Correlation of Brachial Cuff Oscillometric Device Based Central Haemodynamic Indices with Syntax Score in Patients with Coronary Artery Disease

• Main Authors: Srihari Barama, Krishna Malakonda Reddy Parvathareddy, Ravi Srinivas, Praveen Nagula
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2019-11-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: augmentation index; central blood pressure; pulse pressure amplification; total peripheral resistance
• Online Access: https://jcdr.net/articles/PDF/13279/42670_PD_V1_(SL)_CE[Ra1]_F(KM)_PF1(AG_SHU)_PFA(KM)_PB(AG_KM)_PN(SL).pdf

Introduction: Early recognition of atherosclerosis is important, considering the epidemic proportion of Cardiovascular Disease (CVD) across the world. Non invasive methods of estimation of central blood pressure and other parameters help in early recognition of atherosclerosis. Aim: To measure the Central Haemodynamic Indices (CHIs) by a non-invasive brachial cuff based oscillometric methodCentral Blood Pressure (CBP), Central Pulse Pressure (CPP), Pulse Pressure Amplification (PPA), Augmentation Index (AIx), Augmentation index @ 75, Reflection coefficient, Pulse Wave Velocity (PWV), Total Peripheral Resistance (TPR). To evaluate the Angiographic severity of patients by Syntax Score (SS) and correlate with the CHIs. Materials and Methods: The present study was a hospital based observational study. A total of 120 patients presenting with symptoms suggestive of Coronary Artery Disease (CAD) with age >18 years and those willing to undergo conventional coronary angiography were included. Patients with cardiogenic shock, Chronic kidney disease (eGFR <30 mL/min), malignancy, hepatic dysfunction, pregnancy, and contraindications to angiography were excluded. All the patients underwent coronary angiography and the SS was calculated. Patients were grouped into low, intermediate and high SS based on the scores. The CHIs obtained were then compared among the groups of low, intermediate and high SS to identify the parameters which correlate with severity of CAD. Pearson correlation coefficient (r) for the correlation of the CHIs with SS and the Receiver Operating Characteristic (ROC) curve analysis with Area Under Curve (AUC) was done for the cut-off values to predict significant CAD. Results: Males were predominant than females with ratio of 4:1. Most patients, 54 (45%) were between 51 and 60 years. Most of the patients were having dyslipidemia 70 (58.33%), followed by hypertension 58 (48.33%). High SS patients were found to be having diabetes (26 vs. 2 vs. 10), dyslipidemia (45 vs. 17 vs. 8), and increased BMI (27.16±2.55 vs. 22.65±2.12 vs. 21.80±1.73, p=0.001) compared with intermediate and low SS patients respectively. There was no significant difference between males and females, when the various CHIs measured by the oscillometric device were compared but were statistically significant when compared among the groups according to SS. The cut-off points for AP, AI, PWV in predicting the patients with CAD (SS >23) according to ROC curves are 9.5 mmHg, 23.7, 9.35 m/sec respectively. Conclusion: CHIs assessed noninvasively have a significant role in the clinical evaluation and an incremental value in the risk stratification of the CAD patients.