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Aortic pulse pressure is associated with the localization of coronary artery disease based on coronary flow

Georges Khoueiry1, Basem Azab, Estelle Torbey

  • 1Department of Cardiology, Staten Island University Hospital, New York, USA.

American Journal of Hypertension
|June 29, 2012
PubMed

Insights

Aortic pulse pressure, a measure of arterial stiffness, is linked to coronary artery disease (CAD). Higher aortic pulse pressure was associated with more severe disease in the right coronary artery compared to the left.

Area of Science:

  • Cardiovascular Medicine
  • Arterial Physiology
  • Coronary Artery Disease

Background:

  • Aortic pulse pressure (APP) is an indicator of arterial stiffness and is associated with coronary artery disease (CAD).
  • The right coronary artery (RCA) experiences both systolic and diastolic flow, unlike the left coronary artery (LCA) which has predominantly diastolic flow.
  • This suggests a potential for increased systolic-diastolic pressure difference to impact RCA atherogenesis more than LCA.

Purpose of the Study:

  • To investigate the relationship between aortic pulse pressure (APP) and the location of coronary artery disease (CAD) in the left (LCA) versus right (RCA) coronary arteries.
  • To determine if increased systolic-diastolic pressure difference has a differential atherogenic effect on the RCA compared to the LCA.

Main Methods:

  • A cohort of 433 coronary artery disease (CAD) patients undergoing coronary angiography was analyzed.
  • Patients were categorized into groups with isolated LCA lesions, isolated RCA lesions, or mixed LCA and RCA lesions.
  • Aortic pulse pressure (APP) was measured and correlated with CAD location, adjusting for factors like heart rate and left ventricular ejection fraction (LVEF).

Main Results:

  • Aortic pulse pressure (APP) was significantly higher in patients with isolated RCA lesions compared to those with isolated LCA lesions or mixed lesions (P = 0.008).
  • Heart rate was lower in the RCA group and negatively correlated with APP, while left ventricular ejection fraction (LVEF) was lower in the mixed group and positively correlated with APP.
  • The association between higher APP and right-sided CAD remained significant after multivariate logistic regression analysis.

Conclusions:

  • Aortic pulse pressure (APP) is a significant factor associated with the location of coronary artery disease (CAD).
  • Higher APP demonstrates a stronger association with disease in the right coronary artery (RCA) compared to the left coronary artery (LCA).
  • These findings suggest that APP influences CAD development, potentially modulated by coronary flow patterns.
Abstract

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