P1503 Aortic root distensibility and stiffness assessed by echocardiography as predictors of coronary artery lesion severity in patients undergoing coronary angiography

Abstract

Abstract Background Aortic stiffness (AS) and distensibility (AD) have been shown as predictors for cardiovascular morbidity and mortality. Aim: To assess the relation of aortic stiffness and distensibility using simple two-dimensional (2D) and tissue Doppler imaging (TDI) derived measures with the severity of coronary artery disease (CAD) assessed using the syntax score (SS), evaluating which of these measures has better predictivity for CAD severity. Methods We prospectively enrolled 150 individuals who underwent elective coronary angiography for suspected CAD, out of them 29 subjects (19.3%) had normal angiographic findings, while 121 (80.7%) subjects had CAD for whom the SS was calculated. All patients underwent simple 2D and TDI echocardiographic assessment of AS and AD. Results Patients with CAD had significantly higher aortic stiffness and elastic modulus and significantly lower aortic distensibility, aortic strain, aortic peak systolic and peak early diastolic velocities compared to those without CAD. Univariate and multivariate logistic regression analysis showed that decreased aortic distensibility, aortic strain, aortic peak early diastolic velocity and increased elastic modulus were predictors for the severity and complexity of CAD. However, along with diabetes, increased aortic stiffness index (> 17.7) was the only independent predictor of CAD severity, carrying twice the odds of having moderate-high syntax score (OR= 2.19, 95% CI= 0.97 – 4.95, p< 0.05). Conclusion Aortic stiffness index can be a screening tool for detecting patients with more severe CAD. Univariate analysis Multivariate analysis Variables Odd’s ratio 95% confidence interval P value Odd’s ratio 95% confidence interval P value Age (years) 0.98 0.94-1.01 0.3 – –- – Sex (male) 1.52 0.58- 3.94 0.3 – –- – Smoking 1.21 0.59- 2.50 0.5 – –- – Diabetes mellitus 5.00 2.29-10.90 0.000 4.99 2.21- 11.31 0.000 Body mass index 0.93 0.83- 1.04 0.2 – –- – ↓↓ Distensibility (≤3.8)* 2.62 1.08- 4.70 0.02 2.01 0.91- 4.46 0.08 ↑↑ Stiffness index (>17.7)* 2.06 0.99- 4.27 0.05 2.19 0.97- 4.95 <0.05 ↑↑ Elastic modulus (>68.7)* 2.22 1.06- 4.64 0.03 2.01 0.91- 4.45 0.08 ↓↓ Aortic strain (≤9.3%)* 2.04 0.97- 4.27 0.05 1.64 0.73- 3.67 0.2 ↓↓ SAo (≤7cm/sec) 1.49 0.71- 3.12 0.2 – –- – ↓↓ EAo (≤9cm/sec) 2.30 1.08- 4.90 0.03 1.80 0.79- 4.10 0.1 Predictors of severity and complexity of CAD