Coronary flow velocity reserve and indices describing aortic distensibility in patients after coronary angiography

Nemes, Attila; Forster, Tamás; Gruber, N; Csanády, Miklós

doi:10.1016/j.ijcard.2003.06.009

Cited by 29 publications

(26 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Aortic stiffness has been described to reduce the improvement in hyperemic coronary blood flow after a successful percutaneous coronary intervention (45). Nemes et al (46) described reduced CFR and increased indices of aortic stiffness [E(p) and E(s)] in patients with LAD coronary artery disease as compared with patients with normal epicardial coronary arteries. In addition to these findings in patients with coronary artery disease, Nemes et al demonstrated significant correlations between CFR and aortic stiffness in patients without coronary artery disease, but with hypertension, aortic valve stenosis, type-2 diabetes and hypercholesterolemia (16)(17)(18)(19).…”

Section: Discussionmentioning

confidence: 99%

Impaired coronary flow reserve evaluated by echocardiography is associated with increased aortic stiffness in patients with metabolic syndrome: an observational study

Tok¹,

Özcan²,

Kadife³

et al. 2013

AnadoluKardiyolDerg

View full text Add to dashboard Cite

Impaired coronary flow reserve evaluated by echocardiography is associated with increased aortic stiffness in patients with metabolic syndrome: an observational studyMetabolik sendromlu hastalarda ekokardiyografik olarak gösterilen bozulmuş koroner akım rezervi artmış aort sertliği ile ilişkilidir: Gözlemsel bir çalışma ABSTRACTObjective: Metabolic syndrome (MetS) is a strong predictor of cardiovascular events and coronary flow reserve (CFR), an indicator of microvascular function, has been found to be impaired in MetS. Aortic stiffness (AS) is a simple and effective method for assessing arterial elasticity. The aim of this study was to evaluate whether there is an independent association of impaired coronary flow and aortic elasticity in patients with MetS. Methods: Forty-six patients (mean age 47.3±6.6 years) with the diagnosis of MetS according to the ATP III update criteria and 44 age and gender matched controls (mean age 46.0±6.1 years) were included into the cross-sectional observational study. Peak diastolic coronary flow velocities were measured in left anterior descending artery by pulsed wave Doppler at baseline and after adenosine infusion, and CFR was calculated as the ratio of hyperemic to baseline velocities. Aortic strain, distensibility and stiffness were calculated by M-mode echocardiography. Statistical analysis was performed by using Student t-test, Chi-square test, Pearson correlation and linear regression analyses. Results: CFR was significantly lower in patients with MetS than in controls (2.3±0.2 vs 2.7±0.2, p<0.001). In the MetS group, aortic distensibility (10.4±3.5 cm 2 .dyn -1 .10 -6 vs. 12.7±3.4 cm 2 .dyn -1 .10 -6 , p=0.002) was decreased and AS was significantly increased (6.5±2.0 vs. 3.2±0.8, p<0.001). In multivariate linear regression analysis, AS (β=-0.217, p=0.047), systolic blood pressure (β=-0.215, p=0.050) and waist circumference (β=-0.272, p=0.012) had an independent relationship with impaired CFR. Conclusion: This study demonstrated that coronary flow reserve is impaired in patients with MetS and there is an independent relationship between impaired CFR and increased aortic stiffness, systolic blood pressure or waist circumference. (Anadolu Kardiyol Derg 2013; 13: 227-34)

show abstract

Section: Discussionmentioning

confidence: 99%

Impaired coronary flow reserve evaluated by echocardiography is associated with increased aortic stiffness in patients with metabolic syndrome: an observational study

Tok¹,

Özcan²,

Kadife³

et al. 2013

AnadoluKardiyolDerg

View full text Add to dashboard Cite

show abstract

“…12,34 -39 We described reduced CFR and increased E(p) and E(s) (indices of aortic stiffness) in patients with LAD CAD as compared with patients with normal epicardial coronary arteries. 12 In patients with nonsignificant CAD, these values were intermediate between patients with LAD CAD and those with normal epicardial coronary arteries. In addition to these findings in patients with CAD, we demonstrated alterations in these 2 functional parameters in patients without CAD, but with hypertension, 36 Figure 4: Evaluation of PWV.…”

Section: Clinical Implications Of Aortic Stiffnessmentioning

confidence: 95%

“…Several echocardiographic methods are suitable for the evaluation of CFR, including contrast echocardiography 11 and direct Doppler measurement during transthoracic 12 or transesophageal measurements. 12,13 The original protocol of transesophageal Doppler CFR measurement in the left anterior descending (LAD) coronary artery was described by Iliceto et al 13 After visualization of the aortic root and proximal portion of the LAD coronary artery, coronary blood flow velocities can be recorded by pulsewave Doppler.…”

Section: Echocardiographic Evaluation Of Coronary Flow Reservementioning

confidence: 99%

“…12,13 The original protocol of transesophageal Doppler CFR measurement in the left anterior descending (LAD) coronary artery was described by Iliceto et al 13 After visualization of the aortic root and proximal portion of the LAD coronary artery, coronary blood flow velocities can be recorded by pulsewave Doppler. Phasic coronary flow velocity patterns can be recorded under resting conditions and during hyperemia.…”

Section: Echocardiographic Evaluation Of Coronary Flow Reservementioning

confidence: 99%

See 1 more Smart Citation

Echocardiographic Evaluation and Clinical Implications of Aortic Stiffness and Coronary Flow Reserve and their Relation

Nemes

Geleijnse

Forster

et al. 2007

Clinical Cardiology

Self Cite

View full text Add to dashboard Cite

The normal human aorta is not a stiff tube, but is characterized by elastic properties with a buffering Windkessel function. Aortic stiffening may cause an increase in aortic pulse pressure, left ventricular (LV) load, and ultimately left ventricular hypertrophy. This, together with the decreased diastolic transmyocardial pressure gradient, interacts with coronary flow and flow reserve. In recent studies, significant correlations between coronary flow reserve and aortic stiffness have been demonstrated in different patient populations. The aim of this review is to describe the current echocardiographic modalities to measure aortic stiffness and coronary flow reserve, and to overview knowledge about the relationship between aortic stiffness and coronary flow reserve.

show abstract

“…Stress transesophageal echocardiography allows the evaluation of coronary blood flow velocity reserve of LAD. The CFR is reduced in patients with significant LAD disease, in case of proximal location or more severe stenosis, further impairment can be observed [5,[7][8][9][10][11]. When significant stenosis of right coronary artery and/or left circumflex coronary artery is associated, no further CFR impairment can be found [8].…”

Section: Discussionmentioning

confidence: 99%

Grade of Aortic Atherosclerosis: A Valuable Adjunct to Coronary Flow Velocity Reserve in the Evaluation of Coronary Artery Disease

Nemes

Thury

Forster

et al. 2007

Upsala Journal of Medical Sciences

Self Cite

View full text Add to dashboard Cite

Background: Atherosclerosis is a generalized disease of the arterial vasculature; among thus it manifests in the descending aorta and the coronary arteries. We tested whether known risk factors, the coronary flow velocity reserve and the grade of aortic atherosclerosis detected by transoesophageal echocardiography in the course of the same semi-invasive examination is able to distinguish between patients with significant left anterior descending coronary artery (LAD) stenosis or with multivessel disease.Methods and results: The present study involved 125 consecutive patients (mean age: 56 11 years, range: 22-73) with chest pain undergoing coronary angiography. Grade of aortic atherosclerosis was obtained by means of transoesophageal echocardiography, and the coronary flow velocity reserve was calculated in the left anterior descending coronary artery. The age (ROC area, 63%, p<0.01), the gender (ROC area, 63%, p<0.02) and the grade of aortic atherosclerosis (ROC area, 64%, p<0.01) exhibited good power for the prediction of patients with multivessel disease from among all other patients. Only the grade of aortic atherosclerosis (ROC area, 63%, p<0.05) appears useful to distinguish patients with left anterior descending coronary artery disease from those with multivessel disease.Conclusions: These results demonstrate that grade of aortic atherosclerosis furnishes additional help in the prediction of patients with severe coronary artery disease. It can differentiate patients with multivessel disease from those with significant left anterior descending coronary artery stenosis. Coronary flow velocity reserve has no any prognostic power in this evaluation. List of abbreviations

show abstract

Coronary flow velocity reserve and indices describing aortic distensibility in patients after coronary angiography

Cited by 29 publications

References 26 publications

Impaired coronary flow reserve evaluated by echocardiography is associated with increased aortic stiffness in patients with metabolic syndrome: an observational study

Impaired coronary flow reserve evaluated by echocardiography is associated with increased aortic stiffness in patients with metabolic syndrome: an observational study

Echocardiographic Evaluation and Clinical Implications of Aortic Stiffness and Coronary Flow Reserve and their Relation

Grade of Aortic Atherosclerosis: A Valuable Adjunct to Coronary Flow Velocity Reserve in the Evaluation of Coronary Artery Disease

Contact Info

Product

Resources

About