Association Between Elevated Pulse Pressure and High Resting Coronary Blood Flow Velocity in Patients With Angiographically Normal Epicardial Coronary Arteries
BackgroundThe aim of our study was to evaluate the relationship of pulse pressure (PP), a raw index of arterial stiffness, with noninvasively determined coronary flow reserve (CFR) and its components, in patients with angiographically normal epicardial coronary arteries. Methods and ResultsThe study...
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| Format: | Article |
| Language: | English |
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Wiley
2017-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.117.005710 |
| _version_ | 1828948191994707968 |
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| author | Maria Lembo Rosa Sicari Roberta Esposito Fausto Rigo Lauro Cortigiani Francesco Lo Iudice Eugenio Picano Bruno Trimarco Maurizio Galderisi |
| author_facet | Maria Lembo Rosa Sicari Roberta Esposito Fausto Rigo Lauro Cortigiani Francesco Lo Iudice Eugenio Picano Bruno Trimarco Maurizio Galderisi |
| author_sort | Maria Lembo |
| collection | DOAJ |
| description | BackgroundThe aim of our study was to evaluate the relationship of pulse pressure (PP), a raw index of arterial stiffness, with noninvasively determined coronary flow reserve (CFR) and its components, in patients with angiographically normal epicardial coronary arteries. Methods and ResultsThe study population included 398 patients without angiographic evidence of coronary stenosis, who underwent high‐dose dipyridamole stress echocardiography with transthoracic‐derived CFR evaluation on the left anterior descending artery. CFR was calculated as the ratio between high‐dose dipyridamole and resting coronary diastolic peak velocities. Patients were divided into 2 groups: the first group included the first and second PP tertiles (n=298, PP ≤60 mm Hg) and the second group included the highest PP tertile (n=100, PP >60 mm Hg). Mean blood pressure, systolic blood pressure (both P<0.0001), age (P<0.002), and left ventricular mass index (P=0.013) were higher in the highest PP tertile, which also showed higher resting coronary flow velocity (31.6±9.6 cm/s versus 27.7±6.4 cm/s, P<0.0001) and marginally lower CFR (2.5±0.6 versus 2.6±0.6, P=0.044). Hyperemic coronary flow velocity did not differ between the 2 groups. By separate multiple linear regression analyses, after adjusting for sex, age, the highest systolic blood pressure tertile (≥140 mm Hg), left ventricular mass index, and cardiovascular risk factors, the highest PP tertile was associated with resting coronary flow velocity (P=0.003) and only marginally with hyperemic coronary flow velocity (P<0.02), whereas its association with CFR was not significant. ConclusionsIn patients without epicardial coronary artery stenosis, the highest PP tertile is associated with an increased coronary flow velocity at rest. |
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| format | Article |
| id | doaj.art-43f52b64230a47e5b4730d15383c13e9 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-14T05:43:18Z |
| publishDate | 2017-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-43f52b64230a47e5b4730d15383c13e92022-12-21T23:14:57ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802017-07-016710.1161/JAHA.117.005710Association Between Elevated Pulse Pressure and High Resting Coronary Blood Flow Velocity in Patients With Angiographically Normal Epicardial Coronary ArteriesMaria Lembo0Rosa Sicari1Roberta Esposito2Fausto Rigo3Lauro Cortigiani4Francesco Lo Iudice5Eugenio Picano6Bruno Trimarco7Maurizio Galderisi8Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, ItalyInstitute of Clinical Physiology, National Research Council, Pisa, ItalyDepartment of Advanced Biomedical Sciences, Federico II University Hospital, Naples, ItalyDepartment of Cardiology, Dell'Angelo Hospital, Mestre, ItalyDivision of Cardiology, San Luca Hospital, Lucca, ItalyDepartment of Advanced Biomedical Sciences, Federico II University Hospital, Naples, ItalyInstitute of Clinical Physiology, National Research Council, Pisa, ItalyDepartment of Advanced Biomedical Sciences, Federico II University Hospital, Naples, ItalyDepartment of Advanced Biomedical Sciences, Federico II University Hospital, Naples, ItalyBackgroundThe aim of our study was to evaluate the relationship of pulse pressure (PP), a raw index of arterial stiffness, with noninvasively determined coronary flow reserve (CFR) and its components, in patients with angiographically normal epicardial coronary arteries. Methods and ResultsThe study population included 398 patients without angiographic evidence of coronary stenosis, who underwent high‐dose dipyridamole stress echocardiography with transthoracic‐derived CFR evaluation on the left anterior descending artery. CFR was calculated as the ratio between high‐dose dipyridamole and resting coronary diastolic peak velocities. Patients were divided into 2 groups: the first group included the first and second PP tertiles (n=298, PP ≤60 mm Hg) and the second group included the highest PP tertile (n=100, PP >60 mm Hg). Mean blood pressure, systolic blood pressure (both P<0.0001), age (P<0.002), and left ventricular mass index (P=0.013) were higher in the highest PP tertile, which also showed higher resting coronary flow velocity (31.6±9.6 cm/s versus 27.7±6.4 cm/s, P<0.0001) and marginally lower CFR (2.5±0.6 versus 2.6±0.6, P=0.044). Hyperemic coronary flow velocity did not differ between the 2 groups. By separate multiple linear regression analyses, after adjusting for sex, age, the highest systolic blood pressure tertile (≥140 mm Hg), left ventricular mass index, and cardiovascular risk factors, the highest PP tertile was associated with resting coronary flow velocity (P=0.003) and only marginally with hyperemic coronary flow velocity (P<0.02), whereas its association with CFR was not significant. ConclusionsIn patients without epicardial coronary artery stenosis, the highest PP tertile is associated with an increased coronary flow velocity at rest.https://www.ahajournals.org/doi/10.1161/JAHA.117.005710coronary flow reservecoronary flow resting velocitypulse pressurestress echocardiography |
| spellingShingle | Maria Lembo Rosa Sicari Roberta Esposito Fausto Rigo Lauro Cortigiani Francesco Lo Iudice Eugenio Picano Bruno Trimarco Maurizio Galderisi Association Between Elevated Pulse Pressure and High Resting Coronary Blood Flow Velocity in Patients With Angiographically Normal Epicardial Coronary Arteries Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease coronary flow reserve coronary flow resting velocity pulse pressure stress echocardiography |
| title | Association Between Elevated Pulse Pressure and High Resting Coronary Blood Flow Velocity in Patients With Angiographically Normal Epicardial Coronary Arteries |
| title_full | Association Between Elevated Pulse Pressure and High Resting Coronary Blood Flow Velocity in Patients With Angiographically Normal Epicardial Coronary Arteries |
| title_fullStr | Association Between Elevated Pulse Pressure and High Resting Coronary Blood Flow Velocity in Patients With Angiographically Normal Epicardial Coronary Arteries |
| title_full_unstemmed | Association Between Elevated Pulse Pressure and High Resting Coronary Blood Flow Velocity in Patients With Angiographically Normal Epicardial Coronary Arteries |
| title_short | Association Between Elevated Pulse Pressure and High Resting Coronary Blood Flow Velocity in Patients With Angiographically Normal Epicardial Coronary Arteries |
| title_sort | association between elevated pulse pressure and high resting coronary blood flow velocity in patients with angiographically normal epicardial coronary arteries |
| topic | coronary flow reserve coronary flow resting velocity pulse pressure stress echocardiography |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.117.005710 |
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