Interrelationship between noninvasive predictors of atherosclerosis: transthoracic coronary flow reserve, flow-mediated dilation, carotid intima-media thickness, aortic stiffness, aortic distensibility, elastic modulus, and brachial artery diameter.
BACKGROUND
In this study, we searched for a correlation between transthoracic coronary flow reserve (CFR) and well-established surrogates of coronary atherosclerosis.


METHODS
The study was conducted on 136 healthy subjects (mean age: 39.9 +/- 7.3 years) who were free of coronary risk factors. Transthoracic echocardiography was used to measure the aortic stiffness index (AoSI), aortic distensibility (AoD), and aortic elastic modulus (AoEM). High-resolution ultrasound was used to measure brachial artery endothelium-dependent and independent vasomotion and carotid intima-media thickness (IMT). In addition, transthoracic second harmonic Doppler echocardiography was used to measure CFR.


RESULTS
All of the parameters significantly correlated with each other except brachial endothelium-independent dilation. CFR correlated significantly with brachial endothelium-dependent dilation (EDD) (r = 0.302, P < 0.01), carotid IMT (r =-0.388, P < 0.01), brachial artery diameter (r = 0.340, P < 0.01), AoD (r = 0.275, P < 0.01), AoS (r =-0.299, P < 0.01), and AoEM (r =-0.30,7 P < 0.01). Carotid IMT correlated significantly with brachial EDD and modestly with brachial artery diameter, AoD, AoS, and AoEM.In multivariate analysis, carotid IMT (beta=-0.323, P < 0.0001) and brachial artery diameter (beta = -0.259, P = 0.001) were significant independent predictors of CFR. The left ventricular mass index (beta= 0.371, P < 0.0001), brachial EDD (beta = -0.232, P = 0.002), and CFR (beta = -0.228, P = 0.003) were significant predictors for IMT.


CONCLUSIONS
Transthoracic CFR correlated significantly with well-established noninvasive predictors of atherosclerosis, and we suggest that it can be used as a surrogate for coronary atherosclerosis.
Gullu
Hakan
H
Konya Teaching and Medical Research Center, Cardiology Department, Baskent University, Konya, Turkey. gulluhakan@hotmail.com
Erdogan
Dogan
D
Caliskan
Mustafa
M
Tok
Derya
D
Yildirim
Erkan
E
Ulus
Taner
T
Turan Sezgin
Alpay
A
Muderrisoglu
Haldun
H
D000328:Adult; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology; D001158:Arteries / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity; D001794:Blood Pressure; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D003326:Coronary Circulation; D004452:Echocardiography; D004548:Elasticity; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006339:Heart Rate; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012107:Research Design; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D018084:Ultrasonography, Interventional; D014655:Vascular Resistance; D014664:Vasodilation
D015415:Biomarkers