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Carotid Sinus Hypersensitivity in Patients Undergoing Coronary Arteriography:
Author(s) -
KALLIKAZAROS IOANNIS,
STRATOS COSTAS,
TSIOUFIS COSTAS,
STEFANADIS CHRISTODOULOS,
SIDERIS ASIMAKIS,
SIDERIS SKEVOS,
TOUTOUZAS PAVLOS
Publication year - 1997
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.1997.tb01011.x
Subject(s) - medicine , cardiology , stenosis , coronary artery disease , carotid artery disease , incidence (geometry) , carotid endarterectomy , physics , optics
Carotid Sinus Hypersensitivity and Atherosclerosis. Introduction: The purpose of the present investigation was to study the precise relationship between carotid sinus hypersensitivity (CSH) and both the severity of carotid atherosclerosis and the extent of coronary artery disease in patients who were referred for evaluation for suspected ischemic heart disease. Methods and Results: Duplex echocardiography and coronary angiography were used to assess carotid and coronary artery atherosclerosis in 130 consecutive patients. Carotid sinus stimulation was performed before coronary arteriography with simultaneous recordings of the ECG and aortic pressure. Coronary artery disease was present in 103 patients (79%). Thirty patients (23.08%) had one‐vessel disease (1‐VD), 31 (23.85%) had 2‐VD, 29 (22.31%) had 3‐VD, and 13 patients (10%) had left main coronary artery disease. Carotid artery atherosclerosis was present in 100 patients (76.92%) and carotid disease (diameter stenosis ≥ 50%) was present in 24 patients (18.46%). CSH was found in 33 patients (25%). The incidence of CSH was 9% in patients with carotid stenosis 1%‐15%, 17% in patients with stenosis 16%‐49%, 85% in patients with stenosis 50%‐79%, and 100% in patients with stenosis ≥ 80%. The incidence of CSH was 11%, 17%, 23%, 34%, and 62% in patients with no VD, 1‐VD, 2‐VD, 3‐VD, and left main coronary artery disease, respectively. Stepwise multiple logistic regression analysis revealed that carotid disease and left main coronary artery disease were the most significant determinants of CSH (P < 0.001 and P = 0.013, respectively). Conclusion: The incidence of CSH increased in proportion to the severity of carotid and coronary atherosclerosis. These data provide evidence that CSH is closely related to severe carotid atherosclerosis or left main coronary artery disease in patients being evaluated for suspected ischemic heart disease.