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Reflection in the arterial system and the risk of coronary heart disease
Tomoshige Hayashi1, Yasunori Nakayama, Kei Tsumura
1Department of Cardiology, Ishikiriseiki Hospital, Higashiosaka-City, Osaka, Japan.
Insights
Aortic waveform indices, augmentation index and inflection time, are linked to increased coronary heart disease (CHD) risk. Shorter inflection times and higher augmentation indices significantly elevate CHD risk in patients with chest pain.
Area of Science:
- Cardiovascular Physiology
- Arterial Waveform Analysis
- Coronary Heart Disease Risk Factors
Background:
- Augmentation index and inflection time reflect arterial system properties.
- Their association with coronary heart disease (CHD) risk is not well-established.
- Ascending aortic pressure waveform characteristics may indicate CHD risk.
Purpose of the Study:
- To determine if aortic reflection indices predict CHD risk.
- To evaluate the relationship between ascending aortic pressure waveform characteristics and CHD.
Main Methods:
- 190 patients with chest pain, normal cardiac function, and no prior myocardial infarction were studied.
- Ascending aortic pressure was measured using a fluid-filled system.
- Inflection time and augmentation index were analyzed for association with CHD risk.
Main Results:
- Both inflection time and augmentation index correlated with increased CHD risk.
- Shortest inflection time quartile showed 66.0% CHD prevalence; longest quartile had 10.6%.
- Highest augmentation index quartile showed 40.4% CHD prevalence; lowest quartile had 17.0%.
Conclusions:
- Augmentation index and inflection time are significant predictors of CHD risk.
- These aortic waveform indices offer valuable insights into cardiovascular health.
- Further research can explore therapeutic targets based on these findings.
Background:
Although it was reported that the augmentation index and inflection time are closely related to reflection in the arterial system and large artery function, it is not known whether these indices of the ascending aortic pressure waveform increase the risk of coronary heart disease (CHD). The purpose of this study was to evaluate whether the aortic reflection of the ascending aortic pressure waveform is related to an increased risk of CHD.
Methods:
We enrolled 190 men and women who had chest pain, normal contractions, no local asynergy, and no history of myocardial infarction. We measured the ascending aortic pressure using a fluid-filled system. The inflection time was defined as the time interval from initiation of a systolic pressure waveform to the inflection point. We investigated the association between the inflection time and augmentation index of the ascending aorta and the risk of CHD.
Results:
Both the inflection time and augmentation index were associated with an increased risk of CHD. The crude prevalence rates of CHD were 66.0% for the shortest quartile and 10.6% for the longest quartile of the inflection time, and 17.0% for the lowest quartile and 40.4% for the highest quartile of the augmentation index. The multiple-adjusted odds ratio of CHD was 30.8 (95% confidence interval [CI] 7.43-128.05) for the shortest quartile of the inflection time compared with the longest quartile and was 3.82 (95% CI 1.26-11.59) for the highest quartile of the augmentation index compared with the lowest quartile.
Conclusions:
The augmentation index and inflection time were associated with an increased risk of CHD.