Impact of the metabolic syndrome on aortic pulse pressure and ascending aortic pulsatility in patients with angiographically normal coronary arteries.
BACKGROUND
Large artery stiffness is a major determinant of pulse pressure (PP), and PP at baseline has been associated with future coronary events.


OBJECTIVE
To evaluate the impact of the metabolic syndrome on aortic PP and ascending aortic pulsatility (AP) in patients with angiographically normal coronary arteries.


METHODS
Forty-two patients with the metabolic syndrome and 40 age matched control subjects without the metabolic syndrome were included in the study. All subjects had normal coronary arteries. Diagnosis of the metabolic syndrome was based on the International Diabetes Federation guidelines published in 2005. Ascending AP was estimated as the ratio of aortic PP to mean blood pressure.


RESULTS
Aortic PP (59+/-12 mmHg versus 43+/-10 mmHg; P<0.001) and ascending AP (0.54+/-0.10 versus 0.48+/-0.10; P<0.001) were significantly higher in the metabolic syndrome group. Multiple regression analysis revealed statistically independent relationships between ascending AP and fasting blood glucose, waist circumference and systolic blood pressure (model R2=0.408; P<0.001). The metabolic syndrome, as a whole, was also independently associated with both ascending AP (P<0.01) and aortic PP (P<0.01).


CONCLUSIONS
The data showed that the metabolic syndrome is independently associated with increased aortic PP and ascending AP in patients with normal coronary arteries, suggesting aortic stiffness as one of the possible mechanisms underlying the excess cardiovascular risk associated with the metabolic syndrome.
Emre
Ayse
A
Siyami Ersek Thoracic and CV Surgery Center, Istanbul, Turkey. aysesay@superonline.com
Oz
Dilaver
D
Yesilcimen
Kemal
K
Sayar
Nurten
N
Ergun
Dilek
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000473:pathology*; D001794:Blood Pressure; D016022:Case-Control Studies; D003187:Compliance; D003331:Coronary Vessels / Q000473:pathology*; D005215:Fasting; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000503:physiopathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D011673:Pulsatile Flow; D012016:Reference Values; D012044:Regression Analysis; D013599:Systole; D055105:Waist Circumference