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Does increased aortic stiffness predict reduced coronary flow velocity reserve in patients with suspected coronary

A Nemes1, M Csanády, T Forster

  • 1University of Szeged 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, Szeged, Hungary. nemes.attila@med.u-szeged.hu

Acta Physiologica Hungarica
|September 18, 2012
PubMed

Insights

Increased aortic stiffness, measured by echocardiography, predicts reduced coronary flow velocity reserve (CFR) in patients with suspected coronary artery disease (CAD). This finding highlights aortic stiffness as a key indicator for potential cardiac issues.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Diagnostic Imaging

Background:

  • Reduced coronary flow velocity reserve (CFR) is linked to increased aortic stiffness.
  • Stress transesophageal echocardiography (TEE) allows simultaneous assessment of CFR and aortic stiffness.
  • Aortic stiffness is an emerging cardiovascular risk factor.

Purpose of the Study:

  • To investigate if echocardiography-derived aortic elastic modulus [E(p)] predicts impaired CFR.
  • To assess the relationship between aortic stiffness and coronary artery disease (CAD) severity.
  • To determine the predictive value of aortic stiffness for reduced CFR in patients with suspected CAD.

Main Methods:

  • 158 patients with suspected CAD underwent stress TEE.
  • Coronary flow velocity reserve (CFR) was measured.
  • Aortic stiffness was assessed using echocardiography-derived aortic elastic modulus [E(p)].
  • Aortic atherosclerosis (AA) grade was also evaluated.

Main Results:

  • Subjects with CFR < 2 exhibited increased aortic atherosclerosis (AA) grade and higher E(p).
  • Logistic regression identified higher AA grade and increased E(p) as independent predictors of reduced CFR.
  • The cut-off value for E(p) to predict impaired CFR was ≥ 670 mmHg (61% sensitivity, 61% specificity).

Conclusions:

  • Increased aortic stiffness, specifically elevated E(p), independently predicts impaired CFR in patients with suspected CAD.
  • Aortic stiffness parameters are valuable in assessing cardiovascular risk in patients with suspected coronary artery disease.
  • Stress TEE provides a comprehensive evaluation of both coronary and aortic function.
Abstract

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