Aortic pulse pressure is related to the presence and extent of coronary artery disease in men undergoing diagnostic coronary angiography: a multicenter study

Danchin, Nicolás; Bénétos, Athanase; Lopez‐Sublet, Marilucy; Demicheli, Thibaud; Safar, Michel E.; Mourad, Jean‐Jacques

doi:10.1016/j.amjhyper.2003.09.010

Cited by 73 publications

(49 citation statements)

References 22 publications

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“…In subjects with preserved EF, it has been shown that the level of PP is proportional to the number of atherosclerotic coronary stenosis. 13 On the opposite, arterial occlusion that represents the major consequences of coronary stenosis is obviously associated to the extent of myocardial infarction and necrosis, and hence to reduced aortic PP (Table 5).…”

Section: Discussionmentioning

confidence: 99%

“…11,16,17 Invasive intra-aortic SBP and DBP were measured at the time of coronary angiography using a fluid-filled catheter at baseline before any injection of contrast medium as previously documented. 13 Aortic PP was calculated as the difference between aortic SBP and aortic DBP. Heart rate was recorded using electrocardiographic monitoring.…”

Section: Methodsmentioning

confidence: 99%

“…Left ventricular EF was measured on the 301 right anterior oblique projection, using the commercial software available at each of the participating centres. [10][11][12][13][14][15][16] All measurements were performed in the morning and at stable room temperature, after an overnight fast. Brachial BP measurements were performed by traditional mercury sphygmomanometer in the supine position after a 15 min rest in the laboratory, using the first and the fifth Korotkoff sounds for SBP and DBP, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…[10][11][12][13] Several of them have shown a significant association between aortic PP (but not aortic SBP) or aortic stiffness with the presence and extent of atherosclerotic stenosis of the coronary arteries. 11,13,14 However such investigations were mainly documented in subjects with preserved cardiac function, as judged from ejection fractions (EFs). Studies in populations at high CV risk and consistently reduced EF are more difficult to interpret.…”

Section: Introductionmentioning

confidence: 99%

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Aortic pulse pressure and atherosclerotic structural alterations of coronary arteries

Mourad

Danchin²,

Rudnichi

et al. 2009

J Hum Hypertens

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Pulse pressure (PP) is an independent predictor of myocardial infarction, mainly above 50 years of age. In subjects with preserved ejection fraction (EF), aortic PP predicts the severity of coronary atherosclerosis. Comparable findings in subjects with reduced EF have not been evaluated. In 1337 subjects with severe coronary ischaemic disease, intra-aortic and brachial blood pressures were measured together with EF and coronary angiography to evaluate cardiac function, the presence of coronary stenosis and/or occlusions or calcifications. The presence (odds ratio±95% CI) of coronary calcification was marginally but not significantly associated (P ¼ 0.06) to increased aortic PP (1.32 (0.97-1.80)), whereas that of coronary occlusion was significantly associated (Po0.01) with decreased aortic PP (0.62 (0.42-0.91)), even after adjustment to EF and heart rate. Increased aortic PP did not correlate with stenosis number. No comparable predictive value was observed using intra-aortic or non-invasive brachial systolic blood pressure (SBP) or diastolic blood pressure (DBP). In high cardiovascular risk populations, even in the presence of reduced EF and high heart rate, intra-aortic PP, but not SBP or DBP, is a significant predictor of coronary occlusions and possibly calcifications, but not stenosis.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Aortic pulse pressure and atherosclerotic structural alterations of coronary arteries

Mourad

Danchin²,

Rudnichi

et al. 2009

J Hum Hypertens

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“…22 Furthermore, findings of the multicentre ESCAPP study showed that aortic PP was significantly related to the presence and extent of coronary artery disease in patients without antihypertensive therapy. 23 It is surprising that in various mega trials addressing the performance of various treatment modalities for hypertension, their influence on PP is not taken into account. Currently, the choice of the drug for the initial treatment of hypertension is very strongly debuted.…”

Section: Discussionmentioning

confidence: 99%

Differential pulse pressure response to various antihypertensive drug families

et al. 2006

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Pulse pressure (PP) is emerging as a major pressure predictor of cardiac disease. The study comprised 10 185 untreated patients with essential hypertension. A total of 5395 men and 4790 women 56713 years old, with uncomplicated essential hypertension, after a 15-day washout period and after 6 months of antihypertensive monotherapy were included. All patients included in the final cohort were responders and had normalized their blood pressure. PP was decreased least with diuretics (À5 mm Hg) and most with angiotensin II receptor blockers (ARBs) and calcium antagonists (À15 mm Hg), followed by angiotensin-converting enzyme inhibitors (ACEI) (À12 mm Hg) a-and b-blockers (À10 and À9 mm Hg), differentiating among antihypertensive classes (Po0.001). The magnitude of PP fall was related to the degree of left ventricular (LV) mass reduction (Po0.001), seen best with ARBs (r ¼ 0.42) and least with ACEIs (r ¼ 0.18). Of the antihypertensive medications used in everyday practice, PP decrease may be achieved best with ARBs and calcium antagonists, whereas diuretics confer poor response. PP was decreased least with diuretics (À5 mm Hg) and most with ARBs and calcium channel blockers (À15 mm Hg), followed by ACEI (À12 mm Hg) a-and b-blockers (À10 and À9 mm Hg), differentiating among antihypertensive classes (Po0.001). Of the antihypertensive medications used in everyday practice, PP decrease may be achieved best with ARBs and calcium antagonists.

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Coronary artery disease and its impact on the pulsatile brain: A functional NIRS study

Mohammadi

Thomas

Peng

et al. 2021

Human Brain Mapping

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Recent studies have reported that optical indices of cerebral pulsatility are associated with cerebrovascular health in older adults. Such indices, including cerebral pulse amplitude and the pulse relaxation function (PRF), have been previously applied to quantify global and regional cerebral pulsatility. The aim of the present study was to determine whether these indices are modulated by cardiovascular status and whether they differ between individuals with low or high cardiovascular risk factors (LCVRF and HCVRF) and coronary artery disease (CAD). A total of 60 older adults aged 57-79 were enrolled in the study. Participants were grouped as LCVRF, HCVRF, and CAD. Participants were asked to walk freely on a gym track while a near-infrared spectroscopy (NIRS) device recorded hemodynamics data. Low-intensity, short-duration walking was used to test whether a brief cardiovascular challenge could increase the difference of pulsatility indices with respect to cardiovascular status. Results indicated that CAD individuals have higher global cerebral pulse amplitude compared with the other groups. Walking reduced global cerebral pulse amplitude and PRF in all groups but did not increase the difference across the groups. Instead, walking extended the spatial distribution of cerebral pulse amplitude to the anterior prefrontal cortex when CAD was compared to the CVRF groups. Further research is needed to determine whether cerebral pulse amplitude extracted from data acquired with NIRS, which is a noninvasive, inexpensive method, can provide an index to characterize the cerebrovascular status associated with CAD.

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Aortic pulse pressure is related to the presence and extent of coronary artery disease in men undergoing diagnostic coronary angiography: a multicenter study

Abstract: In this multicenter study, aortic PP was significantly correlated with the presence and extent of CAD in patients without antihypertensive therapy. This correlation, however, was independent of other risk factors for CAD in men but not in women.

Cited by 73 publications

References 22 publications

Aortic pulse pressure and atherosclerotic structural alterations of coronary arteries

Aortic pulse pressure and atherosclerotic structural alterations of coronary arteries

Differential pulse pressure response to various antihypertensive drug families

Coronary artery disease and its impact on the pulsatile brain: A functional NIRS study

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