Association of impaired arterial wall properties with the presence of coronary artery disease in patients with abdominal aortic aneurysms

Abstract

Pulse wave velocity (PWV) is a valid, clinically feasible marker of arterial stiffening, and a strong predictor of outcomes. The present study aimed to compare aortic elastic properties in patients with abdominal aortic aneurysms (AAA), with or without coronary artery disease (CAD), as well as healthy individuals. A total of 130 patients with AAA, eligible for interventional repair, and 30 healthy individuals, comprising the control group (HC), were enrolled. Presence of CAD was identified by coronary angiography. Aortic PWV (aPWV) was measured using the Arteriograph. aPWV was found considerably higher in AAA patients compared with HC group (11.5 ± 2.9 vs 7.3 ± 1.6 m/s, P < .001). Importantly, among patients with AAA, those with concomitant CAD (n = 41) had greater aPWV than those without CAD (12.5 ± 2.9 vs 11.0 ± 3.0 m/s, P = .03). In receiver operator curve (ROC) analysis, a value of aPWV above 12.8 m/s was identified to correlate with the presence of CAD in the AAA patient population. After adjustment for confounders, including hypertension which is one of the major risk factors for abdominal aneurysms, multivariate logistic regression analysis revealed that this aPWV cutoff remained independently associated with presence of CAD [odds ratio = 1.64, 95% confidence interval =1.19‐4.08, P = .03]. The coexistence of CAD and AAA is characterized by a greater arterial stiffness. This finding should be taken into consideration when selecting endovascular stents with more favorable elastic properties. Moreover, AAA patients with high aPWV (>12.8 m/s) are more likely to also have CAD, and this may be considered by vascular surgeons when evaluating patients' cardiovascular risk.

The Presence of Simple Renal Cysts Is Associated With Increased Arterial Stiffness in Patients With Abdominal Aortic Aneurysm

“…One metaanalysis included 5 eligible case-control studies enrolling a total of 2897 participants, and demonstrated a 2.5-fold prevalence of SRC in patients with AAA compared with subjects without AAA, suggesting that SRC may be associated with AAA. 4 Another meta-analysis, including 11 retrospective studies, demonstrated that the cumulative incidence of SRC among patients with AAA and no-AAA was 55% and 32%, respectively, with statistically higher odds of 3.02 of SRC among patients with AAA. 5 A common genetic or pathophysiologic link between aortic aneurysms and SRC has been proposed.…”

“…Pulse wave velocity is higher in patients with AAA than healthy control patients, indicating that AAA may be associated with increased AS, in other words, reduced arterial elasticity; 3-5 aortic PWV was significantly higher in patients with AAA than control patients, after adjustment for age, sex, and mean arterial pressure. 4 Alterations in arterial wall composition, such as elastin and collagen, and inflammation were proposed as contributors to increased AS in AAA. In this study, the value of PWV was as high as 1919 ± 399 cm/s in all patients with AAA.…”

“…2 Previous studies have shown that development of AAA is related to increased AS. [3][4][5] Recently, it has been reported that several clinical conditions, including intracranial aneurysm, aortic arch anomalies, bicuspid aortic valve, temporal arteritis, a positive history of aneurysmal disease, a positive thumb-palm sign, and presence of simple renal cysts (SRC), are linked to aneurysm development; these diseases are possible manifestations of common connective tissue degeneration. 6 SRC are a fluid collection in the kidney that is usually benign in nature and a common finding on imaging tests.…”

Changes in aortic stiffness and the hemodynamics following endovascular repair of the thoracic aorta of patients with blunt thoracic aortic injury

“…These patients present aortic vascular diseases and many cerebrovascular risk factors. A recent study showed an association of impaired arterial wall properties with the presence of coronary artery disease in patients with aortic aneurysms [7]. On the contrary, implantation of a relatively rigid tube in a previous healthy not atherosclerotic descending thoracic aorta may result in loss of compliance of the underlying aortic wall and cause impaired cardiac diastolic function and protracted systolic hypertension requiring antihypertensive treatment.…”