Arterial pulse wave velocity but not augmentation index is associated with coronary artery disease extent and
Sarah A Hope1, Paul Antonis, David Adam
1Monash Heart, Monash Medical Centre, Australia. Sarah.Hope@med.monash.edu.au
Insights
Aorto-radial pulse wave velocity, not central aortic augmentation index, correlates with coronary artery disease extent and severity. This finding impacts the use of generalized arterial transfer functions in cardiovascular risk assessment.
Area of Science:
- Cardiovascular Medicine
- Biomedical Engineering
- Diagnostic Imaging
Background:
- Central aortic pressure waveform characteristics, including augmentation index, are implicated in cardiovascular disease progression and risk prediction.
- The relationship between central waveform characteristics and the extent/severity of coronary artery disease (CAD) remains unclear.
Purpose of the Study:
- To investigate the association between central aortic pressure waveform characteristics and the extent and severity of coronary artery disease.
- To test the hypothesis linking CAD characteristics with specific pressure waveform parameters.
Main Methods:
- Central aortic waveforms were recorded during coronary angiography in 40 patients using Millar pressure transducer-tipped catheters.
- Coronary artery disease severity and extent were quantified using modified Gensini's stenosis and Sullivan's extent scores.
- Regression analyses assessed relationships between disease scores, waveform characteristics, aorto-radial pulse wave velocity, and demographics.
Main Results:
- Both CAD extent and severity scores correlated with increasing age and male sex.
- Aorto-radial pulse wave velocity was independently associated with both disease extent and severity, preceding age and sex in regression models.
- Neither disease score showed association with central aortic augmentation index, even after accounting for heart rate, demographics, and risk factors.
Conclusions:
- Aorto-radial pulse wave velocity, but not central aortic augmentation index, is significantly associated with the extent and severity of coronary artery disease.
- These findings suggest implications for the application of generalized arterial transfer functions in assessing cardiovascular health and risk.
Objectives:
The aim of this study was to test the hypothesis that coronary artery disease extent and severity are associated with central aortic pressure waveform characteristics.
Background:
Although it is thought that central aortic pressure waveform characteristics, particularly augmentation index, may influence cardiovascular disease progression and predict cardiovascular risk, little is known of the relationship between central waveform characteristics and the severity and extent of coronary artery disease.
Methods:
Central aortic waveforms (2F Millar pressure transducer-tipped catheters) were acquired at the time of coronary angiography for suspected native coronary artery disease in 40 patients (24 male). The severity and extent of disease were assessed independently by two observers using two previously described scoring systems (modified Gensini's stenosis and Sullivan's extent scores). Relationships between disease scores, aortic waveform characteristics, aorto-radial pulse wave velocity and subject demographic features were assessed by regression techniques.
Results:
Both extent and severity scores were associated with increasing age and male sex (P < 0.001), but no other risk factors. Both scores were independently associated with aorto-radial pulse wave velocity (P < 0.001), which entered a multiple regression model prior to age and sex. This association was not dependent upon blood pressure. Neither score was associated with central aortic augmentation index, by either simple or multiple linear regression techniques including heart rate, subject demographic features and cardiovascular risk factors.
Conclusions:
Aorto-radial pulse wave velocity, but not central aortic augmentation index, is associated with both the extent and severity of coronary artery disease. This has potentially important implications for applicability of a generalized arterial transfer function.
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