The value of diastolic flow reversal in the descending thoracic aorta as a determinant of invasively measured aortic pulse pressure.
OBJECTIVE
Although the diastolic flow reversal of the descending aorta has been recognized in patients with aortic regurgitation, its generation without this condition is still unknown. This study was performed to investigate whether flow patterns of the descending thoracic aorta, as measured by echocardiography, can represent invasively measured aortic pulse pressure (APP).


METHODS
A total of 100 patients (age, 62.3±11.0 years; men, 62.0%) undergoing invasive coronary angiography (ICA) was analyzed. APP was measured at ascending thoracic aorta using pigtail catheter before ICA. Flow in the descending thoracic aorta was assessed using pulse wave Doppler echocardiography, and R/F ratio was defined as reverse peak velocity (R)/forward peak velocity (F).


RESULTS
Eighty patients (80.0%) had obstructive coronary artery disease (CAD) (≥50% stenosis of one or more epicardial coronary arteries) in ICA. APP and R/F ratio were significantly higher in patients with obstructive CAD than those without (P<.05 for each). Both R/F ratio (β=0.379, P<.001) and APP (β=0.255, P<.001) were positively correlated with age. In simple linear regression analysis, there was a significant positive correlation between R/F ratio and APP (β=0.266, P<.001). This correlation remained significant even after controlling for potential confounders including age, gender, E/e', and left atrial volume index in multiple linear regression analysis (β=0.193, P=.036).


CONCLUSIONS
R/F ratio may be independently associated with APP in patients undergoing ICA.
Division of Cardiology, Department of Internal Medicine, Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea.
Hack-Lyoung
HL
Kim
Cardiovascular Center, Boramae Hospital, Seoul, Korea.
Yu Nui
YN
Kim
Cardiovascular Center, Boramae Hospital, Seoul, Korea.
Hee-Jun
HJ
Kim
Division of Cardiology, Department of Internal Medicine, Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea.
Woo-Hyun
WH
Lim
Division of Cardiology, Department of Internal Medicine, Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea.
Jae-Bin
JB
Seo
Division of Cardiology, Department of Internal Medicine, Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea.
Sang-Hyun
SH
Kim
Division of Cardiology, Department of Internal Medicine, Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea.
Myung-A
MA
Kim
Division of Cardiology, Department of Internal Medicine, Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea.
Joo-Hee
http://orcid.org/0000-0003-1417-1049
JH
Zo
D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D062186:Arterial Pressure; D001783:Blood Flow Velocity; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000503:physiopathology*; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
Doppler echocardiography; cardiac catheterization; diastolic flow reversal; pulse pressure