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Relation between aortic stiffness and coronary flow reserve in patients with coronary artery disease
D Fukuda1, M Yoshiyama, K Shimada
1Department of Internal Medicine and Cardiology, Graduate School of Medicine, Osaka City University Medical School, 1-4-3, Asahimachi, Abenoku, Osaka 545-8585, Japan. daiju@qg7.so-net.ne.jp
Insights
Aortic stiffness, measured by brachial-ankle pulse wave velocity (ba-PWV), is linked to reduced coronary flow reserve (CFR) in coronary artery disease (CAD) patients. This suggests aortic stiffening may be a key cardiovascular risk factor.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Diagnostic Imaging
Background:
- Aortic stiffness is an emerging cardiovascular risk factor.
- Coronary artery disease (CAD) impacts myocardial perfusion.
- The relationship between aortic stiffness and coronary flow reserve (CFR) in CAD requires further elucidation.
Purpose of the Study:
- To investigate the association between aortic stiffness and CFR in patients with established CAD.
Main Methods:
- An observational study involving 192 patients undergoing coronary angiography.
- Brachial-ankle pulse wave velocity (ba-PWV) was used to assess aortic stiffness.
- Coronary flow reserve (CFR) and CAD severity were quantified.
Main Results:
- Brachial-ankle pulse wave velocity (ba-PWV) significantly increased with the number of diseased coronary vessels.
- A significant negative correlation was observed between ba-PWV and CFR (r = -0.45, p < 0.0001).
- ba-PWV was identified as an independent determinant of CFR in multiple regression analysis.
Conclusions:
- Aortic stiffening is associated with altered coronary flow in patients with CAD.
- These findings suggest a potential mechanism linking aortic stiffness to adverse cardiovascular outcomes.
- Aortic stiffness may represent a critical factor in the pathophysiology of CAD.
Objectives:
To investigate the relation between aortic stiffness and coronary flow reserve (CFR) in patients with coronary artery disease (CAD).
Design:
Observational study.
Setting:
Coronary care unit of a primary care hospital.
Patients:
192 consecutive patients who underwent coronary angiography.
Main Outcome Measure:
Brachial-ankle pulse wave velocity (ba-PWV), CFR, and severity of CAD.
Results:
According to the angiographic findings, patients were divided into four subgroups: patients without significant stenosis (normal coronary artery (NCA) group, n = 28) and those with one vessel disease (1VD group, n = 92), two vessel disease (2VD group, n = 50), or three vessel disease (3VD group, n = 22). ba-PWV increased with the number of diseased vessels and was significantly correlated with the number of diseased vessels (NCA group v 1VD group v 2VD group v 3VD group: 1481 (252) v 1505 (278) v 1577 (266) v 1727 (347) cm/s, p < 0.001). CFR had a significant negative correlation with ba-PWV (r = -0.45, p < 0.0001). The diastolic to systolic velocity ratio obtained in 45 patients also was significantly correlated with ba-PWV (r = -0.35, p < 0.05). Multiple regression analysis showed that ba-PWV was an independent determinant of CFR (p < 0.01).
Conclusions:
Coronary flow is altered with aortic stiffening in patients with CAD. These results suggest one possible mechanism for recent reports that aortic stiffness is a key cardiovascular risk factor.
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