관상동맥 질환 환자에서 경동맥 초음파의 유용성
Carotid ultrasonography in patients with coronary artery disease
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목적 : 경동맥 초음파로 측정한 내중막 두께 및 경화반의 유무와 관상동맥 질환 여부와의 관련성에 관한 보고가 있었으나, 이들과 관상동맥 질환의 중증도와의 관련성에 관한 연구는 적었다. 저자들은 이들 지표들과 관상동맥 질환의 중증도의 관련성을 검토하여 관상동맥 질환 환자에서 경동맥 초음파의 유용성을 평가하였다. 방법 : 2005년 11월부터 2006년 11월까지 관상동맥조영검사와 경동맥 초음파를 시행한 환자를 대상으로 하였고, 관상동맥 질환의 중증도는 50% 이상의 협착이 있는 관상동맥의 수에 따라 1군, 2군, 3군으로, 그리고 정상인 경우를 대조군(0군)으로 분류하여, 경동맥 초음파상 좌우 총경동맥 내중막 두께의 평균치, 최대치 및 동맥 경화반 유무를 비교하였다. 결과 : 총 환자수는 90명이었고, 3군으로 갈수록 남자가 많았다(p=0.001). 총경동맥 내중막 두께의 평균치는 3군으로 갈수록 유의한 증가를 보였다(0군, 0.67±0.11 mm; 1군, 0.66±0.13 mm; 2군, 0.68±0.08 mm; 3군, 0.78±0.10 mm, p=0.001). 내중막 두께의 최대치도 유사한 결과를 나타내었다(0군, 0.88±0.16 mm; 1군, 0.85±0.20 mm; 2군, 0.89±0.13 mm; 3군, 1.06±0.17 mm, p=0.000). 경화반의 빈도도 3군으로 갈수록 유의한 증가를 보였다(p=0.004). 결론 : 경동맥 내중막 두께 및 경화반의 유무 등 경동맥 초음파 지표들과 관상동맥 질환의 중증도의 관련성을 평가한 결과 관상동맥 질환이 심할수록 경동맥 내중막 두께가 증가하고, 동맥 경화반의 빈도도 증가되었다. 경동맥 초음파는 관상동맥 질환을 가진 환자에서 관상동맥 질환의 중증도를 평가하는데 유용하게 사용될 것으로 사료된다.
Abstract
Background : Carotid intima-media thickness (IMT) or the presence of carotid plaque has been reported to be related to coronary artery disease (CAD). We evaluated the relationship of the parameters of carotid ultrasonography (US) with the severity of the CAD. Methods : From November, 2005 to November, 2006, the patients who underwent both coronary angiography and carotid US were enrolled in our study. The severity of CAD was defined by the number of diseased major coronary arteries with a percent diameter stenosis over 50. Four groups including Group 0, which has normal coronary arteries, were compared. The average and maximal IMT and the presence of plaque were used as the parameters of carotid US. Results : The total number of patients was 90. Men had a greater severity of CAD (p=0.001). The average carotid IMTs were increased with the severity of CAD (Group 0, 0.67±0.11 mm; Group 1, 0.66±0.13 mm; Group 2, 0.68±0.08 mm; Group 3, 0.78±0.10 mm; p=0.001). The maximal carotid IMTs were also increased (Group 0, 0.88±0.16 mm; Group 1, 0.85±0.20 mm; Group 2, 0.89±0.13 mm; Group 3, 1.06±0.17 mm; p=0.000). Carotid plaques were also more frequently present with the increased severity of CAD (p=0.004). Conclusions : Increased carotid IMT and the presence of carotid plaque were related to the severity of CAD. Carotid ultrasonography is useful for evaluating the severity of CAD.(Korean J Med 73:11-17, 2007)
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