Possible link between large artery stiffness and coronary flow velocity reserve

Saito, Makoto; Okayama, Hideki; Nishimura, Kazuhisa; Ogimoto, Akiyoshi; Ohtsuka, Tomoaki; Inoue, Kentaro; Hiasa, Go; Sumimoto, Takumi; Higaki, Jitsuo

doi:10.1136/hrt.2007.126128

Cited by 71 publications

(67 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…18 Furthermore, increased arterial stiffness is an independent prognostic predictor of cardiovascular events in several populations. 1 Thus, a non-invasive assessment of arterial stiffness is important in terms of an early stratification for future cardiovascular events.…”

Section: Discussionmentioning

confidence: 99%

Carotid arterial circumferential strain by two-dimensional speckle tracking: a novel parameter of arterial elasticity

Saito¹,

Okayama

Inoue

et al. 2012

Hypertens Res

View full text Add to dashboard Cite

Recently, the development of two-dimensional speckle-tracking (2DST) technology has allowed the direct measurement of the elastic parameters of the carotid arterial wall. The aims of this study were to determine the feasibility of measuring peak circumferential strain (CS) of the carotid arterial wall using 2DST and to compare this value with conventional arterial stiffness parameters in subjects with and without hypertension. The study included 90 healthy subjects and 40 age-and sex-matched patients with hypertension. The short-axis view of the right common carotid artery was recorded. The CS in the posterior region of the carotid artery was calculated by 2DST using special software and corrected by the following equation: e circ ¼ ln (systolic blood pressure/diastolic blood pressure)/CS. We simultaneously measured the stiffness index b (b) at the same location and the brachial-ankle pulse wave velocity (baPWV). Sixty randomly selected healthy subjects were used to assess the inter/ intra-observer variability of e circ and b. In healthy subjects, e circ was significantly correlated with b, age and baPWV. These correlations were slightly better than the corresponding correlations of b with age and baPWV. The hypertensive patients had a significantly larger e circ than the healthy subjects (0.112 ± 0.074 vs. 0.066 ± 0.029/%, Po0.001). The inter/intra-observer variability for e circ was significantly lower than that for b. Our data suggest that the measurement of carotid e circ using 2DST is feasible and has better reproducibility than conventional carotid arterial stiffness.

show abstract

Section: Discussionmentioning

confidence: 99%

Carotid arterial circumferential strain by two-dimensional speckle tracking: a novel parameter of arterial elasticity

Saito¹,

Okayama

Inoue

et al. 2012

Hypertens Res

View full text Add to dashboard Cite

show abstract

“…Several conditions can be associated with decreased CFR, such as a significant epicardial coronary artery stenosis, but also aging, aortic valve stenosis, left ventricular (LV) hypertrophy, hypertrophic and dilated cardiomyopathy, and even isolated coronary microvascular dysfunction 20, 21, 22, 23. Although previous studies have shown an inverse relationship between arterial stiffness and CFR,24, 25 limited information is available on the relationships between PP and CFR, in particular in patients who have cardiovascular risk factors but are free of obstructive coronary artery disease 26, 27, 28. Accordingly, the aim of our study was to evaluate the relationships of PP with noninvasively determined CFR and its components, ie, resting and hyperemic coronary flow velocities, in patients without angiographic evidence of epicardial coronary artery stenosis.…”

Section: Introductionmentioning

confidence: 99%

Association Between Elevated Pulse Pressure and High Resting Coronary Blood Flow Velocity in Patients With Angiographically Normal Epicardial Coronary Arteries

Lembo

Sicari

Esposito

et al. 2017

JAHA

View full text Add to dashboard Cite

BackgroundThe aim of our study was to evaluate the relationship of pulse pressure (PP), a raw index of arterial stiffness, with noninvasively determined coronary flow reserve (CFR) and its components, in patients with angiographically normal epicardial coronary arteries.Methods and ResultsThe study population included 398 patients without angiographic evidence of coronary stenosis, who underwent high‐dose dipyridamole stress echocardiography with transthoracic‐derived CFR evaluation on the left anterior descending artery. CFR was calculated as the ratio between high‐dose dipyridamole and resting coronary diastolic peak velocities. Patients were divided into 2 groups: the first group included the first and second PP tertiles (n=298, PP ≤60 mm Hg) and the second group included the highest PP tertile (n=100, PP >60 mm Hg). Mean blood pressure, systolic blood pressure (both P<0.0001), age (P<0.002), and left ventricular mass index (P=0.013) were higher in the highest PP tertile, which also showed higher resting coronary flow velocity (31.6±9.6 cm/s versus 27.7±6.4 cm/s, P<0.0001) and marginally lower CFR (2.5±0.6 versus 2.6±0.6, P=0.044). Hyperemic coronary flow velocity did not differ between the 2 groups. By separate multiple linear regression analyses, after adjusting for sex, age, the highest systolic blood pressure tertile (≥140 mm Hg), left ventricular mass index, and cardiovascular risk factors, the highest PP tertile was associated with resting coronary flow velocity (P=0.003) and only marginally with hyperemic coronary flow velocity (P<0.02), whereas its association with CFR was not significant.ConclusionsIn patients without epicardial coronary artery stenosis, the highest PP tertile is associated with an increased coronary flow velocity at rest.

show abstract

“…baEI is associated with left ventricular function, 41 left ventricular hypertrophy, 6,42 and impaired coronary perfusion. 43 Furthermore, baEI is an independent predictor of longitudinal increases in BP, as well as of new onset of hypertension and microalbuminuria. 44,45 An interesting finding of our analysis is that baEI is a predictor of all-cause mortality in addition to CV outcomes.…”

Section: Baei: Clinical Implicationsmentioning

confidence: 99%

Prediction of Cardiovascular Events and All-Cause Mortality With Brachial-Ankle Elasticity Index

et al. 2012

View full text Add to dashboard Cite

Abstract-Brachial-ankle elasticity index (baEI; also known as brachial-ankle pulse wave velocity) has been proposed as a surrogate end point for cardiovascular disease. We performed a meta-analysis of longitudinal cohort studies for determining the ability of baEI to predict risk of cardiovascular events and all-cause mortality and dissecting factors influencing this predictive ability. Multiple online databases, reference lists from retrieved articles, and abstracts from international cardiovascular conventions were searched until April 2012. Longitudinal cohort studies that reported associations of baEI with clinical risk were included. Of the 18 studies included (8169 participants; mean follow-up, 3.6 years), 15 reported results on total cardiovascular events (5544 individuals), 7 on cardiovascular mortality (2274 individuals), and 9 on all-cause mortality (5097 individuals). The pooled relative risks for total cardiovascular events, cardiovascular mortality, and all-cause mortality were 2.95 (95% CI, 1.63-5.33), 5.36 (95% CI, 2.17-13.27), and 2.45 (95% CI, 1.56 -3.86), respectively, for subjects with high versus low baEI (all PϽ0.001). An increase in baEI by 1 m/s corresponded with an increase of 12%, 13%, and 6% in total cardiovascular events, cardiovascular mortality, and all-cause mortality, respectively. We conclude that baEI is associated with increased risk of total cardiovascular events and all-cause mortality. Issues such as expansion of data to non-Asian populations, validation of path length estimation, determination of reference values, and prospective comparison with carotid-femoral pulse wave velocity remain to be resolved. (Hypertension. 2012;60:556-562.) • Online Data Supplement Key Words: brachial-ankle pulse wave velocity Ⅲ cardiovascular risk Ⅲ cardiovascular disease Ⅲ mortality Ⅲ prediction Ⅲ meta-analysis Ⅲ arterial stiffness A rterial stiffness is increasingly recognized as a surrogate end point for cardiovascular (CV) disease and is associated with presence of CV risk factors and atherosclerotic disease.1 Arterial stiffness can be measured with noninvasive, reproducible, and relatively inexpensive techniques, and, thus, it is suitable for large-scale studies. Carotid-femoral pulse wave velocity (PWV; cfPWV) is considered the goldstandard method for assessing aortic stiffness 2 and predicts future CV events and all-cause mortality in a strong and independent manner. Brachial-ankle PWV, calculated as the ratio of the distance between the brachial and the tibial artery divided by the transit time between these 2 arteries, has been proposed as an additional arterial biomarker of CV risk. PWV is classically referred to "segmental stiffness." Because of the complexity of the anatomic course of the brachial-ankle arterial system, it is unclear whether the term brachial-ankle PWV is appropriate to define any particular segmental stiffness or whether it is just the ratio of a virtual brachial-ankle distance and the measurement of the brachial-ankle transit time. For this reason, this index will ...

show abstract

Possible link between large artery stiffness and coronary flow velocity reserve

Abstract: The data suggest that large artery stiffening is linked to a reduction of CFVR, which may partially explain the higher cardiac event rate in patients with increased large artery stiffness.

Cited by 71 publications

References 31 publications

Carotid arterial circumferential strain by two-dimensional speckle tracking: a novel parameter of arterial elasticity

Carotid arterial circumferential strain by two-dimensional speckle tracking: a novel parameter of arterial elasticity

Association Between Elevated Pulse Pressure and High Resting Coronary Blood Flow Velocity in Patients With Angiographically Normal Epicardial Coronary Arteries

Prediction of Cardiovascular Events and All-Cause Mortality With Brachial-Ankle Elasticity Index

Contact Info

Product

Resources

About