Fractional diastolic and systolic pressure in the ascending aorta are related to the extent of coronary artery disease.
BACKGROUND
Ascending aortic fractional pulse pressure and fractional systolic pressure (FSP) were demonstrated to differentiate patients with and without coronary artery disease. However, no study so far has analyzed the relationship between FSP and fractional diastolic pressure (FDP) and the extent of coronary artery disease. Therefore, we investigated the relationship between ascending aortic FSP and FDP and the extent of coronary atherosclerosis in unselected patients with angiographically confirmed coronary artery disease.


METHODS
The study group consisted of 445 patients (350 men and 95 women, mean age 58.5 +/- 9.7 years) with angiographically confirmed coronary artery disease and ejection fraction > 55%. Invasive ascending aortic blood pressure during catheterization and conventional sphygmomanometer measurements were taken.


RESULTS
Pulse pressure (PP), FSP, and FDP derived from intraaortic measurements differentiated patients with one-, two-, and three-vessel coronary artery disease (PP, 62.8 +/- 15.8 v 64.8 +/- 17.9 v 71.7 +/- 19.1 [P < .0001]; FSP, 1.45 +/- 0.09 v 1.46 +/- 0.10 v 1.51 +/- 0.12 [P < .0001]; FDP 0.77 +/- 0.05 v 0.77 +/- 0.05 v 0.75 +/-0.06 [P < .0001]). After multivariate stepwise adjustment, the odds ratio (OR) and confidence interval (CI) of having three-vessel disease was as follows: PP per 10 mm Hg, OR = 1.15, 95% CI = 1.01 to 1.30; FSP per 0.1, OR = 1.28, 95% CI = 1.03 to 1.60; and FDP per 0.1, OR = 0.61, 95% CI = 0.39 to 0.95. None of the brachial pressure indices was independently related to the extent of coronary atherosclerosis.


CONCLUSIONS
Pulse pressure (PP), FSP, and FDP of the ascending aorta are related to the risk of three-vessel disease in patients with coronary artery disease and preserved left ventricular function.
First Department of Cardiology Collegium Medicum Jagiellonian University, Kraków, Poland. piotr_jankowski@interia.pl
Piotr
P
Jankowski
Kalina
K
Kawecka-Jaszcz
Leszek
L
Bryniarski
Danuta
D
Czarnecka
Magorzata
M
Brzozowska-Kiszka
Aneta
A
Pośnik-Urbańska
Grzegorz
G
Kopeć
Jacek
J
Dragan
Artur
A
Klecha
Dariusz
D
Dudek
D000368:Aged; D001011:Aorta / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors