title: Impaired aortic distensibility measured by computed tomography is associated with the severity of coronary artery disease.
abstract: Impaired aortic distensibility index (ADI) is associated with cardiovascular risk factors. This study evaluates the relation of ADI measured by computed tomographic angiography (CTA) with the severity of coronary atherosclerosis in subjects with suspected coronary artery disease (CAD). Two hundred and twenty-nine subjects,age 63 ± 9 years, 42% female, underwent coronary artery calcium (CAC) scanning and CTA, and their ADI and Framingham risk score (FRS) were measured. End-systolic and end-diastolic (ED) cross-sectional-area(CSA) of ascending-aorta (AAo) was measured 15-mm above the left-main coronary ostium. ADI was defined as: [(Δlumen-CSA)/(lumen-CSA in ED × systemic-pulse-pressure) × 10(3)]. ADI measured by 2D-trans-thoracic echocardiography (TTE) was compared with CTA-measured ADI in 26 subjects without CAC. CAC was defined as 0, 1-100, 101-400 and 400+. CAD was defined as luminal stenosis 0, 1-49% and 50%+. There was an excellent correlation between CTA- and TTE-measured ADI (r(2)=0.94, P=0.0001). ADI decreased from CAC 0 to CAC 400+; similarly from FRS 1-9% to FRS 20% + (P<0.05). After adjustment for risk factors, the relative risk for each standard deviation decrease in ADI was 1.66 for CAC 1-100, 2.26 for CAC 101-400 and 2.32 for CAC 400+ as compared to CAC 0; similarly, 2.36 for non-obstructive CAD and 2.67 for obstructive CAD as compared to normal coronaries. The area under the ROC-curve to predict significant CAD was 0.68 for FRS, 0.75 for ADI, 0.81 for CAC and 0.86 for the combination (P<0.05). Impaired aortic distensibility strongly correlates with the severity of coronary atherosclerosis. Addition of ADI to CAC and traditional risk factors provides incremental value to predict at-risk individuals.
authors: Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, 1124 W. Carson Street, RB2, Torrance, CA 90502, USA. nahmadi@labiomed.org
authors: Naser
authors: N
authors: Ahmadi
authors: Vahid
authors: V
authors: Nabavi
authors: Fereshteh
authors: F
authors: Hajsadeghi
authors: Ferdinand
authors: F
authors: Flores
authors: Shahdad
authors: S
authors: Azmoon
authors: Hussain
authors: H
authors: Ismaeel
authors: David
authors: D
authors: Shavelle
authors: Song S
authors: SS
authors: Mao
authors: Ramin
authors: R
authors: Ebrahimi
authors: Matthew J
authors: MJ
authors: Budoff
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001011:Aorta / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002140:California; D003187:Compliance; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography