Does increased aortic stiffness predict reduced coronary flow velocity reserve in patients with suspected coronary artery disease?

Attila Nemes, M. Csanády, T. Forster

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: In recent studies, reduction in coronary flow velocity reserve (CFR) has been demonstrated in patients with increased aortic stiffness. Stress transoesophageal echocardiography (TEE) is a suitable method for the simultaneous evaluation of CFR and aortic stiffness parameters. The present study was designed to test whether increased echocardiography-derived aortic elastic modulus [E(p)] predicts impaired CFR in patients with suspected coronary artery disease (CAD). Results: The present study comprised 158 patients with suspected CAD. A CFR value <2 was considered abnormal. Both mean grade of aortic atherosclerosis (AA) (as a morphologic characteristic) (1.31 ± 0.68 vs. 1.02 ± 0.89, p <0.05) and aortic distensibility (E(p) as a functional characteristic) (892 ± 584 mmHg vs. 723 ± 495 mmHg, p <0.05) were increased in subjects with CFR <2. In ROC analysis, the cut-off value for E(p) to predict impaired CFR was = 670 mmHg, with 61% sensitivity and 61% specificity (ROC area 0.60, p = 0.026). The logistic regression model identified higher AA grade (hazard ratio (HR) 2.01, p <0.05) and increased E(p) as independent predictors of reduced CFR (HR 1.10, p <0.05). Conclusion: Increased aortic stiffness predicts impaired CFR in patients with suspected CAD.

Original languageEnglish
Pages (from-to)271-278
Number of pages8
JournalActa Physiologica Hungarica
Volume99
Issue number3
DOIs
Publication statusPublished - Sep 1 2012

Fingerprint

Vascular Stiffness
Coronary Artery Disease
Atherosclerosis
Logistic Models
Stress Echocardiography
Elastic Modulus
Transesophageal Echocardiography
ROC Curve
Echocardiography
Sensitivity and Specificity

Keywords

  • aortic
  • coronary artery disease
  • coronary flow reserve
  • distensibility
  • echocardiography
  • prognosis
  • stiffness

ASJC Scopus subject areas

  • Physiology (medical)

Cite this

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title = "Does increased aortic stiffness predict reduced coronary flow velocity reserve in patients with suspected coronary artery disease?",
abstract = "Purpose: In recent studies, reduction in coronary flow velocity reserve (CFR) has been demonstrated in patients with increased aortic stiffness. Stress transoesophageal echocardiography (TEE) is a suitable method for the simultaneous evaluation of CFR and aortic stiffness parameters. The present study was designed to test whether increased echocardiography-derived aortic elastic modulus [E(p)] predicts impaired CFR in patients with suspected coronary artery disease (CAD). Results: The present study comprised 158 patients with suspected CAD. A CFR value <2 was considered abnormal. Both mean grade of aortic atherosclerosis (AA) (as a morphologic characteristic) (1.31 ± 0.68 vs. 1.02 ± 0.89, p <0.05) and aortic distensibility (E(p) as a functional characteristic) (892 ± 584 mmHg vs. 723 ± 495 mmHg, p <0.05) were increased in subjects with CFR <2. In ROC analysis, the cut-off value for E(p) to predict impaired CFR was = 670 mmHg, with 61{\%} sensitivity and 61{\%} specificity (ROC area 0.60, p = 0.026). The logistic regression model identified higher AA grade (hazard ratio (HR) 2.01, p <0.05) and increased E(p) as independent predictors of reduced CFR (HR 1.10, p <0.05). Conclusion: Increased aortic stiffness predicts impaired CFR in patients with suspected CAD.",
keywords = "aortic, coronary artery disease, coronary flow reserve, distensibility, echocardiography, prognosis, stiffness",
author = "Attila Nemes and M. Csan{\'a}dy and T. Forster",
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AU - Csanády, M.

AU - Forster, T.

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N2 - Purpose: In recent studies, reduction in coronary flow velocity reserve (CFR) has been demonstrated in patients with increased aortic stiffness. Stress transoesophageal echocardiography (TEE) is a suitable method for the simultaneous evaluation of CFR and aortic stiffness parameters. The present study was designed to test whether increased echocardiography-derived aortic elastic modulus [E(p)] predicts impaired CFR in patients with suspected coronary artery disease (CAD). Results: The present study comprised 158 patients with suspected CAD. A CFR value <2 was considered abnormal. Both mean grade of aortic atherosclerosis (AA) (as a morphologic characteristic) (1.31 ± 0.68 vs. 1.02 ± 0.89, p <0.05) and aortic distensibility (E(p) as a functional characteristic) (892 ± 584 mmHg vs. 723 ± 495 mmHg, p <0.05) were increased in subjects with CFR <2. In ROC analysis, the cut-off value for E(p) to predict impaired CFR was = 670 mmHg, with 61% sensitivity and 61% specificity (ROC area 0.60, p = 0.026). The logistic regression model identified higher AA grade (hazard ratio (HR) 2.01, p <0.05) and increased E(p) as independent predictors of reduced CFR (HR 1.10, p <0.05). Conclusion: Increased aortic stiffness predicts impaired CFR in patients with suspected CAD.

AB - Purpose: In recent studies, reduction in coronary flow velocity reserve (CFR) has been demonstrated in patients with increased aortic stiffness. Stress transoesophageal echocardiography (TEE) is a suitable method for the simultaneous evaluation of CFR and aortic stiffness parameters. The present study was designed to test whether increased echocardiography-derived aortic elastic modulus [E(p)] predicts impaired CFR in patients with suspected coronary artery disease (CAD). Results: The present study comprised 158 patients with suspected CAD. A CFR value <2 was considered abnormal. Both mean grade of aortic atherosclerosis (AA) (as a morphologic characteristic) (1.31 ± 0.68 vs. 1.02 ± 0.89, p <0.05) and aortic distensibility (E(p) as a functional characteristic) (892 ± 584 mmHg vs. 723 ± 495 mmHg, p <0.05) were increased in subjects with CFR <2. In ROC analysis, the cut-off value for E(p) to predict impaired CFR was = 670 mmHg, with 61% sensitivity and 61% specificity (ROC area 0.60, p = 0.026). The logistic regression model identified higher AA grade (hazard ratio (HR) 2.01, p <0.05) and increased E(p) as independent predictors of reduced CFR (HR 1.10, p <0.05). Conclusion: Increased aortic stiffness predicts impaired CFR in patients with suspected CAD.

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