title: Non-invasively measured aortic wave reflection and pulse pressure amplification are related to the severity of coronary artery disease.
abstract: BACKGROUND
  Augmentation index (AIx) and pulse pressure amplification (PPA, here the aortic/brachial pulse pressure ratio) are an age-related emerging risk factor for cardiovascular disease. However, it has not been clearly shown that AIx and PPA predict a high risk of coronary artery disease (CAD).
  
  
  OBJECTIVE
  The aim of the study was to investigate the association between non-invasively measured aortic wave reflection (AWR) and PPA and CAD.
  
  
  METHODS
  The study group consisted of 80 patients who were admitted to our institute for elective coronary angiography. We non-invasively measured augmentation pressure (AP), AIx, and PPA using radial applanation tonometry.
  
  
  RESULTS
  When the extent of CAD was divided by no or minimal CAD, 1- or 2- and 3-vessel disease (VD), there was a significant association between the extent of CAD and AIx and PPA in patients aged <65 years, but not in patients aged ≥ 65 years. In multivariate regression analysis after controlling the traditional risk factors, the odds ratio of having 3VD was significant in patients aged <65 years: 2.15 (1.04-4.44; p=0.039) per 5% increase of AIx and 2.02 (1.15-3.55; p=0.015) per 0.05 increase of PPA, but not in patients aged ≥ 65 years. The severity of CAD expressed as a Gensini score showed a significant correlation with AP, AIx, and PPA in patients aged <65 years, but not in patients aged ≥ 65 years.
  
  
  CONCLUSIONS
  Increasing of non-invasively measured AWR and PPA is related to the severity of CAD, particularly in younger patients up to 65 years of age.
authors.affiliation: Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea.
authors.forename: Sung Woo
authors.initials: SW
authors.lastname: Cho
authors.forename: Byung Kyu
authors.initials: BK
authors.lastname: Kim
authors.forename: Jeong Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Young Sup
authors.initials: YS
authors.lastname: Byun
authors.forename: Choong Won
authors.initials: CW
authors.lastname: Goh
authors.forename: Kun Joo
authors.initials: KJ
authors.lastname: Rhee
authors.forename: Hyo Seung
authors.initials: HS
authors.lastname: Ahn
authors.forename: Byoung Kwon
authors.initials: BK
authors.lastname: Lee
authors.forename: Byung Ok
authors.initials: BO
authors.lastname: Kim
mesh_terms: D000367:Age Factors; D000368:Aged; D001011:Aorta / Q000503:physiopathology*; D062186:Arterial Pressure / Q000502:physiology*; D015415:Biomarkers; D001916:Brachial Artery / Q000503:physiopathology*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D012306:Risk; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers
keywords: Aortic wave reflection; Arterial stiffness; Coronary artery disease; Pulse pressure amplification; Radial applanation tonometry