Pulse wave velocity >10.7 m/s predicted impaired coronary flow reserve (CFR <2) with 79% sensitivity and 75% specificity in never-treated hypertensive patients.
Cross-Sectional (n=120)
Does pulse wave velocity determine coronary flow reserve in never-treated patients with essential hypertension?
Carotid-to-femoral pulse wave velocity provides incremental value beyond standard clinical parameters in identifying impaired coronary microcirculation in never-treated hypertensive patients.
Effect estimate: r2 change from 0.25 to 0.46
p-value: p=<0.01
BACKGROUND: Coronary microcirculation is disturbed in essential hypertension. We investigated whether arterial stiffness determines coronary flow reserve (CFR) in hypertensive patients. METHODS: We examined 100 never-treated hypertensives and 20 healthy controls. We measured (i) carotid-to-femoral pulse wave velocity (PWV); (ii) Systolic (V (s)) and diastolic (V (d)) coronary flow velocity, time integral (V (TI)-V (d)) of diastolic velocity and CFR after adenosine by transthoracic echocardiography; (iii) ratio of E wave from mitral inflow to Em of mitral annulus, as an index of left ventricular (LV) diastolic pressures using tissue Doppler; (iv) carotid intima-media thickness (IMT), as an index of vascular damage; and (v) 24-h blood pressure parameters using ambulatory blood pressure monitoring. RESULTS: Patients had abnormal PWV, IMT, E/Em, resting V (d)/V (s), and CFR than controls (P 10.7 m/s predicted a CFR <2 with 79 and 75% and a CFR <2.6 with 83 and 82% sensitivity and specificity, respectively, using adjusted-receiver operating characteristic curve (ROC) analysis. CONCLUSIONS: Elevated LV diastolic compressive forces on coronary microcirculation and the presence of generalized vascular damage may explain the association between PWV and CFR. PWV has an incremental value in the determination of impaired coronary microcirculation in hypertensive patients.
Ikonomidis et al. (Thu,) conducted a cross-sectional in Essential hypertension (n=120). Pulse wave velocity (PWV) vs. Healthy controls was evaluated on Coronary flow reserve (CFR) (r2 change from 0.25 to 0.46, p=<0.01). Pulse wave velocity >10.7 m/s predicted impaired coronary flow reserve (CFR <2) with 79% sensitivity and 75% specificity in never-treated hypertensive patients.