEY WORDS：Endothelium；Carotid arteries；Left ventricle；Coronary disease；Vasodilation. 서 론내피세포 기능이상과 경동맥 내중막