Arterial Stiffening is Associated with Exercise Intolerance and Hyperventilatory Response in Patients with Coronary Artery Disease

Exercise intolerance is a common feature of patients with coronary artery disease (CAD). Arterial stiffness is increased in CAD patients; however, the association between arterial stiffness and exercise capacity of CAD patients has not been fully clarified. In this study, we investigated the association between arterial stiffness and the exercise capacity of 62 CAD patients (67 ± 7 yo, 49 men). The patients underwent symptom-limited cardiopulmonary exercise testing and measurement of pulse wave velocity (PWV). The patients were divided into the high-PWV group (n = 31) and the low-PWV group (n = 31), according to the median PWV (1622 cm/sec). In exercise testing, the peak VO2 was lower in the high-PWV group than in the low-PWV group. VE/VCO2 slope was higher and the time to ST depression was shorter in the high-PWV group than in the low-PWV group. Multivariate analysis results showed that PWV significantly correlated with peak VO2 as well as sex. PWV also significantly correlated with time to ST depression and VE/VCO2 slope. In conclusion, patients with high PWV had lower exercise capacity than patients with low PWV. A low myocardial ischemia threshold, as well as an enhancement of the ventilatory response to exercise, was also found in patients with high PWV.