Clinical Impliaction of Carotid-Radial Pulse Wave Velocity for Patients with Coronary Artery Disease

Abstract

Background and Objectives : Arterial stiffness assessed non-invasively with the aortic pulse wave velocity (PWV) has been associated with atherosclerosis in the coronary arteries and also cardiovascular mortality. The aim of this study was to determine whether arterial stiffness may predict the severity of coronary artery disease (CAD). Subjects and Methods : We enrolled 106 consecutive, symptomatic patients (males: 71 (67%), mean age: 57.0±10.5 years) who underwent coronary angiography. The extent of the CAD was defined by single or multiple vessel disease according to the number of coronary vessels with a ≥50% narrowing, the lesion type according to the AHA/ACC guidelines, and a modified stenosis scoring system. Arterial stiffness was characterized by measurement of the carotid-radial PWV. In addition, such cardiovascular risk factors as the body mass index, hypertension, smoking, LDL-and HDL-cholesterol, ejection fraction (EF), left ventricle mass index (LVMI), pulse pressure, plasma homocysteine and C-reactive protein (CRP) were evaluated. Results : The carotid-radial PWV in multiple vessel CAD was faster than in single vessel CAD and the normal arteries (10.33±1.46 vs. 8.76±1.65 m/sec, respectively, p<0.001). On the univariate analysis, the extent of the CAD, as expressed as a modified stenosis score, was associated with the total cholesterol, LDL-cholesterol, the EF and the PWV. However, on the multivariate analysis, the extent of CAD was associated with the carotid-radial PWV (p<0.001). Conclusion : Arterial stiffness identified by carotid-radial PWV may predict the severity of the CAD after adjusting for other cardiovascular risk factors.