Abstract 3643: Aortic Stiffness is an Independent Determinant of Exercise Capacity in Patients with Coronary Artery Disease
Pulse wave velocity (PWV) is elevated in patients with coronary artery disease (CAD). Previous studies demonstrated that PWV modulates left ventricular systolic and diastolic function; however, the influence of PWV on exercise capacity in patients with CAD has not been fully clarified. In this study, we evaluated the relationship between PWV and exercise capacity in patients with CAD with preserved left ventricular systolic function.
(Methods) We studied 79 patients with CAD (69±7yo, 64men). Subjects underwent symptom limited cardiopulmonary exercise testing (CPX). We also measured brachial-ankle PWV (baPWV) using an automated device (form ABI/PWV, Colin, Japan) prior to CPX.
(Results) In univariate analysis, baPWV significantly correlated with PVO2 (r=−0.44, figure⇓). In multivariate analysis, baPWV was an independent predictor of PVO2 independently of left ventricular function. In patients with incresaed baPWV (over 2000cm/sec, n=16), time to ST depression was shorter (317±83 vs 410±84sec, p<0.05) and the increase in systolic blood pressure (SBP) rise during CPX was smaller (45±33 vs 61±30mmHg, p<0.05) than in patients without increased baPWV (under 2000cm/sec, n=73), whereas severity of CAD was comparable between the two groups. In addition, postexercise SBP recovery (defined as SBP 3min/SBP peak exercise) was prolonged in patients with increased PWV (0.89±0.18 vs 0.80±0.14, p<0.05).
(Conclusions) Aortic stiffness is an independent predictor of exercise capacity. Impairment of left ventricular functional reserve and lowering of threshold myocardial ischemia caused by increased aortic stiffness may be involved in the impairment in exercise capacity.