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Aortic pulse wave velocity and its relationship with complexity of coronary artery disease based on SYNTAX score
R Ranjith1, T G Binu1, Vijo George1
1Department of Cardiology , Govt TD Medical College Alappuzha , Alappuzha, Kerala , India.
Insights
Aortic pulse wave velocity (APWV) predicts coronary artery disease (CAD) complexity. Higher APWV indicates more severe CAD, suggesting it’s a valuable tool for assessing atherosclerosis progression.
Area of Science:
- Cardiovascular Medicine
- Medical Imaging
- Biomedical Engineering
Background:
- Aortic pulse wave velocity (APWV) is a validated marker for arterial stiffness and predictor of cardiovascular events.
- Echo Doppler measurement of APWV offers a simple, accessible alternative to complex imaging modalities.
- The relationship between APWV and coronary artery disease (CAD) complexity remained unexplored.
Purpose of the Study:
- To investigate the correlation between APWV measurements and the severity of coronary artery disease (CAD).
- To assess if APWV can predict the complexity of CAD, as quantified by SYNTAX (SX) scores.
Main Methods:
- A study cohort of 500 patients undergoing APWV measurement and coronary angiography was analyzed.
- APWV was calculated using pulsed Doppler ultrasound with ECG synchronization.
- SYNTAX scores were determined by blinded observers to APWV values.
Main Results:
- A significant, nearly linear correlation was found between APWV and the advancement of CAD (p<0.0001).
- Patients with multi-vessel CAD exhibited significantly higher APWV compared to those without CAD.
- Elevated APWV values (>11.5 m/s) were identified as a predictor for the presence of CAD.
Conclusions:
- APWV demonstrates predictive value for SYNTAX scores, indicating its utility in assessing CAD complexity.
- A positive association exists between aortic stiffening and coronary atherosclerosis.
- 2D Doppler-derived APWV is an effective predictor of advancing coronary artery disease.
Background:
Aortic pulse wave velocity (APWV), a marker of arterial stiffness, was found to be a good predictor for the presence of incipient vascular disease and cardiovascular events in observational studies. APWV measured by echo Doppler is a simple and readily available method comparable with other costlier and complex modalities of APWV measurement like MRI, Complior method or applanation tonometry.
Aims And Objectives:
No previous studies have demonstrated a relationship between APWV findings and the complexity of coronary artery disease (CAD). Our aim was to examine the relationship between APWV findings and the severity of SYNTAX scores (SX scores).
Methods:
500 patients who had undergone APWV measurements and elective coronary angiography from September 2012 to June 2013 were taken. Pulsed Doppler ultrasound (6.6 MHZ) probe with ECG synchronisation was used to calculate APWV. SYNTAX scoring was performed by observers who were blinded to APWV values.
Results:
A significant, nearly linear correlation between APWV and advancing CAD (p<0.0001) was observed. Patients with dual-vessel and triple-vessel disease had significantly higher APWV than patients without CAD. It was also found that mean APWV values were significantly more in patients with high or intermediate SX scores than in patients with low SX scores. The Fischer's linear discriminant analysis showed a cut-off value of APWV for predicting the possibility of having CAD to be >11.5 m/s.
Conclusions:
APWV has predictive value for the SX score. A positive relation exists between aortic stiffening and coronary atherosclerosis and APWV measured by 2D Doppler is a good predictor of advancing CAD.
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