title: Increased pulse wave velocity and augmentation index after isometric handgrip exercise in patients with coronary artery disease.
abstract: BACKGROUND
  Arterial stiffness of patients with coronary artery disease (CAD), which is expected to be increased due to a generalized atherosclerotic process of human body, may be more evident after the acute increase of blood pressure (BP) or peripheral vascular resistance. Isometric handgrip exercise is a simple and easily applicable method to achieve this goal. We investigated the changes of hemodynamic parameters and arterial stiffness indexes after handgrip exercise in patients with CAD.
  
  
  METHODS
  Forty-two subjects, who underwent coronary angiography (CAG), were enrolled. After CAG, baseline arterial waveforms were traced at the aortic root and external iliac artery using right coronary catheters. Arterial waveforms were recorded at 1, 2, and 3 min in the aortic root and at 3 min in the external iliac artery after isometric handgrip exercise at 30% ~ 40% of the maximal handgrip power. Augmentation pressure (AP) and augmentation index (AIx) were measured at aortic pressure waveforms. Pulse wave velocity (PWV) was calculated using the ECG-gated time difference of the upstroke of arterial waveforms and the distance between the aortic root and the external iliac artery.
  
  
  RESULTS
  Thirty patients had CAD (CAD group), and others showed no significant coronary stenosis (non-CAD group). Baseline hemodynamic parameters including AIx and PWV were not different between both groups. After isometric handgrip exercise, central systolic blood pressure (BP), central diastolic BP, central pulse pressure, peripheral systolic BP, and peripheral pulse pressure were increased in all patients. AIx inclined significantly from 1 min after exercise only in patients with CAD (before 17.7% ± 9.7% vs. 3 min after exercise 22.3% ± 10.7%, p < 0.001). PWV also increased significantly after exercise only in patients with CAD (before 10.03 ± 1.99 m/s vs. 3 min after 11.09 ± 2.45 m/s, p < 0.001).
  
  
  CONCLUSIONS
  Arterial stiffness indexes at rest were not different between patients with and without CAD. After isometric handgrip exercise, increased arterial stiffness became evident only in patients with CAD.
authors.affiliation: Cardiology Division, Department of Internal Medicine, Jeju National University Hospital, 15 Aran 13-gil, Jeju City, Jeju Province 690-767 Republic of Korea.
authors.forename: Shin-Hang
authors.initials: SH
authors.lastname: Moon
authors.affiliation: Cardiology Division, Department of Internal Medicine, Jeju National University Hospital, 15 Aran 13-gil, Jeju City, Jeju Province 690-767 Republic of Korea.
authors.forename: Jae-Cheol
authors.initials: JC
authors.lastname: Moon
authors.affiliation: Cardiology Division, Department of Internal Medicine, Jeju National University Hospital, 15 Aran 13-gil, Jeju City, Jeju Province 690-767 Republic of Korea.
authors.forename: Da-Hee
authors.initials: DH
authors.lastname: Heo
authors.affiliation: Cardiology Division, Department of Internal Medicine, Jeju National University Hospital, 15 Aran 13-gil, Jeju City, Jeju Province 690-767 Republic of Korea.
authors.forename: Young-Hyup
authors.initials: YH
authors.lastname: Lim
authors.affiliation: Cardiology Division, Department of Internal Medicine, Jeju National University Hospital, 15 Aran 13-gil, Jeju City, Jeju Province 690-767 Republic of Korea.
authors.forename: Joon-Hyouk
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Cardiology Division, Department of Internal Medicine, Jeju National University Hospital, 15 Aran 13-gil, Jeju City, Jeju Province 690-767 Republic of Korea.
authors.forename: Song-Yi
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Cardiology Division, Department of Internal Medicine, Jeju National University Hospital, 15 Aran 13-gil, Jeju City, Jeju Province 690-767 Republic of Korea.
authors.forename: Ki-Seok
authors.initials: KS
authors.lastname: Kim
authors.affiliation: Cardiology Division, Department of Internal Medicine, Jeju National University Hospital, 15 Aran 13-gil, Jeju City, Jeju Province 690-767 Republic of Korea.
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Joo
keywords: Aortic pressure; Arterial stiffness; Coronary artery disease; Isometric exercise; Pulse wave velocity