The predictive role of aortic propagation velocity for coronary artery disease.

BACKGROUND: It is well recognized that cardio- vascular risk factors lead to histological and functional changes in aorta, and aortic stiffness is the best predictor of cardiovascular morbidity and mortality. In this study we evaluated the relation of a less evaluated echocardiographic parameter of aortic stiffness, aortic propagation velocity (APV) with the presence and severity of CAD.

METHODS: This cross sectional study was conducted from May 2015 to March 2016 in Imam Reza hospital, Mashhad, Iran. Seventy patients who were referred for elective coronary artery angiography were enrolled. Patients were divided into two sub-groups based on angiographic findings: patients with CAD (38 patients, 54.3%) and non-CAD (32 patients, 45.7%). Transthoracic echocardiography was performed using the conventional 2D and color M-Mode imaging. Aortic propagation velocity (APV), aortic strain (AS) and distensibility (AD) were measured. The presence and Severity of CAD (assessing by syntax score) and their relation with aortic stiffness indices were assessed.

RESULTS: Aortic strain (6.23 ± 1.93% versus 11.66 ± 4.86%, P < 0.0001), distensibility (2.46 ± 0.91 vs 5.57 ± 2.25 cm 2 dyn-110-3, P < 0.0001) and APV (48.63 ± 10.31 cm/sec vs 77.75 ± 9.97 cm/s, P < 0.0001) were significantly decreased in CAD group compared with non-CAD group. In our study, APV showed significant inverse relationship with CAD. Based on our results, APV less than 56 cm/sec could be used to predict CAD with sensitivity and specificity of 96.9 and 78.9% respectively. We also found an inverse correlation between APV and severity of CAD.

CONCLUSION: Aortic strain, AD and APV (a less evaluated echocardiographic index) showed significant inverse correlation with presence and severity of CAD.