Comparison of Aortic and Carotid Arterial Stiffness Parameters in Patients With Verified Coronary Artery Disease

Abstract

Background: Arterial stiffness parameters are commonly used to determine the development of atherosclerotic disease. The independent predictive value of aortic stiffness has been demonstrated for coronary events. Hypothesis: The aim of our study was to compare regional and local arterial functional parameters measured by 2 different noninvasive methods in patients with verified coronary artery disease (CAD). We also compared and contrasted these stiffness parameters to the coronary SYNTAX score in patients who had undergone coronary angiography. Methods: In this study, 125 CAD patients were involved, and similar noninvasive measurements were performed on 125 healthy subjects. The regional velocity of the aortic pulse wave (PWVao) was measured by a novel oscillometric device, and the common carotid artery was studied by a Doppler echo-tracking system to determine the local carotid pulse wave velocity (PWVcar). The augmentation index (AIx), which varies proportionately with the resistance of the small arteries, was recorded simultaneously. Results: In the CAD group, the PWVao and aortic augmentation index (Alxao) values increased significantly (10.1 ± 2.3 m/sec and 34.2% ± 14.6%) compared to the control group (9.6 ± 1.5 m/sec and 30.9% ± 12%; P < 0.05). We observed similar significant increases in the local stiffness parameters (PWVcar and carotid augmentation index [Alxcar]) in patients with verified CAD. Further, we found a strong correlation for PWV and AIx values that were measured with the Arteriograph and those obtained using the echo-tracking method (r = 0.57, P < 0.001 for PWV; and r = 0.65, P < 0.001 for AIx values). Conclusions: Our results indicate that local and regional arterial stiffness parameters provide similar information on impaired arterial stiffening in patients with verified CAD.

Comparison between Regional and Local Pulse‐Wave Velocity Data

“…The association between the two variables remained significant after adjusting for possible confounding factors. This finding is confirmatory of previously published data in different clinical settings . Regarding direct comparison between regional and local PWV values, we found only a single study comparing cfPWV with local (abdominal aorta) PWV values .…”

“…Some clinical studies analyzed both local PWV and cfPWV, showing that these parameters increase in parallel in the presence of other evidence of subclinical atherosclerosis, such as carotid plaque . Although there is consistency regarding the good correlation between regional and local PWV values in clinical and experimental settings, regional PWV has been shown to be more sensitive to detect changes in arterial stiffness than local PWV . The only available comparison between local (at the abdominal aorta) and regional PWV in a small group of healthy subjects describes significantly lower local PWV versus cfPWV in the subgroup with PWV ≤7 m/s, and significantly higher local versus regional PWV in individuals with PWV >7 m/s …”

Interplay between arterial stiffness and diastolic function

“…Other studies provided similar results. 44,45 Therefore, high-resolution echo-tracking has emerged as a fast and accurate tool of which the major advantage is that local arterial stiffness is directly determined from the change in pressure that drives the change in volume without using assumptions from a circulation model. 20 Previous studies have demonstrated possible clinical applications of this software, highlighting the feasibility of vascular function assessment in different clinical conditions.…”

Increased aortic stiffness in ulcerative colitis

“…Stefanadis et al described that such noninvasive measurements of aortic elastic properties by echocardiography are as accurate as invasive methods [7]. PWV and Aix are another two major characteristics of arterial stiffness, their measurement by Arteriograph has recently been validated [4,[8][9][10].…”

“…The aortic elasticity parameters was calculated as follows: Pulse-wave assessment. The oscillometry-based Arteriograph device was used in all cases to measure aortic PWV and Aix [4,[8][9][10]. It is based on the complete occlusion of the brachial artery by a simple cuff allowing recording and separation of pronounced early forward and late reflected systolic waves [8][9][10].…”