Second Department of Cardiology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
First Department of Internal Medicine, Division of Endocrinology and Metabolism, Diabetes Center, Medical School, AHEPA University Hospital, Thessaloniki, Greece.
J Clin Hypertens (Greenwich). 2020 Feb;22(2):187-193. doi: 10.1111/jch.13825. Epub 2020 Feb 12.
Pulse wave velocity (PWV) is a valid, clinically feasible marker of arterial stiffening, and a strong predictor of outcomes. The present study aimed to compare aortic elastic properties in patients with abdominal aortic aneurysms (AAA), with or without coronary artery disease (CAD), as well as healthy individuals. A total of 130 patients with AAA, eligible for interventional repair, and 30 healthy individuals, comprising the control group (HC), were enrolled. Presence of CAD was identified by coronary angiography. Aortic PWV (aPWV) was measured using the Arteriograph. aPWV was found considerably higher in AAA patients compared with HC group (11.5 ± 2.9 vs 7.3 ± 1.6 m/s, P < .001). Importantly, among patients with AAA, those with concomitant CAD (n = 41) had greater aPWV than those without CAD (12.5 ± 2.9 vs 11.0 ± 3.0 m/s, P = .03). In receiver operator curve (ROC) analysis, a value of aPWV above 12.8 m/s was identified to correlate with the presence of CAD in the AAA patient population. After adjustment for confounders, including hypertension which is one of the major risk factors for abdominal aneurysms, multivariate logistic regression analysis revealed that this aPWV cutoff remained independently associated with presence of CAD [odds ratio = 1.64, 95% confidence interval =1.19-4.08, P = .03]. The coexistence of CAD and AAA is characterized by a greater arterial stiffness. This finding should be taken into consideration when selecting endovascular stents with more favorable elastic properties. Moreover, AAA patients with high aPWV (>12.8 m/s) are more likely to also have CAD, and this may be considered by vascular surgeons when evaluating patients' cardiovascular risk.
脉搏波速度(PWV)是动脉僵硬度的有效且临床可行的标志物,也是预后的强有力预测因子。本研究旨在比较伴有或不伴有冠状动脉疾病(CAD)的腹主动脉瘤(AAA)患者与健康个体的主动脉弹性特性。共纳入 130 名适合介入修复的 AAA 患者和 30 名健康个体作为对照组(HC)。通过冠状动脉造影确定 CAD 的存在。使用 Arteriograph 测量主动脉 PWV(aPWV)。与 HC 组相比,AAA 患者的 aPWV 明显更高(11.5±2.9 比 7.3±1.6 m/s,P<0.001)。重要的是,在 AAA 患者中,同时伴有 CAD(n=41)的患者的 aPWV 高于不伴有 CAD 的患者(12.5±2.9 比 11.0±3.0 m/s,P=0.03)。在受试者工作特征(ROC)曲线分析中,aPWV 值高于 12.8 m/s 被确定与 AAA 患者人群中 CAD 的存在相关。在校正包括高血压(这是腹主动脉瘤的主要危险因素之一)等混杂因素后,多元逻辑回归分析显示,该 aPWV 截点与 CAD 的存在仍然独立相关[比值比=1.64,95%置信区间=1.19-4.08,P=0.03]。CAD 和 AAA 的共存表现为更大的动脉僵硬度。在选择具有更有利弹性特性的血管内支架时,应考虑到这一发现。此外,aPWV 值较高(>12.8 m/s)的 AAA 患者更有可能同时患有 CAD,血管外科医生在评估患者的心血管风险时可以考虑这一点。