title: Coronary flow velocity reserve in patients with ascending aorta aneurysm.
abstract: BACKGROUND
  Ascending aorta aneurysms (AAA) are one of the leading causes of morbidity and mortality. Impairment in coronary flow may contribute to cardiovascular consequences in AAA patients. Coronary flow velocity reserve (CFVR) has been considered an important diagnostic index of the functional capacity of coronary arteries noninvasively. The aim of this study was to evaluate, by noninvasive CVFR, whether patients with AAA demonstrate significant coronary microvascular dysfunction in the absence of coronary artery disease (CAD).
  
  
  METHODS
  We prospectively included 44 patients with thoracic AAA in the absence of concomitant CAD (30 men, 14 women; mean age 57.5 ± 8.4 years). A total of 36 patients without aortic dilatation (mean age 55.2 ± 9.9 years) were selected as the control group. Coronary flow velocities in the distal left anterior descending (LAD) artery were measured using transthoracic echocardiography. CFVR was calculated as the hyperemic to resting coronary diastolic peak velocities ratio.
  
  
  RESULTS
  Compared with controls, patients with AAA had higher baseline LAD peak diastolic coronary flow velocities (28.3 ± 5.8 vs. 25.2 ± 4.5 cm/sec, P = 0.01), lower hyperemic LAD flow velocities (54.0 ± 10.3 vs. 57.2 ± 12.7 cm/sec, P = 0.220), and consequently lower CFVR (1.9 ± 0.3 vs. 2.3 ± 0.5, P < 0.001). Multivariate linear regression analysis showed that CFVR was independently associated only with aortic systolic diameter (AoSD) (β = -0.679, P = <0.001).
  
  
  CONCLUSIONS
  Our study demonstrates that noninvasive CFVR is significantly reduced in patients with AAA and AoSD is the most important determinant of impaired CFVR.
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Ahmet Oytun
authors.initials: AO
authors.lastname: Baykan
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Gülhan
authors.initials: G
authors.lastname: Yüksel Kalkan
authors.affiliation: Department of Cardiology, Kafkas University School of Medicine, Kars, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Gür
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Uçar
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Armağan
authors.initials: A
authors.lastname: Acele
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Şeker
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Ömer
authors.initials: Ö
authors.lastname: Şen
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Kaypakli
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Hazar
authors.initials: H
authors.lastname: Harbalioğlu
authors.affiliation: Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Çayli
mesh_terms: D001011:Aorta / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001014:Aortic Aneurysm / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D001783:Blood Flow Velocity; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: ascending aorta aneurysm; coronary flow reserve; echocardiography