Evaluation of Aortic Propagation Velocity as a Non-Invasive Predictor of Coronary Artery Disease Severity: A Correlative Study with Aortic Stiffness and SYNTAX Score - A Tertiary Hospital Based Observational Study.

Q: What are the key findings of this study?

Aortic propagation velocity correlated inversely with CAD SYNTAX score severity (r = -0.63, p < 0.0001) and was significantly lower in significant vs non-significant CAD (48.9 vs 72.6 cm/s).

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Suspected coronary artery disease (n=99). Intervention: Aortic Propagation Velocity (APV) via colour M-mode Doppler echocardiography vs. Invasive coronary angiography SYNTAX score and non-significant CAD (<50% stenosis). Primary outcome: Correlation between Aortic Propagation Velocity (APV) and CAD severity measured by SYNTAX score (r = -0.63, p=<0.0001).

Q: What does this research mean for the field?

Aortic propagation velocity correlates inversely with coronary artery disease severity as measured by the SYNTAX score and is significantly decreased in patients with angiographically significant disease. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To assess the effectiveness of aortic propagation velocity in determining coronary artery disease severity by examining its correlation with the SYNTAX score and indices of aortic stiffness.

doi:10.25258/ijddt.16.67s.188

October 14, 2026International Journal of Drug Delivery TechnologyOpen Access

Evaluation of Aortic Propagation Velocity as a Non-Invasive Predictor of Coronary Artery Disease Severity: A Correlative Study with Aortic Stiffness and SYNTAX Score - A Tertiary Hospital Based Observational Study.

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Key result

Lower aortic propagation velocity correlates strongly with more severe CAD by SYNTAX score.

r = -0.63
P<0.0001
n=99

Why the study?

Aortic propagation velocity has emerged as a non-invasive echocardiographic measure of vascular health, and this study sought to evaluate its effectiveness in determining CAD severity through correlation with the SYNTAX score and aortic stiffness indices.

Does echocardiographic Aortic Propagation Velocity (APV) correlate with angiographic SYNTAX score and aortic stiffness indices to predict coronary artery disease severity in adults undergoing coronary angiography?

Key Points

To assess the effectiveness of aortic propagation velocity in determining coronary artery disease severity by examining its correlation with the SYNTAX score and indices of aortic stiffness.
Prospective observational study conducted in 99 patients with coronary artery disease at an Indian tertiary hospital.
Aortic propagation velocity was measured using colour M-mode Doppler echocardiography, and aortic strain and distensibility were calculated.
Coronary artery disease severity was stratified by SYNTAX score (mild <22, moderate 22–32, severe >32) and angiographic stenosis (significant defined as ≥50%).
Aortic propagation velocity inversely correlated with SYNTAX score (r = -0.63, p < 0.0001), declining from 65.2 ± 9.3 cm/s in mild disease to 55.9 ± 10.1 cm/s in moderate and 37.1 ± 8.0 cm/s in severe disease.
Patients with significant coronary artery disease exhibited significantly lower velocities than those without significant disease (48.9 ± 11.4 vs. 72.6 ± 10.2 cm/s; p < 0.0001).
Velocity correlated positively with aortic strain (r = 0.61, p < 0.0001) and distensibility (r = 0.59, p < 0.0001); a 60 cm/s cutoff predicted severe disease with 72.5% sensitivity and 62% specificity.

Study Design

Type

Observational (n=99)

Blinding

Open-label

Multicenter

No

Structured PICO

Does echocardiographic Aortic Propagation Velocity (APV) correlate with angiographic SYNTAX score and aortic stiffness indices to predict coronary artery disease severity in adults undergoing coronary angiography?

P

Population

99 adults (mean age 52.7 years, 30.3% female) with suspected CAD undergoing coronary angiography, excluding valvular disease, cardiomyopathy, arrhythmias, or heart failure, evaluated cross-sectionally over 6 months.

E

Exposure

Transthoracic echocardiographic measurement of Aortic Propagation Velocity (APV) using colour M-mode Doppler from the suprasternal window (averaged across three consecutive cardiac cycles), alongside calculation of aortic strain (AS) and aortic distensibility (AD), performed prior to invasive coronary angiography

C

Comparator

Invasive coronary angiography with SYNTAX score calculation (categorized as mild <22, moderate 22-32, or severe >32; and significant CAD defined as ≥50% stenosis in at least one major epicardial coronary artery vs non-significant CAD <50% luminal narrowing)

O

Outcome

Correlation of Aortic Propagation Velocity (APV) with coronary artery disease severity as assessed by the angiographic SYNTAX scoresurrogate

Main Result

Effect estimate: r = -0.63

Absolute Event Rate: 48.9% vs 72.6%

p-value: p=<0.0001

Echocardiographic Aortic Propagation Velocity (APV) correlates inversely with angiographic SYNTAX score and positively with aortic elasticity indices, suggesting its potential utility as a non-invasive adjunctive marker for CAD complexity.

Limitations

Single-center design with a relatively small sample size (n = 99)
Absence of longitudinal follow-up for clinical cardiovascular outcomes
Operator-dependent APV measurement without formal intraobserver or interobserver reproducibility assessment
Echocardiographer was not formally blinded to the patient's clinical presentation
Predominance of acute coronary syndrome patients limits generalizability to stable CAD or asymptomatic populations
Underrepresentation of women (30.3%)
Other established arterial stiffness markers like carotid-femoral pulse wave velocity were not evaluated
Smaller, single-centre sample size limiting the precision and stability of the threshold estimate
Predominantly male population (69.7%), requiring future deliberate recruitment strategies for balanced sex representation
Echocardiographer was not formally blinded to the patient's clinical presentation and no structured, independent, blinded re-analysis of stored images was undertaken
Intraobserver and interobserver reproducibility of APV measurement was not formally assessed
Absence of prospective clinical outcome data and modest diagnostic performance (sensitivity 72.5%, specificity 62%) relative to prior meta-analytic estimates

Implication

Supports aortic propagation velocity as a potential CAD severity marker; leaves open its pre-angiographic utility pending confirmatory studies.

Abstract

Background: Coronary artery disease (CAD) remains a major global health concern.Arterial stiffness is a critical marker of cardiovascular risk, and Aortic Propagation Velocity (APV) has emerged as a valuable non-invasive echocardiographic alternative for assessing vascular health.Aims and Objective: This study aimed to assess the effectiveness of APV in determining the severity of CAD by exploring its correlation with the SYNTAX score and indices of aortic stiffness.Materials and Methods: This prospective observational study was conducted among 99 patients with CAD.The measurement of APV was conducted using colour M-mode Doppler; in addition, aortic strain (AS) and distensibility (AD) were calculated.The severity of CAD was evaluated using the SYNTAX score to facilitate stratification and screening before invasive angiography.Results: APV showed a significant inverse correlation with CAD severity (r = -0.63,p < 0.0001).Mean APV decreased as disease complexity rose: 65.2 ± 9.3 cm/s (mild), 55.9 ± 10.1 cm/s (moderate), and 37.1 ± 8.0 cm/s (severe).Significant CAD patients had lower APV than those without (48.9± 11.4 vs. 72.6 ± 10.2 cm/s; p < 0.0001).APV correlated positively with AS (r = 0.61) and AD (r = 0.59).A 60 cm/s threshold predicted severe CAD with 72.5% sensitivity and 62% specificity.Conclusion: APV may serve as a useful adjunctive noninvasive marker of CAD complexity and vascular stiffness.Incorporating APV into standard echocardiography may help complement early risk assessment and pre-angiographic screening, pending external validation in larger, multicentre cohorts with prospective outcome data.

Discussion

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Cite This Study

A 2026 study conducted an observational in Suspected coronary artery disease (n=99). Aortic Propagation Velocity (APV) via colour M-mode Doppler echocardiography vs. Invasive coronary angiography SYNTAX score and non-significant CAD (<50% stenosis) was evaluated on Correlation between Aortic Propagation Velocity (APV) and CAD severity measured by SYNTAX score (r = -0.63, p=<0.0001). Aortic propagation velocity correlated inversely with CAD SYNTAX score severity (r = -0.63, p < 0.0001) and was significantly lower in significant vs non-significant CAD (48.9 vs 72.6 cm/s).

synapsesocial.com/papers/6ae28e56cbadf70daf6c41d1 https://doi.org/10.25258/ijddt.16.67s.188

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Evaluation of Aortic Propagation Velocity as a Non-Invasive Predictor of Coronary Artery Disease Severity: A Correlative Study with Aortic Stiffness and SYNTAX Score - A Tertiary Hospital Based Observational Study.

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Evaluation of Aortic Propagation Velocity as a Non-Invasive Predictor of Coronary Artery Disease Severity: A Correlative Study with Aortic Stiffness and SYNTAX Score - A Tertiary Hospital Based Observational Study.

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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