Dilek Şen DOKUMACI, Cansu ÖZTÜRK, Elif ERGÜN, Pınar KOŞAR

İntima-media kalınlığı, koroner kalsiyum skorlama ve koroner arter hastalığının ilişkisi

Amaç: Bu çalışmanın amacı daha önce bilinen koroner arter hastalığı (KAH) tanısı olmayan olgularda karotid arter intima-media kalınlığı ve koroner arter kalsiyum skorlamanın koroner arter BT anjiografi incelemesi ile belirlenen koroner arter hastalığının yaygınlığını ve derecesini belirlemedeki değerlerini karşılaştırmaktır. Materyal-Metod: Çalışmaya 64-dedektörlü çok kesitli bilgisayarlı tomografi (ÇKBT) anjiografisi çekilen ve koroner arter kalsiyum skorlama tetkiki yapılan 184 hasta dahil edildi. Anjiografi incelemesinin ardından 7.5 MHz lineer prob kullanılarak B-mod ultrason cihazı ile tüm hastalara karotid arter intima-media kalınlığı ölçümü yapıldı. ÇKBT anjiografi sonuçlarına göre hastalar normal, hafif KAH, orta KAH, anlamlı stenotik KAH ve şiddetli stenotik KAH olarak sınıflandırıldı. Gruplar arasındaki carotid arter intima media kalınlığı ve kalsiyum skoru düzeylerinde anlamlı fark olup olmadığı istatistiksel analiz ile incelendi. Bulgular: Kalsiyum skoru ve intima-media kalınlıkları KAH olan hastalarda önemli bir artış gösterdi. Ayrıca her ikisi de KAH öngörmede değerli bulundu. Ancak stenotik KAH'nı öngörmede intima-media kalınlığına göre kalsiyum skorunun daha belirleyici olduğu görüldü. Karotid arter intima-media kalınlığı değeri için stenotik KAH'nı öngörmede en iyi kesim noktası 0.88 olarak saptandı. Sonuç: Karotid arter intima-media kalınlığı ve kalsiyum skoru KAH'nın yaygınlığını öngörmede değerlidir ancak kalsiyum skoru intima-media kalınlığına gore KAH yaygınlığı ve şiddeti ile daha iyi korelasyon göstermektedir. Sadece kalsiyum skoru sıfır olan hastalar değerlendirildiğinde KAH olan ve KAH olmayan gruplar arasında ortalama intima-media kalınlıkları açısından anlamlı fark saptanmadı.

Anahtar Kelimeler:

Kalsiyum skorlama, intima-media kalınlığı, koroner arter hastalığı, koroner BTanjiografi

The relationship of intima-media thickness, coronary calcium score and coronary artery disease

Background: The aim of this study is to compare the values of carotid artery intima-media thickness (CIMT) and coronary artery calcium scoring (CACS) in determining extention and severity of coronary artery disease (CAD) that diagnosed via coronary CT angiography in patients without known diagnosis of CAD previously. Methods: 184 patients were included in the study. All patients were undergone CACS examination with 64- detector MDCTscanner for coronary angiography examination. Following angiography examination, CIMT was measured for all patients using B-mode ultrasound device with a 7.5 MHz linear probe. According to the results of coronary CT angiography, patients were classified as normal, mild CAD, moderate CAD, significant stenotic CAD, severely stenotic CAD. The significant difference of calcium score and CIMT levels between these groups was examined with statistical analysis. Results: Calcium score and CIMT showed significant increase in patients with CAD. They were also found valuable in predicting stenotic CAD, however CACS was found to be more decisive than CIMT for prediction of stenotic CAD. The best cut-off point for CIMTto predict stenotic CAD was 0.88mm. Conclusion: CACS and CIMT measurements are valuable in determining extention of CAD, however CACS has a better correlation with extention and severity of CAD compared with CIMT. When we evaluated the patients with zero calcium score alone, we found no significant difference in terms of the average CIMT between the group of existing CAD, and the group of non-existing CAD

Keywords:

Calcium score, intima-media thickness, coronary artery disease, coronary CTangiography,

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