Correlation between Coronary Angiography and Impedance Cardiography
Aims and Objectives: The aims of the study were to find out the correlation between coronary angiographic findings and hemodynamic parameters derived from impedance cardiography (ICG) and echo-Doppler study.
Patients, Materials and Methods: A total of 200 patients of acute myocardial infarction having chest pain, ST elevation in two or more contiguous leads of electrocardiogram (ECG), biomarker positivity, echocardiographic evidence of regional wall motion abnormality (RWMA), and coronary angiographic evidence of coronary lesions were recruited. Subjects unwilling to participate, moribund, critically ill subjects, and patients with concomitant heart failure, arrhythmia, and valvular lesions were excluded from the study. GE™ Vivid 7 Dimension machine was used for ECG-gated echo-Doppler studies. The left ventricular ejection fraction (LVEF), stroke volume (SV), RWMA, diastolic function, etc., were observed. ICG measured LVEDV, LVESV, LVEF, and other parameters particularly amplitudes of the different waves. Coronary angiography (CAG) was done in the Cath Lab having “Siemens™ Axiom Artis Zee (floor)” equipment.
Results and Analysis: Results-analysis revealed there is negative correlation (Pearson’s correlation coefficient, r = −0.8) between augmentation pressure and coronary angiographic stenosis percentage and P value is also significant (P = 0.034). Pulse pressure (PP) also is positively correlated (r = −0.78) with coronary angiographic stenosis percentage and P value is also significant (P = 0.027). There is a negative correlation (r = −0.259) between augmentation index (AIx) and coronary angiographic lesions and that is statistically significant (P = 0.03).
Conclusion: There is a positive correlation between ICG -derived hemodynamic parameters and the percentage stenosis of coronary arteries. Rise of augmentation pressure and PP in the ICG waveform is associated with coronary artery disease severity. AIx is negatively correlated with severity of coronary arterial stenosis
Estimation of echocardiogram parameters with the aid of impedancecardiography and artificial neural networks. Artif Intell Med
2. Ghosh S, Chattopadhyay BP, Roy RM, Mukhopadhyay J, Mahadevappa M.
Stroke Volume, Ejection Fraction and Cardiac Health Monitoring
using Impedance Cardiography. Conf Proc IEEE Eng Med Biol Soc
3. Kubicek WG, Karnegis JN, Patterson RP, Witsoe DA, Mattson RH.
Development and evaluation of an impedance cardiac output system.
Aerosp Med 1966;37:1208-12.
4. Nyboer J, Kreider MM, Hannapel L. Electrical impedance plethysmography.
5. Weber T, Auer J, O’Rourke MF, Kvas E, Lassnig E, Berent R, et al.
Arterial stiffness, wave reflections, and the risk of coronary artery disease.
6. Marchais SJ, Guerin AP, Pannier BM, Levy BI, Safar ME, London GM.
Wave reflections and cardiac hypertrophy in chronic uremia. Influence of
body size. Hypertension 1993;22:876-83.
7. Tsioufis C, Tzioumis C, Marinakis N, Toutouzas K, Tousoulis D,
Kallikazaros I, et al. Microalbuminuria is closely related to impaired
arterial elasticity in untreated patients with essential hypertension. Nephron
Clin Pract 2003;93:c106-11.
8. Rema M, Mohan V, Deepa R, Ravikumar R, Chennai Urban Rural
Epidemiology Study-2. Association of carotid intima-media thickness
and arterial stiffness with diabetic retinopathy: The Chennai urban rural
epidemiology study (CURES-2). Diabetes Care 2004;27:1962-7.
9. Qureshi G, Brown R, Salciccioli L, Qureshi M, Rizvi S, Farhan S, et al.
Relationship between aortic atherosclerosis and non-invasive measures of
arterial stiffness. Atherosclerosis 2007;195:e190-4.
10. Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D,
et al. Differential impact of blood pressure-lowering drugs on central aortic
pressure and clinical outcomes: Principal results of the conduit artery
function evaluation (CAFE) study. Circulation 2006;113:1213-25.
11. Wilenius M, Tikkakoski AJ, Tahvanainen AM, Haring A, Koskela J,
Huhtala H, et al. Central wave reflection is associated with peripheral
arterial resistance in addition to arterial stiffness in subjects without
antihypertensive medication. BMC Cardiovasc Disord 2016;16:131.
12. Weber T, Auer J, O’rourke MF, Kvas E, Lassnig E, Lamm G, et al.
Increased arterial wave reflections predict severe cardiovascular events
in patients undergoing percutaneous coronary interventions. Eur Heart J
13. London GM, Blacher J, Pannier B, Guérin AP, Marchais SJ, Safar ME.
Arterial wave reflections and survival in end-stage renal failure.
14. Ito H, Yamakoshi KI, Togawa T. A model study of stroke volume values
calculated from impedance and their relation to the waveform of blood flow.
IEEE Trans Biomed Eng 1977;24:489-91.