Non-invasive measures of pulse wave velocity correlate with coronary arterial plaque load in humans
Andrew L McLeod1, Neal G Uren, Ian B Wilkinson
1Department of Cardiology, Western General Hospital, Edinburgh, UK.
Insights
Arterial stiffness, measured by carotid-radial pulse wave velocity, correlates with coronary artery plaque volume. This non-invasive measure may indicate the extent of coronary atherosclerosis, suggesting stiffness promotes heart disease.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Diagnostic Imaging
Background:
- Arterial stiffness is a significant risk factor for cardiovascular disease.
- Assessing arterial stiffness non-invasively is crucial for risk stratification.
- Coronary artery plaque load is a key indicator of atherosclerosis severity.
Purpose of the Study:
- To investigate the correlation between coronary artery plaque burden and non-invasive measures of arterial stiffness.
- To determine if arterial stiffness can serve as a surrogate marker for coronary atherosclerosis.
Main Methods:
- Prospective study at a tertiary university hospital.
- Coronary artery plaque volume assessed via intravascular ultrasound and 3D reconstruction.
- Central arterial stiffness measured using applanation tonometry and pulse wave analysis.
Main Results:
- A positive correlation was found between proximal coronary artery plaque volume and carotid-radial pulse wave velocity (r=0.47, P=0.008).
- A trend towards correlation was observed with carotid-femoral pulse wave velocity (r=0.34, P=0.07).
- Other measures of arterial stiffness did not show significant correlation with plaque volume.
Conclusions:
- Carotid-radial pulse wave velocity is a potential non-invasive marker for coronary artery plaque extent.
- Findings support the hypothesis that central aortic stiffness contributes to the development of coronary atherosclerosis and ischemic heart disease.
Objective:
Arterial stiffness is an emerging major risk factor for cardiovascular morbidity and mortality. The aim of the present study was to assess if coronary artery plaque load correlates with non-invasive measures of arterial stiffness.
Design:
Prospective investigational study.
Setting:
Tertiary university hospital centre.
Patients:
Patients undergoing elective diagnostic coronary angiography.
Interventions And Main Outcome Measures:
Coronary artery plaque burden was assessed using a 30 MHz intravascular ultrasound catheter during an automated pullback. Proximal coronary artery plaque volume was determined using a validated edge-detection algorithm following three-dimensional computerized reconstruction. Central arterial stiffness was assessed in each patient using applanation tonometry to radial, carotid and femoral pulses, with derivation of aortic pressure augmentation and pulse wave velocity using pulse wave analysis.
Results:
In 35 patients (61 +/- 2 years), proximal coronary arterial plaque volume was 5.9 +/- 0.6 mm3/mm of vessel. Plaque volume correlated positively with carotid-radial pulse wave velocity (r = 0.47, P = 0.008) and appeared to correlate with carotid-femoral pulse wave velocity (r = 0.34, P = 0.07). Aortic augmentation (r = 0.24, P = 0.16), augmentation index (r = 0.3, P = 0.08), and pulse pressure (r = 0.22, P = 0.2) did not correlate significantly with proximal coronary artery plaque volume.
Conclusions:
Non-invasive measures of carotid-radial pulse wave velocity correlate with the extent of coronary artery plaque volume and may be a useful non-invasive surrogate marker for the extent of coronary atherosclerosis. Our findings are consistent with the suggestion that central aortic stiffness may promote the development of coronary atherosclerosis and ischaemic heart disease.
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