Study population and grouping principles
Our study enrolled patients, who had been clinically diagnosed with CHD
at the department of cardiology, from hospital admissions made between
June 2019 and December 2020 in our hospital. Our diagnostic criteria for
CHD was consistent with the diagnostic and therapeutic guidelines of CHD
from the European Society of Cardiology (ESC) published in
2013[9]. Among them,
sixty patients with TVD were selected as the experimental group.
Diagnostic criteria of TVD was as follows: coronary angiography showed
that the diameter stenosis rates of three subepicardial vessels (left
anterior descending coronary artery, circumflex coronary artery, right
coronary artery) and / or their main branches were all≥50%. 60 patients
with TVD were divided into two groups: 31 patients with
the stenosis rate of all triple
vessel coronary artery<75% served as group B (age,
45~77 years; mean age, 57.41±8.29 years; ratio of
females to males: 20:11), 29 patients with all three-vessel stenosis
rate≥75% served as group C (age, 44~71 years; mean age,
57.37±8.16 years; ratio of females to males: 20:9). At the same time, we
recruited 30 gender and age-matched healthy subjects (age,
41~69 years; mean age, 55.43±7.54 years; ratio of
females to males: 18:12) as group A. And all of the above participants
were in sinus rhythm.
Exclusion criteria included: 1) therapeutic history of coronary
revascularization; 2) myocardial infarction; 3) cardiac injury caused by
coronary heart disease-related complications, such as papillary muscle
rupture, ventricular wall rupture, interventricular septal perforation;
4) cardiac enlargement and cardiac dysfunction resulted by other types
of heart disease, such as dilated cardiomyopathy, congenital heart
disease, rheumatic heart disease, chronic pulmonary heart disease,
valvular disease; 5) combined with hypertension, diabetes, nephrotic
syndrome that contribute to heart damage. We also excluded the poor
quality images.
Before the examination, we recorded the basic information of all
participants on the checklist including name, gender, age, height and
weight, then calculated body mass index (BMI, kg/m²) and body surface
area(BSA,m2). After taking a 10 min break, a
physician who was blind the purpose of the study measured the blood
pressure (BP) and the heart rate (HR) of all participants. And 4 mL
venous blood samples were retrieved in fasting in the morning from three
groups of participants, and the serum was obtained by centrifuging
venous blood at 3000 r/min for 10 min and stored in the
refrigerator(-30℃). Then the content of N-terminal pro-brain natriuretic
peptide (NT-proBNP) of the serum were measure by photochemical method.
LV end-diastolic pressure (LVEDP) was measured by left cardiac
catheterization after coronary angiography in groups B and C, and the
acquisition of ultrasonic images should be carried out within two days
after left cardiac catheterization.