ROLE OF GRAY-SCALE AND DOPPLER ULTRASOUND OF CAROTID ARTERY IN RISK STRATIFICATION OF STABLE ISCHEMIC HEART DISEASE AND ITS CORRELATION WITH CORONARY ANGIOGRAPHY

Abstract

Background: Ischemic heart disease (IHD) is a major cause of mortality and morbidity all over the world. The burden of IHD in India can be explained by the alarming rise in the prevalence of coronary risk factors like diabetes, hypertension, atherogenic dyslipidemia, smoking, central obesity and physical inactivity. For more than a decade various sonographic techniques have been used for the assessment arterial of carotid disease. Aim: to establish the role of Gray Scale USG and carotid artery Doppler study as a leading investigation in general population presenting with Stable Ischemic Heart Disease and to evaluate the frequency and degree of carotid artery stenosis in these patients & also assess the morphology of atherosclerotic plaque and IMT;to nd association between carotid artery stenosis and risk factors such as hypertension, diabetes, ,deranged lipid prole ,smoking and age. Materials and methods: 50 patients were included in a prospective cross sectional study.Patients below 12 years of age were not included.Forty two were male(84%) and rest were female(16%);all were admitted in cardiology ward and OPD already having undergone coronary angiography.They were evaluated by gray scale as well as doppler ultrasound of both carotid arteries and the results were corroborated with angiography ndings. For statistical analysis data were entered into a Microsoft excel spreadsheet and then analyzed by SPSS (version 24.0; SPSS Inc., Chicago, IL, USA) and Graph Pad Prism version 5. Correlation was calculated by Pearson correlation analysis Results: In our study out of 50 patients with IHD 33 patients had atheromatous plaque. Abnormal carotid intima – media thickness (IMT) was found in 40 (80%) of the study population. Multiple risk factors were present in our study group where most common risk factor was hypertension (78%) ,smoking (74%) and followed by Dyslipidaemia (72%) and Diabetes (70%). Other risk factors (66%) were present in signicant number of cases. From our study we can conclude that raised PSV across the carotid lesion will predict severe nature of coronary artery disease. Conclusions: It has been found that multiple risk factors are associated with increased risk of ischemic heart disease. Further studies can be done in persons with multiple risk factors to assess Carotid Intima media thickness as a screening tool to reduce risk of ischemic heartdisease. .Highresolution B-mode real-time sonography with Continuous-wave Doppler and single-gate pulsed wave sono Doppler graphy easily evaluates the frequency and degree of carotid artery stenosis in these patients and also assess the morphology of atherosclerotic plaque and intima-medial thickness which are clearly related to pathogenesis and aid in planning of management.