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

To investigate the relation between aortic stiffness and coronary flow reserve (CFR) in patients with coronary artery disease (CAD).Observational study.Coronary care unit of a primary care hospital.192 consecutive patients who underwent coronary angiography.Brachial-ankle pulse wave velocity (ba-PWV), CFR, and severity of CAD.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, p0.001). CFR had a significant negative correlation with ba-PWV (r = -0.45, p0.0001). The diastolic to systolic velocity ratio obtained in 45 patients also was significantly correlated with ba-PWV (r = -0.35, p0.05). Multiple regression analysis showed that ba-PWV was an independent determinant of CFR (p0.01).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.