Stiffness of systemic arteries in patients with myocardial infarction. A noninvasive method to predict severity of coronary atherosclerosis.

Abstract

The static elastic properties of arterial tree (abdominal aorta and common carotid artery) were studied in 19 normal subjects and in 49 patients with myocardial infarction with an ultrasonic phase-locked echo-tracking system that allows continuous transcutaneous measurement of the arterial diameter. The stifTness index (, which represented the mechanical properties in the arterial wall, was calculated from the relation between systemic blood pressure and the diameter of the artery. Patients with myocardial infarction underwent coronary angiography in their convalescent period to determine involved vessels. In 11 patients, coronary artery was patent; 15 patients had one-vessel disease, 12 had two-vessel disease, and the remaining 11 patients had three-vessel disease. In normal subjects, increasing age was associated with an increase in arterial stiffness. An average value of the stiffiess index of the abdominal aorta was 8.58±3.02 (mean± SD) and that of common carotid artery was 9.17±2.22. In patients with three-vessel disease, these values were significantly higher (22.37± 4.29 in abdominal aorta and 13.17 ±4.56 in common carotid artery) than those in normal subjects. Stiffness index of patients with two-or one-vessel disease was also increased but lower than those in patients with three-vessel disease (p<0.05). Forty-four of 49 patients with infarction had an arterial stiffness index of abdominal aorta higher than the 95% confidence limits of the normal data (p<0.05).Twenty-eight patients were outside the nomogram of common carotid artery (p<0.05). The mechanical properties of these elastic arteries provided sufficiently reliable information on changes caused by atherosclerosis. (Circulation 1989;80:78-86) T he amount of severity of atherosclerosis in the coronary bed shows a positive correlation with the degree of atherosclerosis in the aorta or other major arterial branches.1-5 Atherosclerotic changes in arterial wall have been shown to include smooth muscle cell proliferation, deposition of lipid, and accumulation of collagen, elastin, and proteoglycans.6,7 Changes in the ratio of collagen to elastin have been known to structurally affect the elastic behavior of arterial walls. The former is much stiffer than the latter, the elastic modulus (Young's modulus) being about 1,000x 106 dynes/ cm' at 100% elongation in collagen and only 3 x 106 dynes/cm2 in elastin.8,9 However, conflicting results

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

“…2 Among them, carotid stiffness b is used to easily evaluate arterial stiffness in the clinical setting, because it was found to be independent of blood pressure within the normal physiological range and was associated with the severity of hypertension and coronary atherosclerosis. 19,20 However, this parameter is based on the cyclic changes of the internal luminal diameter of the artery and does not take into account the expansion of the intima-media wall itself. Currently, 2DST is available to detect regional myocardial deformation in various cardiac diseases.…”

Carotid Intimal-Medial Thickness and Stiffness Are Not Affected by Hypercholesterolemia in Uncomplicated Essential Hypertension

“…32 Carotid stiffness was also calculated by the pressureindependent stiffness index ␤ according to the formula 33,34 …”

Aortic pulse pressure and atherosclerotic structural alterations of coronary arteries

“…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.…”

“…[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.…”