Aortic distensibility is associated with both resting and hyperemic coronary blood flow

Abstract

A large body of evidence demonstrates an independent association between arterial stiffness and prospective risk of cardiovascular events. A reduction in coronary perfusion is presumed to underscore this association; however, studies confirming this are lacking. This study compared invasive measures of coronary blood flow (CBF) with cardiac magnetic resonance (CMR)-derived aortic distensibility (AD). Following coronary angiography, a Doppler FloWire and infusion microcatheter were advanced into the study vessel. Average peak velocity (APV) was acquired at baseline and following intracoronary adenosine to derive coronary flow velocity reserve (CFVR = hyperemic APV/resting APV) and CBF [π × (diameter)2 × APV × 0.125]. Following angiography, patients underwent CMR to evaluate distensibility at the ascending aorta (AA), proximal descending aorta (PDA) and distal descending aorta (DDA). Fifteen participants (53 ± 13 yr) with minor epicardial disease (maximum stenosis <30%) were enrolled. Resting CBF was 44.1 ± 11.9 mL/min, hyperemic CBF was 143.8 ± 37.4 mL/min, and CFVR was 3.15 ± 0.48. AD was 3.89 ± 1.72·10−3mmHg−1 at the AA, 4.08 ± 1.80·10−3mmHg−1 at the PDA, and 4.42 ± 1.67·10−3mmHg−1 at the DDA. All levels of distensibility correlated with resting CBF ( R2 = 0.350–0.373, P < 0.05), hyperemic CBF ( R2 = 0.453–0.464, P < 0.01), and CFVR ( R2 = 0.442–0.511, P < 0.01). This study demonstrates that hyperemic and, to a lesser extent resting CBF, are significantly associated with measures of aortic stiffness in patients with only minor angiographic disease. These findings provide further in vivo support for the observed prognostic capacity of large artery function in cardiovascular event prediction. NEW & NOTEWORTHY Cardiac magnetic resonance-derived aortic distensibility is associated with invasive measures of coronary blood flow. Large artery function is more strongly correlated with hyperemic than resting blood flow. Increased stiffness may represent a potential target for novel antianginal medications.

Candesartan prevents arteriopathy progression in cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy model

“…These results indicate that the matrisome protein accumulation contributes to arterial dysfunction in HTRA1 −/− mice. In other organs, the accumulation of matrisome proteins was shown to increase arterial stiffness and reduce vascular distensibility, resulting in reduced blood flow (51)(52)(53). Therefore, even in HTRA1 −/− mice, we speculate that the accumulated matrisome proteins promote stiffening of the cerebral arteries and reduce vascular distensibility, which may lead to a decrease in cerebral blood flow.…”

Aortic Distensibility Can Predict Events in Patients With Premature Coronary Artery Disease: A Cardiac Magnetic Resonance Study

“…There are limited data for the relationship between AD and the complexity of CAD in patients with premature CAD. However, AD was impaired in atherosclerotic diseases such as CAD 18 and carotid 19 and aortic atherosclerosis. 20…”

Hipertansif hastalarda presistolik A dalgası ile aort distensibilitesi arasındaki ilişki

“…Global arterial stiffness measured as carotid-femoral pulse wave velocity correlates with AD, which also can be easily measured by echocardiography 24 . At the same time, AD measurement provides more valuable information in terms of central hemodynamics 25 . The relationship between AD and cardiovascular disease outcomes has been shown in previous publications 23,25,26 .…”

“…At the same time, AD measurement provides more valuable information in terms of central hemodynamics 25 . The relationship between AD and cardiovascular disease outcomes has been shown in previous publications 23,25,26 . AD is impaired with the effect of aortic hardening in hypertensive patients.…”