title: Significant relationship between changes in brachial-ankle pulse wave velocity relative to blood pressure elevation and coronary artery disease.
abstract: OBJECTIVE
  Based on well-established physiological theories, we studied correlations between changes in brachial-ankle pulse wave velocity (baPWV) relative to blood pressure (BP) elevation (elasticity of large-to-medium-sized arteries), and coronary artery disease (CAD).
  
  
  METHODS
  The baPWV (in centimeters/second) and BP (in millimeters of mercury) were determined in 101 patients before, during, and/or after a cold pressor test using a volume-plethysmographic system.
  
  
  RESULTS
  Significantly higher rates of increase in PWV relative to changes in BP were observed in the CAD(+) group than in the CAD(-) group when mean BP [median (25th-75th percentiles): 14.8 (8.3-24.9) vs. 8.6 (5.7-11.4) cm/s/mmHg, P<0.0001], and systolic [10.1 (6.0-17.5) vs. 6.4 (4.4-10.6) cm/s/mmHg, P=0.0023] and diastolic BP [21.0 (14.0-34.4) vs. 10.8 (6.8-16.1) cm/s/mmHg, P<0.0001] were used as BP indices. Similarly, the rates of increase in baPWV showed a significant correlation with the extent of CAD. The rate of increase in baPWV obtained using the mean, systolic and diastolic BP as indices showed an area under the receiver operating characteristic curve of 0.68-0.76, sensitivity of 65-75%, and specificity of 65-75% for the detection of CAD. The area under the receiver operating characteristic curve, sensitivity, and specificity for the rate of increase were slightly higher than those for baseline baPWV and baseline baPWV/baseline BP ratio, but not to a significant degree.
  
  
  CONCLUSIONS
  The rate of increase in baPWV relative to BP elevation determined by cold pressor test is significantly and moderately correlated with CAD. To identify patients with CAD, the rate of increase in baPWV relative to changes in BP can provide considerable, but limited, information.
authors.affiliation: Department of Cardiology, Tsuyama General Hospital, Japan.
authors.forename: Issei
authors.initials: I
authors.lastname: Komatsubara
authors.forename: Shinichi
authors.initials: S
authors.lastname: Inoue
authors.forename: Rie
authors.initials: R
authors.lastname: Koumoto
authors.forename: Shigeru
authors.initials: S
authors.lastname: Matano
authors.forename: Tomoki
authors.initials: T
authors.lastname: Kitawaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hirohata
authors.forename: Toru
authors.initials: T
authors.lastname: Miyoshi
authors.forename: Hiroko
authors.initials: H
authors.lastname: Ogawa
authors.forename: Ryoko
authors.initials: R
authors.lastname: Shinohata
authors.forename: Shozo
authors.initials: S
authors.lastname: Kusachi
mesh_terms: D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D001158:Arteries / Q000473:pathology / Q000528:radiation effects; D001783:Blood Flow Velocity / Q000528:radiation effects; D001794:Blood Pressure / Q000528:radiation effects; D058639:Cold-Shock Response; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000503:physiopathology; D004548:Elasticity / Q000528:radiation effects; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D007564:Japan; D008297:Male; D008875:Middle Aged; D010991:Plethysmography / Q000379:methods; D011237:Predictive Value of Tests; D014655:Vascular Resistance / Q000528:radiation effects