Does increased aortic stiffness predict reduced coronary flow velocity reserve in patients with suspected coronary artery disease?

Abstract

In recent studies, reduction in coronary flow velocity reserve (CFR) has been demonstrated in patients with increased aortic stiffness. Stress transoesophageal echocardiography (TEE) is a suitable method for the simultaneous evaluation of CFR and aortic stiffness parameters. The present study was designed to test whether increased echocardiography-derived aortic elastic modulus [E(p)] predicts impaired CFR in patients with suspected coronary artery disease (CAD). The present study comprised 158 patients with suspected CAD. A CFR value < 2 was considered abnormal. Both men grade of aortic atherosclerosis (AA) (as a morphologic characteristic) (1.31 ± 0.68 vs. 1.02 ± 0.89, p < 0.05) and aortic distensibility (E(p) as a functional characteristic) (892 ± 594 mmHg vs. 723 ± 495 mmHg, P < 0.05) were increased in subjects with CFR < 2. In ROC analysis, the cut-off value for E(p) to predict impaired CFR was ≥ 670 mmHg, with 61% sensitivity and 61% specificity (ROC area 0.60, p = 0.026). The logistic regression model identified higher AA grade (hazard ratio (HR) 2.01, p < 0.05) and increased E(p) as independent predictors of reduced CFR (HE 1.10, p < 0.05). Increased aortic stiffness predicts impaired CFR in patients with suspected CAD.