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Relation between aortic stiffness and coronary flow reserve in patients with coronary artery disease
  1. D Fukuda1,
  2. M Yoshiyama1,
  3. K Shimada1,
  4. H Yamashita1,
  5. S Ehara1,
  6. Y Nakamura1,
  7. K Kamimori1,
  8. A Tanaka2,
  9. T Kawarabayashi2,
  10. J Yoshikawa1
  1. 1Department of Internal Medicine and Cardiology, Graduate School of Medicine, Osaka City University Medical School, Osaka, Japan
  2. 2Baba Memorial Hospital, Sakai, Japan
  1. Correspondence to:
    Dr Daiju Fukuda
    Department of Internal Medicine and Cardiology, Graduate School of Medicine, Osaka City University Medical School, 1-4-3, Asahimachi, Abenoku, Osaka 545-8585, Japan; daiju{at}qg7.so-net.ne.jp

Abstract

Objectives: To investigate the relation between aortic stiffness and coronary flow reserve (CFR) in patients with coronary artery disease (CAD).

Design: Observational study.

Setting: Coronary care unit of a primary care hospital.

Patients: 192 consecutive patients who underwent coronary angiography.

Main outcome measure: Brachial-ankle pulse wave velocity (ba-PWV), CFR, and severity of CAD.

Results: According to the angiographic findings, patients were divided into four subgroups: patients without significant stenosis (normal coronary artery (NCA) group, n  =  28) and those with one vessel disease (1VD group, n  =  92), two vessel disease (2VD group, n  =  50), or three vessel disease (3VD group, n  =  22). ba-PWV increased with the number of diseased vessels and was significantly correlated with the number of diseased vessels (NCA group v 1VD group v 2VD group v 3VD group: 1481 (252) v 1505 (278) v 1577 (266) v 1727 (347) cm/s, p < 0.001). CFR had a significant negative correlation with ba-PWV (r  =  −0.45, p < 0.0001). The diastolic to systolic velocity ratio obtained in 45 patients also was significantly correlated with ba-PWV (r  =  −0.35, p < 0.05). Multiple regression analysis showed that ba-PWV was an independent determinant of CFR (p < 0.01).

Conclusions: Coronary flow is altered with aortic stiffening in patients with CAD. These results suggest one possible mechanism for recent reports that aortic stiffness is a key cardiovascular risk factor.

  • 1VD, one vessel disease
  • 2VD, two vessel disease
  • 3VD, three vessel disease
  • ba-PWV, brachial-ankle pulse wave velocity
  • BP, blood pressure
  • CAD, coronary artery disease
  • CFR, coronary flow reserve
  • DSVR, diastolic to systolic velocity ratio
  • NCA, normal coronary artery
  • aortic stiffness
  • coronary artery disease
  • coronary circulation

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Footnotes

  • Published Online First 10 October 2005

  • There is no financial support in this study.

  • There is no conflict in this study.

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