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KMID : 0978920090100040274
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Korean Journal of Clinical Geriatrics
2009 Volume.10 No. 4 p.274 ~ p.380
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Impaired Aortic Distensibility as an Independent Marker of Coronary Artery Disease
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Kim Eung-Ju
Seo Hong-Seog
Lim Sung-Yoon
Kim Mi-Na
Na Jin-Oh
Choi Cheol-Ung
Kim Jin-Won
Lim Hong-Euy
Rha Seung-Woon
Park Chang-Gyu
Oh Dong-Joo
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Abstract
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Background: Elastic properties of aorta have been known to be abnormal in patients with coronary artery disease (CAD). However, aortic distensibility (AD), one of the elasticity indexes, has not been ascertained whether it is independently associated with CAD.
Methods: We prospectively enrolled 305 subjects (107 patients with CAD and 198 patients without it) among 373 consecutive patients undergoing coronary angiography for the assessment of suspected CAD. Patients with acute coronary syndrome, previous myocardial infarction, valvular heart disease more than mild, left ventricular ejection fraction ＜40%, atrial fibrillation, and history of coronary intervention or surgery were excluded. Aortic diameters were measured at a level 3 cm above the aortic valve using echocardiography. AD (cm2×dyn-1×10-6) was calculated from the aortic diameters and brachial artery pressure using the formula: 2×(change in aortic diameter)/(diastolic aortic diameter×pulse pressure).
Results: Systolic, diastolic blood pressure and pulse rate were similar in both CAD and control subjects. AD was significantly lower in patients with CAD than controls (1.15±0.30 vs. 3.00±0.25, P＜0.001). In multivariate analysis, AD remained significantly associated with CAD (P＜0.001) after adjustment for age, gender, hypertension, diabetes, hyperlipidemia and smoking. Moreover, AD showed significant inverse relationship with the severity of CAD, expressed as one-, two-, and three-vessel disease(P＜0.001).
Conslusion: Our findings suggest that impaired AD is an independent risk marker for CAD, as well as significantly associated with the severity of CAD.
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KEYWORD
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Aortic distensibility, Aortic ela sticity, Coronary artery disease
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