Aortic pulse wave velocity and its relationship with complexity of coronary artery disease based on SYNTAX score.
BACKGROUND
Aortic pulse wave velocity (APWV), a marker of arterial stiffness, was found to be a good predictor for the presence of incipient vascular disease and cardiovascular events in observational studies. APWV measured by echo Doppler is a simple and readily available method comparable with other costlier and complex modalities of APWV measurement like MRI, Complior method or applanation tonometry.


OBJECTIVE
No previous studies have demonstrated a relationship between APWV findings and the complexity of coronary artery disease (CAD). Our aim was to examine the relationship between APWV findings and the severity of SYNTAX scores (SX scores).


METHODS
500 patients who had undergone APWV measurements and elective coronary angiography from September 2012 to June 2013 were taken. Pulsed Doppler ultrasound (6.6 MHZ) probe with ECG synchronisation was used to calculate APWV. SYNTAX scoring was performed by observers who were blinded to APWV values.


RESULTS
A significant, nearly linear correlation between APWV and advancing CAD (p<0.0001) was observed. Patients with dual-vessel and triple-vessel disease had significantly higher APWV than patients without CAD. It was also found that mean APWV values were significantly more in patients with high or intermediate SX scores than in patients with low SX scores. The Fischer's linear discriminant analysis showed a cut-off value of APWV for predicting the possibility of having CAD to be >11.5 m/s.


CONCLUSIONS
APWV has predictive value for the SX score. A positive relation exists between aortic stiffening and coronary atherosclerosis and APWV measured by 2D Doppler is a good predictor of advancing CAD.
Department of Cardiology , Govt TD Medical College Alappuzha , Alappuzha, Kerala , India.
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R
Ranjith
Department of Cardiology , Govt TD Medical College Alappuzha , Alappuzha, Kerala , India.
T G
TG
Binu
Department of Cardiology , Govt TD Medical College Alappuzha , Alappuzha, Kerala , India.
Vijo
V
George
Department of Cardiology , Govt TD Medical College Alappuzha , Alappuzha, Kerala , India.
K G
KG
Madhu
Department of Pediatrics , Govt TD Medical College Alappuzha , Alappuzha, Kerala , India.
P
P
Devika
Department of Cardiology , Govt TD Medical College Alappuzha , Alappuzha, Kerala , India.
Kunju
K
Subair
Department of Cardiology , Govt TD Medical College Alappuzha , Alappuzha, Kerala , India.
V
V
Jayaram
Department of Cardiology , Govt TD Medical College Alappuzha , Alappuzha, Kerala , India.
K S
KS
Mohanan
Department of Cardiology , Govt TD Medical College Alappuzha , Alappuzha, Kerala , India.
V V
VV
Radhakrishnan
AORTA, GREAT VESSELS AND TRAUMA; CORONARY ARTERY DISEASE