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  =  −0.35, 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