Abstract 12391: Ventriculo-arterial Stiffening in Association With Coronary Artery Disease in Patients With Low to Intermediate Framingham Risk
Background: Ventriculo-arterial coupling that represents the interaction of the heart with the systemic vasculature was known to influence the coronary perfusion and myocardial response to ischemia. We hypothesized that ventriculo-arterial stiffening could be used for detecting subclinical coronary artery disease (CAD).
Methods: Total of 723 patients with low to intermediate Framingham risk (≤20%), and no diabetes mellitus were consecutively enrolled. Ventriculo-arterial coupling index (VVI) was defined as arterial elastance (Ea)/ventricular elastance (Ees). Presence of CAD was confirmed by myocardial SPECT, coronary CT or coronary angiography.
Results: Forty-four (6.1%) patients were diagnosed CAD. VVI was significantly higher in patients with CAD than non-CAD (0.87±0.55 vs. 0.66±0.24, p=0.028). Patients who had the highest tertile of VVI (VVI>0.70, n=226) showed higher prevalence of CAD than patients who had VVI ≤0.70 (8.4% vs. 4.1%, p=0.021). With multivariate logistic regression, VVI was strongly predictive of CAD (OR 2.58, 95% CI 1.20-5.56, p=0.015). The area under the ROC curve of VVI for CAD was 0.619 (95% CI 0.516-0.723, p=0.013). When we combined with left ventricular stiffness (e’ of tissue velocity), diagnostic accuracy was increased (AUC 0.748, 95% CI 0.676-0.819, p<0.001) (Figure).
Conclusion: In patients with low to intermediate Framingham risk, ventriculo-arterial stiffness was associated with presence of CAD. Ventriculo-arterial stiffness can be used a non-invasive screening tool for CAD in clinical practice.
- © 2012 by American Heart Association, Inc.