Changes in the subendocardial viability ratio in patients with atherosclerotic coronary heart disease

Abstract Background The subendocardial viability ratio (SEVR) is a pulse wave analysis parameter that reflects coronary perfusion noninvasively. Coronary angiography is the gold-standard modality for assessing the involvement of the coronary artery in patients with atherosclerotic coronary heart disease (CHD). Changes in SEVR in patients with CHD have not been elucidated. Therefore, the aim of the present study was to analyze changes in SEVR in patients with atherosclerotic CHD. Methods We enrolled 243 patients with atherosclerotic CHD who had visited our hospital from July 1, 2021, to January 30, 2022. Inclusion criteria were: clinical diagnosis of atherosclerotic CHD and availability of the SYNTAX score derived by coronary angiography. The patients were further divided into the control (n = 100), low stenosis (n = 107), and high stenosis (n = 36) groups, with SYNTAX scores of 0, ≤ 22, and > 22, respectively. Pressure waveforms were obtained with a high-fidelity tonometer within the outspread supply route for SEVR calculation before coronary angiography. SEVR was measured and compared among the three groups. Results Atherosclerosis-related data, including the ankle–brachial index (ABI), pulse pressure, heart rate (75 beats/min)-corrected aortic augmentation index (AIx@75), brachial–ankle pulse wave velocity (BaPWV), and SEVR, differed significantly among the three groups. SEVR was significantly lower in the high stenosis group (1.02 ± 0.14) than in the control (1.13 ± 0.20) and low stenosis (1.12 ± 0.21) groups (p༜0.05). However, SEVR was lower in the low stenosis group than in the control group, although without statistical significance. In patients with CHD, the SYNTAX score correlated positively with age (r = 0.375, p = 0.001) and AIx@75 (r = 0.226, p = 0.007) and negatively with ABI (r = − 0.255, p = 0.002) and SEVR (r = − 0.18, p = 0.029). Conclusions In this study, the SEVR, ABI, and AIx@75 correlated well with atherosclerotic CHD. A decrease in SEVR measurements represents an increase in coronary artery stenosis. Thus, SEVR calculation could be used as a noninvasive method for the detection of CHD.