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In the evaluation of patients with suspected coronary artery disease (CAD), the presence of the superficial femoral artery (SFA) plaque is more informative than a carotid plaque and at least as informative as coronary plaque in the identification of coronary death individuals. In 60 patients with chest pain with a normal electrocardiogram, B-flow ultrasound estimation of SFA plaque and radionuclide myocardial perfusion scintigraphy (MPS) estimation for CAD was performed. We found significant positive correlations between age and SFA plaque score (PS) (P = 0.0084), myocardial ischemia in rest and SFA PS (P < 0.0001), and between transient ischemic dilation (TID) and SFA PS (P = 0.0069), too. The TID correlates only with myocardial ischemia in rest (P = 0.0022) and SFA PS (P = 0.0069). The results we got by the receiver operating characteristics (ROC) curve analysis with TID/without TID were the area under curve (0.704, P = 0.0038). The multiple regression analysis showed standardized coefficient β coefficients for SFA PS and TID (3.4577 and 1.9903, P < 0.001 and P = 0.0021), respectively. By proven correlative relationship of SFA atherosclerotic plaques and CAD, we can use B-flow as a screening method for triage of patients with chest pain before being sent to the assessment of coronary circulation with radionuclide MPS.

Transient ischemic dilation (TID) is a sensitive and specific marker for detecting the severity and extent of coronary artery disease (CAD), which is closely associated with endothelial dysfunction. TID can be observed on stress-rest myocardial perfusion scan (MPS) due to subendocardial hypoperfusion. Hyperglycemia in type 2 diabetes mellitus (T2DM) could lead to micro- and macrovascular complications and begins with endothelial dysfunction. Endothelin-1 (ET-1), a potent vasocontrictor, increases in endothelial dysfunction. The aim of this study was to examine the correlation between TID index and ET​​-1 levels in T2DM patients without any sign or symptom of cardiovascular complication. An analytic-correlational cross-sectional study was done on T2DM patients who met the inclusion criteria and agreed to participate by signing an informed consent form. The TID index was calculated automatically using standard software provided by the gamma camera GE-Infinia. Stress-rest MPS was done using technetium-99m ( 99m Tc)-tetrofosmin and a pharmacological stress test using adenosine. The ET-1 level was determined by radioimmunoassay. Data distribution was analyzed using the Shapiro-Wilk normality test. The Mann-Whitney test was used to compare the average difference of the variables and Spearman′s rank for correlation analysis. A total of 47 subjects consisting of 24 (51%) males and 23 (49%) females were included in this study. The age range was 37-74 years (54.3 ± 8.4). The TID index range was 0.86-1.26 (median = 1.12) and abnormal TID index was found in 23/47 (49%) subjects. ET-1 levels range 8.02-17.91 pg/mL (median = 11.08). The results showed no significant differences in age, ET-1 levels, and TID index based on age and sex (P > 0.05). There was a significant positive correlation between TID index and ET-1 level with r = 0.7 and P < 0.001. There was a positive correlation between TID index and ET-1 plasma level in patients with T2DM.