Relation between aortic stiffness and coronary flow reserve in patients with coronary artery disease

Objectives: To investigate the relation between aortic stiffness and coronary flow reserve (CFR) in patients with coronary artery disease ( CAD). Design: Observational study. Setting: Coronary care unit of a primary care hospital. Patients: 192 consecutive patients who underwent coronary angiography. Main outcome measure: Brachial-ankle pulse wave velocity (ba-PWV), CFR, and severity of CAD. Results: According to the angiographic findings, patients were divided into four subgroups: patients without significant stenosis (normal coronary artery (NCA) group, n = 28) and those with one vessel disease (1VD group, n = 92), two vessel disease (2VD group, n = 50), or three vessel disease (3VD group, n = 22). ba-PWV increased with the number of diseased vessels and was significantly correlated with the number of diseased vessels ( NCA group v 1VD group v 2VD group v 3VD group: 1481 ( 252) v 1505 (278) v 1577 (266) v 1727 (347) cm/s, p < 0.001). CFR had a significant negative correlation with ba-PWV (r = -0.45, p < 0.0001). The diastolic to systolic velocity ratio obtained in 45 patients also was significantly correlated with ba-PWV (r = 20.35, p < 0.05). Multiple regression analysis showed that ba-PWV was an independent determinant of CFR (p < 0.01). \ Conclusions: Coronary flow is altered with aortic stiffening in patients with CAD. These results suggest one possible mechanism for recent reports that aortic stiffness is a key cardiovascular risk factor.