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The predictive role of aortic propagation velocity for coronary artery disease
Fereshteh Ghaderi1, Hossein Samim2, Faeze Keihanian3,4
1Fellowship in echocardiography, Cardiology Department, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Insights
Aortic propagation velocity (APV) is a novel echocardiographic marker for aortic stiffness. Lower APV levels correlate with coronary artery disease (CAD) presence and severity, suggesting its potential as a predictive tool for cardiovascular risk.
Area of Science:
- Cardiology
- Medical Imaging
- Vascular Biology
Background:
- Cardiovascular risk factors induce aortic changes, with aortic stiffness predicting morbidity and mortality.
- Aortic stiffness, a key cardiovascular risk factor, is assessed using various parameters.
- Aortic propagation velocity (APV) is an under-evaluated echocardiographic measure of aortic stiffness.
Purpose of the Study:
- To investigate the relationship between aortic propagation velocity (APV) and the presence/severity of coronary artery disease (CAD).
- To evaluate APV as a potential echocardiographic marker for aortic stiffness in patients undergoing coronary angiography.
Main Methods:
- A cross-sectional study involving 70 patients undergoing elective coronary artery angiography.
- Patients were categorized into CAD (n=38) and non-CAD (n=32) groups based on angiography.
- Transthoracic echocardiography was used to measure APV, aortic strain (AS), and aortic distensibility (AD).
Main Results:
- Aortic strain, distensibility, and APV were significantly lower in the CAD group compared to the non-CAD group (P<0.0001).
- APV demonstrated a significant inverse relationship with CAD presence and severity.
- An APV cutoff of <56 cm/sec predicted CAD with 96.9% sensitivity and 78.9% specificity.
Conclusions:
- Aortic strain, distensibility, and APV are inversely correlated with the presence and severity of CAD.
- APV is a valuable echocardiographic index for assessing aortic stiffness and its association with CAD.
- APV may serve as a useful predictor for detecting CAD and evaluating its severity.
Background:
It is well recognized that cardio- vascular risk factors lead to histological and functional changes in aorta, and aortic stiffness is the best predictor of cardiovascular morbidity and mortality. In this study we evaluated the relation of a less evaluated echocardiographic parameter of aortic stiffness, aortic propagation velocity (APV) with the presence and severity of CAD.
Methods:
This cross sectional study was conducted from May 2015 to March 2016 in Imam Reza hospital, Mashhad, Iran. Seventy patients who were referred for elective coronary artery angiography were enrolled. Patients were divided into two sub-groups based on angiographic findings: patients with CAD (38 patients, 54.3%) and non-CAD (32 patients, 45.7%). Transthoracic echocardiography was performed using the conventional 2D and color M-Mode imaging. Aortic propagation velocity (APV), aortic strain (AS) and distensibility (AD) were measured. The presence and Severity of CAD (assessing by syntax score) and their relation with aortic stiffness indices were assessed.
Results:
Aortic strain (6.23 ± 1.93% versus 11.66 ± 4.86%, P < 0.0001), distensibility (2.46 ± 0.91 vs 5.57 ± 2.25 cm 2 dyn-110-3, P < 0.0001) and APV (48.63 ± 10.31 cm/sec vs 77.75 ± 9.97 cm/s, P < 0.0001) were significantly decreased in CAD group compared with non-CAD group. In our study, APV showed significant inverse relationship with CAD. Based on our results, APV less than 56 cm/sec could be used to predict CAD with sensitivity and specificity of 96.9 and 78.9% respectively. We also found an inverse correlation between APV and severity of CAD.
Conclusion:
Aortic strain, AD and APV (a less evaluated echocardiographic index) showed significant inverse correlation with presence and severity of CAD.
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