L.V. Zhuravlyova, N.A. Lopina Value of carotid-femoral pulse wave velocity in prediction of atherosclerotic lesions of the coronary vessels depending on presence of type 2 diabetes mellitus

The aim – to assess carotid-femoral pulse wave velocity (cfPWV) in patients with coronary artery disease (CAD), depending on presence of type 2 diabetes mellitus (T2DM) and coronary arteries lesions, to establish its value in predicting presence and severity of coronary atherosclerosis.

Material and methods. 131 patients with CAD (89 men, 42 women), mean age of 59.60±9.11 years were examined. Depending on presence of T2DM patients with CAD were divided into 2 groups: 1st group (n=70) – patients with concomitant T2DM, 2nd group (n=61) – patients with CAD without T2DM. All patients were performed coronary angiography to verify the diagnosis of CAD. Also cfPWV was assessed in all patients. The comparison group consisted of 10 patients with T2DM without CAD. The control group consisted of 20 healthy volunteers of corresponding gender and age.

Results. The study found that patients with CAD both with and without concomitant T2DM ​​had significantly increased levels of cfPWV compared to the control group and group of comparison (Р<0.05). In patients with diffuse lesions of coronary arteries with and without T2DM, cfPWV values ​​were significantly higher than in patients without diffuse coronary artery lesions (p˂0.05). The predictive value for the presence of coronary atherosclerosis was set for the value of cfPWV more than 8.3 m/s, the sensitivity and specificity were high – 93.1 and 90 %, respectively, the area under the ROC curve (AUC) – 0.959±0.017 (95 % confidence interval: 0.914 to 0.984; P<0.0001). Prognostic significance of determining the value of cfPWV for the presence of hemodynamically significant stenosis of the coronary arteries was set for the value cfPWV more than 8.8 m/s, the sensitivity and specificity of 95.9 % and constitute 50.9 %, respectively, the area under the ROC curve (AUC) – 0.762±0.044 (95 % CI 0.685–0.827; P<0.0001). Prognostic significance of determining the value of cfPWV with predict the presence of diffuse coronary artery disease was set for the value cfPWV more than 11.4 m/s, the sensitivity and specificity of the method constitute 86.0 % and 73.3 %, respectively, the area under the ROC curve (AUC) – 0.853±0.032 (95 % confidence interval: 0.787–0.906; Р<0.0001). Conclusions. Determination cfPWV is important both for predicting the presence of the coronary atherosclerotic lesions and diagnosis of hemodynamically significant coronary artery stenosis, diffuse coronary lesions.

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