Influence of arterial compliance on presence and extent of ischaemia during stress echocardiography
- 1University of Queensland, Brisbane, Australia
- 2Cardiovascular Research Foundation, New York, New York, USA
- Correspondence to:
Professor Thomas Marwick
University of Queensland Department of Medicine, Princess Alexandra Hospital, Ipswich Road, Brisbane, Queensland 4102, Australia;
- Accepted 10 February 2005
Objective: To seek an association between total arterial compliance (TAC) and the extent of ischaemia at stress echocardiography.
Design: Cohort study.
Setting: Regional cardiac centre.
Methods: 255 consecutive patients (147 men; mean (SD) age 58 (8)) presenting for stress echocardiography for clinical indications were studied. Wall motion score index (WMSI) was calculated and ischaemia was defined by an inducible or worsening wall motion abnormality. Peak WMSI was used to reflect the extent of dysfunction (ischaemia or scar), and ΔWMSI was indicative of extent of ischaemia. TAC was assessed at rest by simultaneous radial applanation tonometry and pulsed wave Doppler in all patients.
Results: Ischaemia was identified by stress echocardiography in 65 patients (25%). TAC was similar in the groups with negative and positive echocardiograms (1.08 (0.41) v 1.17 (0.51) ml/mm Hg, not significant). However, the extent of dysfunction was associated with TAC independently of age, blood pressure, risk factors, and use of a β blocker. Moreover, the extent of ischaemia was determined by TAC, risk factors, and use of a β blocker.
Conclusion: While traditional cardiovascular risk factors are strong predictors of ischaemia on stress echocardiography, TAC is an independent predictor of the extent of ischaemia.