Objective The goal of this study was to evaluate the relationship between large artery stiffness and coronary flow velocity reserve (CFVR). Population studies have shown that increased large artery stiffness is an independent predictor of cardiovascular events. Experimental studies have shown that a stiff aorta is associated with decreased coronary blood flow. However, a link between large artery stiffness and coronary microvascular function in the clinical setting has not been demonstrated previously.
Patients and methods This study enrolled 102 consecutive subjects (mean age 62 iÀ 10) without coronary and peripheral arterial disease. After 15 min of rest, measurements were obtained of brachial-ankle pulse wave velocity (baPWV), augmentation index (AIx) from a carotid pulse tracing, and transthoracic echocardiographic parameters, including coronary flow velocity in the left anterior descending coronary artery. In addition, coronary flow velocity during hyperemia was measured during an intravenous infusion of adenosine triphosphate. CFVR was defined as the ratio of hyperemic to basal coronary velocity.
Results Subjects with decreased CFVR (< 2.5; n = 40) had significantly higher baPWV (P < 0.0001), greater AIx (P = 0.01) and greater pulse pressure (PP) (P < 0.001) than those with normal CFVR (n = 62). Multivariate analysis revealed that AIx and PP were independent predictors of CFVR (r = -0.32, P < 0.0001 and -0.25, P = 0.02, respectively).
Conclusions Our data suggest that large artery stiffening is linked to a reduction of CFVR, which may partially explain the higher cardiac event rate in patients with increased large artery stiffness.
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