title: Does increased aortic stiffness predict reduced coronary flow velocity reserve in patients with suspected coronary artery disease?
abstract: OBJECTIVE
  In recent studies, reduction in coronary flow velocity reserve (CFR) has been demonstrated in patients with increased aortic stiffness. Stress transoesophageal echocardiography (TEE) is a suitable method for the simultaneous evaluation of CFR and aortic stiffness parameters. The present study was designed to test whether increased echocardiography-derived aortic elastic modulus [E(p)] predicts impaired CFR in patients with suspected coronary artery disease (CAD).
  
  
  RESULTS
  The present study comprised 158 patients with suspected CAD. A CFR value < 2 was considered abnormal. Both men grade of aortic atherosclerosis (AA) (as a morphologic characteristic) (1.31 ± 0.68 vs. 1.02 ± 0.89, p < 0.05) and aortic distensibility (E(p) as a functional characteristic) (892 ± 594 mmHg vs. 723 ± 495 mmHg, P < 0.05) were increased in subjects with CFR < 2. In ROC analysis, the cut-off value for E(p) to predict impaired CFR was ≥ 670 mmHg, with 61% sensitivity and 61% specificity (ROC area 0.60, p = 0.026). The logistic regression model identified higher AA grade (hazard ratio (HR) 2.01, p < 0.05) and increased E(p) as independent predictors of reduced CFR (HE 1.10, p < 0.05).
  
  
  CONCLUSIONS
  Increased aortic stiffness predicts impaired CFR in patients with suspected CAD.
authors.affiliation: University of Szeged 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, Szeged, Hungary. nemes.attila@med.u-szeged.hu
authors.forename: A
authors.initials: A
authors.lastname: Nemes
authors.forename: M
authors.initials: M
authors.lastname: Csanády
authors.forename: T
authors.initials: T
authors.lastname: Forster
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000503:physiopathology; D001018:Aortic Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D003326:Coronary Circulation / Q000502:physiology*; D017548:Echocardiography, Transesophageal / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity; D059289:Vascular Stiffness / Q000502:physiology*