Abstract 14348: Percutaneous Transluminal Angioplasty for Peripheral Artery Disease Immediately Confers Cardioprotection by Reducing the Carotid Augmentation Index
Background: There has been no report showing benefits of percutaneous transluminal angioplasty (PTA) beyond those related to the improvement of limb blood flow.
Objective: We tested the hypothesis that the carotid augmentation index (AI), the measure of cardiovascular load, can be improved by PTA and could result in cardio-renal protection.
Methods: We enrolled 76 consecutive peripheral artery disease (PAD) patients who were scheduled to undergo elective PTA procedures. The mean age was 70.0±9.5 years; 81.6% of them were male. The following parameters were measured before, just after, and several months after PTA: blood pressure (BP), heart rate (HR), ankle-brachial index (ABI), the augmentation index (AI), and the urinary albumin/creatinine ratio (UACR).
Results: Compared to BP at pretreatment (140/77 mmHg), BP just after PTA (129/71 mmHg) and several months after PTA (129/72 mmHg) were significantly reduced, but HR did not change. The ABI in the diseased foot was significantly improved just after PTA, and also several months after PTA compared to the pre PTA (p<0.001 vs. pre PTA for both). The carotid AI was significantly reduced just after PTA (13.9±15.6%) and after several months (14.8±17.5%) compared to the pre PTA (21.7±15.2) (p<0.01 vs. pre PTA for both). As shown in the Figure, the change in AI was significantly associated with the change in UACR.
Conclusions: In addition to improving limb blood flow, PTA could unload cardiovascular mechanical stress by reducing aortic wave reflection, and consequently, results in cardio-renal protection in patients with PAD.
- © 2010 by American Heart Association, Inc.