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Reduction of coronary flow reserve in patients with increased aortic stiffness

Attila Nemes1, Tamás Forster, Miklós Csanády

  • 1Second Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Medical and Pharmaceutical Centre, University of Szeged, H-6720 Szeged, Korányi fasor 6, Hungary. nemes@in2nd.szote.u-szeged.hu

Canadian Journal of Physiology and Pharmacology
|September 29, 2007
PubMed

Insights

Increased aortic stiffness, a measure of arterial elasticity, is linked to reduced coronary flow reserve (CFR). This study found lower CFR in patients with stiffer aortas, indicating impaired heart blood flow.

Area of Science:

  • Cardiovascular Physiology
  • Biomedical Engineering

Background:

  • Aortic stiffness is implicated in affecting coronary blood flow.
  • The precise impact of aortic stiffness on coronary flow reserve (CFR) remains largely uncharacterized.

Purpose of the Study:

  • To investigate the relationship between aortic stiffness and CFR.
  • To compare CFR in patients with and without increased aortic stiffness, matched for key demographics and risk factors.

Main Methods:

  • Utilized stress transesophageal echocardiography (TEE) for CFR measurement and coronary angiography.
  • Defined increased aortic stiffness using an elastic modulus (Ep) > 680 mmHg.
  • Compared 36 subjects with normal aortic distensibility against 19 age-, sex-, and risk factor-matched patients with increased aortic stiffness, all free of coronary artery disease.

Main Results:

  • Patients with increased aortic stiffness exhibited significantly reduced CFR (2.12 +/- 0.58) compared to those with normal aortic distensibility (2.64 +/- 1.16; p < 0.01).
  • Hyperemic diastolic flow velocities were diminished in patients with increased aortic stiffness (102.1 +/- 39.8 cm/s) versus controls (129.5 +/- 36.6 cm/s; p < 0.05).
  • Significant negative correlations were observed between elastic modulus (Ep) and both hyperemic diastolic coronary flow velocity (r = -0.41, p < 0.01) and CFR (r = -0.21, p < 0.05).

Conclusions:

  • Increased aortic stiffness is associated with reduced coronary flow reserve in patients without coronary artery disease.
  • Aortic stiffness negatively impacts coronary microvascular function, as evidenced by reduced hyperemic diastolic flow velocities.
  • These findings highlight aortic stiffness as a potential contributor to impaired myocardial perfusion.

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