Non-invasively measured aortic wave reflection and pulse pressure amplification are related to the severity of coronary artery disease

Abstract

Background: Augmentation index (AIx) and pulse pressure amplification (PPA, here the aortic/brachial pulse pressure ratio) are an age-related emerging risk factor for cardiovascular disease. However, it has not been clearly shown that AIx and PPA predict a high risk of coronary artery disease (CAD). Objectives: The aim of the study was to investigate the association between non-invasively measured aortic wave reflection (AWR) and PPA and CAD. Methods: The study group consisted of 80 patients who were admitted to our institute for elective coronary angiography. We non-invasively measured augmentation pressure (AP), AIx, and PPA using radial applanation tonometry. Results: When the extent of CAD was divided by no or minimal CAD, 1- or 2- and 3-vessel disease (VD), there was a significant association between the extent of CAD and AIx and PPA in patients aged <65 years, but not in patients aged >= 65 years. In multivariate regression analysis after controlling the traditional risk factors, the odds ratio of having 3VD was significant in patients aged <65 years: 2.15(1.04-4.44; p = 0.039) per 5% increase of AIx and 2.02 (1.15-3.55; p = 0.015) per 0.05 increase of PPA, but not in patients aged >= 65 years. The severity of CAD expressed as a Gensini score showed a significant correlation with AP, AIx, and PPA in patients aged <65 years, but not in patients aged >= 65 years. Conclusion: Increasing of non-invasively measured AWR and PPA is related to the severity of CAD, particularly in younger patients up to 65 years of age. (C) 2013 Published by Elsevier Ltd on behalf of Japanese College of Cardiology.