Noninvasively assessed pulsatility of ascending aortic pressure waveform is associated with the presence of coronary artery narrowing.
Several hemodynamic indices, measured invasively in the ascending aorta during routine angiography, are related to the presence and severity of coronary atherosclerosis. Radial artery tonometry, when combined with a validated transfer function, offers the possibility of noninvasive assessment of central arterial pressure. We aim to evaluate the association between noninvasive indices of aortic or radial pressure waveforms and the presence of a significant coronary stenosis. Patients who underwent elective coronary angiography were studied (110 men, 91 women, mean age 53 +/- 0.9 years). Noninvasive measurement of their central hemodynamics was performed by analysis of the aortic pressure waveform derived from the radial artery. An increase in aortic fractional pulse pressure was associated with coronary artery narrowing or previous myocardial infarction. After multivariate adjustment, the odds ratio and confidence intervals (CI) of having a significant coronary aortic stenosis was 1.72 (95% CI, 1.1-2.7) and of previous myocardial infarction 1.6 (95% CI, 1.1-2.2). An increase in noninvasively assessed aortic fractional pulse pressure, but not of the peripheral index is significantly associated with the presence of coronary artery disease.
Wykretowicz
Andrzej
A
Department of Internal Medicine, Division of Cardiology-Intensive Therapy, University School of Medicine, 49 Przybyszewskiego, 60-355 Poznan, Poland. awykreto@ptkardio.pl
Metzler
Lidia
L
Milewska
Agata
A
Balinski
Marek
M
Rutkowska
Agnieszka
A
Adamska
Karolina
K
Krauze
Tomasz
T
Guzik
Przemysław
P
Dziarmaga
Mieczysław
M
Wysocki
Henryk
H
D001013:Aorta, Thoracic / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011673:Pulsatile Flow / Q000502:physiology*; D012720:Severity of Illness Index