Abstract
The aim of this study was to investigate whether brachial-ankle pulse wave velocity (baPWV) is associated with the severity of coronary artery disease (CAD) assessed by coronary computed tomography angiography (CCTA), and to evaluate baPWV as a predictor of obstructive CAD on CCTA. A total of 470 patients who underwent both baPWV and CCTA were included. We evaluated stenosis degree and plaque characteristics on CCTA. To estimate the severity of CAD, we calculated the number of segment with plaque (segment involvement score; SIS), stenosis degree-weighted plaque score (segment stenosis score; SSS), and coronary artery calcium score (CACS). The mean baPWV was 1,485 ± 315 cm/s (range, 935-3,175 cm/s). Non-obstructive (stenosis < 50%) and obstructive (stenosis ≥ 50%) CAD was found in 129 patients (27.4%) and 144 (30.6%), respectively. baPWV in patients with obstructive CAD was higher than that of patients with non-obstructive (1,680 ± 396 cm/s versus 1,477 ± 244 cm/s, P < 0.001) or no CAD (1,680 ± 396 cm/s versus ± 196 1,389 cm/s, P < 0.001). baPWV showed significant correlation with SSS (r = 0.429, P < 0.001), SIS (r = 0.395, P < 0.001), CACS (r 0.346, P < 0.001), and the number of segment with non-calcified plaque (r 0.092, P = 0.047), mixed plaque (r = 0.267, P < 0.001), and calcified plaque (r = 0.348, P < 0.001), respectively. The optimal baPWV cut-off value for the detection of obstructive CAD was 1,547 cm/s. baPWV ≥ 1,547 cm/s was independent predictor for the obstructive CAD. In conclusion, baPWV is well correlated with the severity of CAD evaluated by CCTA. baPWV has the potential to predict severity of coronary artery atherosclerosis.
Highlights
Arterial stiffness represents arterial aging and arteriosclerosis [1,2]
The present study showed that brachial-ankle pulse wave velocity (baPWV) has significant positive correlations with coronary artery disease (CAD) extent, severity and calcium score (CACS) as assessed by coronary computed tomography angiography (CCTA)
The predicting power of baPWV for obstructive CAD was independent of age, sex and traditional risk factors, which was confirmed in the multivariable analysis
Summary
Increased arterial stiffness is associated with an increased risk of cardiovascular morbidity and mortality [3,4,5,6,7]. Pulse wave velocity (PWV) is a noninvasive method measuring arterial stiffness. PWV has been widely applied, and played an important role as an indicator of atherosclerotic burden and future cardiovascular events independent of conventional risk factors [3,7,10,11]. Because of the noninvasive nature and high specificity and negative predictive value of CCTA, it has been commonly used for the evaluation of coronary artery disease (CAD) [12,13,14]. CCTA allows the evaluation of plaque characteristics and the calcium amount of the coronary tree, which provide additional information on the coronary risk [15,16,17]
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