Coronary flow velocity reserve in patients with ascending aorta aneurysm

Area of Science:

• Cardiovascular Medicine
• Diagnostic Imaging
• Aortic Disease Research

Background:

• Ascending aorta aneurysms (AAA) represent a significant cause of cardiovascular morbidity and mortality.
• Coronary microvascular function may be compromised in AAA patients, potentially leading to adverse cardiac events.
• Coronary flow velocity reserve (CFVR) offers a noninvasive method to assess coronary artery functional capacity.

Purpose of the Study:

• To investigate coronary microvascular dysfunction in patients with ascending aorta aneurysms (AAA) using noninvasive CFVR.
• To determine if AAA patients exhibit impaired CFVR in the absence of diagnosed coronary artery disease (CAD).

Main Methods:

• Prospective study involving 44 patients with thoracic AAA and no CAD, compared to 36 controls.
• Transthoracic echocardiography used to measure coronary flow velocities in the distal left anterior descending (LAD) artery.
• CFVR calculated as the ratio of hyperemic to resting diastolic peak coronary flow velocities.

Main Results:

• AAA patients exhibited significantly lower CFVR compared to controls (1.9 ± 0.3 vs. 2.3 ± 0.5, P < 0.001).
• Higher baseline LAD peak diastolic flow velocities and lower hyperemic velocities were observed in AAA patients.
• Multivariate analysis identified aortic systolic diameter (AoSD) as the sole independent determinant of reduced CFVR (β = -0.679, P < 0.001).

Conclusions:

• Noninvasive CFVR is significantly reduced in patients with ascending aorta aneurysms (AAA).
• Aortic systolic diameter is the most critical factor associated with impaired CFVR in this patient group.
• These findings highlight potential coronary microvascular dysfunction in AAA patients, influenced by aortic dimensions.