Why the study?
Are invasively measured central aortic pressure parameters associated with echocardiographic parameters of left ventricular diastolic function in patients undergoing coronary angiography?
Are invasively measured central aortic pressure parameters associated with echocardiographic parameters of left ventricular diastolic function in patients undergoing coronary angiography?
Invasively measured central aortic pulse pressure, fractional pulse pressure, and pulsatility index are independently associated with echocardiographic markers of LV diastolic function (e' and E/e'), highlighting the interaction between LV diastolic function and aortic stiffness.
May support stiffness assessment in diastolic evaluation during angiography; extends observational links but leaves causal and therapeutic implications open.
BACKGROUND: Because of the invasive nature of catheterization, limited information is available on hemodynamic interaction between the left ventricle and aorta using invasive aortic pressure monitoring. Our aim was to investigate whether parameters of invasively measured central aortic pressure waveform were related with those of left ventricular (LV) diastolic function. METHODS: A total of 153 consecutive stable patients (mean age = 64±11 years; 62% men) undergoing invasive coronary angiography (ICA) and transthoracic echocardiography (TTE) were prospectively evaluated. Central aortic pressure waveform was obtained at the ascending aorta using a pigtail catheter before ICA. We calculated pulse pressure (PP), fractional PP (FPP; the ratio of PP to mean pressure), pulsatility index (PI; the ratio of PP to diastolic pressure), augmentation index, wave reflection time, and ejection duration and analyzed their associations with parameters of LV diastolic function in TTE. RESULTS: Most patients (n = 135/153; 88.2%) had significant stenosis (≥50%) of ≥1 epicardial coronary arteries. In multiple linear regression analyses, e' and E/e' were significantly correlated with PP, FPP, and PI even after adjustment for potential confounders. There were no significant correlations between other parameters of LV diastolic function, including E/A, deceleration time, and left atrial volume index and parameters of central aortic pressure wave. CONCLUSIONS: Invasively measured central aortic PP, FPP, and PI were independently associated with e' and E/e' in patients undergoing ICA. This result adds to the evidence of a close interaction between LV diastolic function and aortic stiffness in this population.
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Kim et al. (2014) studied this question.
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