Association Between Pulsed-Wave Velocity and Coronary Artery Calcification in the Iranian Population

Document Type : Original Article

Authors

1 Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

2 Imaging Department, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

3 Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

Abstract

Background: Albeit coronary artery angiography is the gold standard of the diagnosis of coronary artery disease (CAD), coronary artery calcification (CAC) is a less invasive diagnostic method. We evaluated pulsed-wave velocity (PWV) as another accessible diagnostic tool to detect early CAD in the Iranian population.
Methods: From March 2016 to March 2017, we enrolled 350 patients referred for an evaluation of CAD to Rajaie Cardiovascular, Medical, and Research Center (Tehran, Iran). The patients underwent coronary artery computed tomography angiography, and their CAC scores were measured simultaneously. The PWV index was defined as the distance between the brachial and dorsalis pedis arteries divided by time, and the correlations between the PWV index and the CAC score and known CAD risk factors were assessed.
Results: From 350 patients, 52.3% were men and the rest were women. The mean PWV was 8.7 ± 2.2 m/s and the mean CAC score was 251 ± 99.52. There was no significant relationship between the CAC score and the PWV index (P = 0.16). In the women, the CAC score and the PWV index were meaningfully higher (P ≤ 0.001 and P < 0.04, respectively). The CAC score was significantly different between the patients with and without CAD (P <0.001), whereas there was no difference concerning the PWV index (P = 0.31). Among all CAD risk factors, hypertension and diabetes mellitus were significantly correlated with the CAC score (P = 0.001 and P = 0.015, correspondingly) and the PWV index (P = 0.001 and P = 0.009, respectively).
Conclusions: In contrast to some recent studies that have shown a significant increase in the PWV index in relation to the CAC score, our results did not prove it. The PWV index, thus, needs further studies if it is to be fully utilized in clinical practice. (Iranian Heart Journal 2020; 21(2): 6-12)

Keywords

References

1. Mannacio VA, Imbriaco M, Iesu S, Giordano AL, Di Tommaso L, Vosa C. 64-slice multidetector computed tomographic evaluation of arterial conduit patency after off-pump coronary artery bypass grafting. Tex Heart Inst J 2009; 36(5):409-15.
2. Ridker PM, Libby P. Risk factors for atherothrombotic disease. In: Zipes DP, Libby P, Bonow RO, Braunwald E, editors. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 7th ed. Philadelphia, PA: Elsevier Saunders; 2005. p. 939-58.
3. Samady H, Eshtehardi P, McDaniel MC, Suo J, Dhawan SS, Maynard C, et al. Coronary artery wall shear stress is associated with progression and transformation of atherosclerotic plaque and arterial remodeling in patients with coronary artery disease. Circulation 2011; 124(7):779-88.
4. Cademartiri F, Maffei E, Palumbo A, Seitun S, Martini C, Tedeschi C, et al. Coronary calcium score and computed tomography
coronary angiography in high-risk asymptomatic subjects: assessment of diagnostic accuracy and prevalence of non-obstructive coronary artery disease. Eur Radiol 2010; 20(4): 846-54.
5. Einstein AJ, Johnson LL, Bokhari S, Son J, Thompson RC, Bateman TM, et al. Agreement of visual estimation of coronary artery calcium from low-dose CT attenuation correction scans in hybrid PET/CT and SPECT/CT with standard Agatston score. J Am Coll Cardiol 2010; 56(23):1914-21.
6. Ueda H, Harimoto K, Tomoyama S, Tamaru H, Miyawaki M, Mitsusada N, et al. Relation of cardiovascular risk factors and angina status to obstructive coronary artery disease according to categorical coronary artery calcium score. Heart Vessels 2012; 27(2):128-34.
7. Kennedy JW, Baxley WA, Bunnel IL, Gensini GG, Messer JV, Mudd JG, Noto TJ, Paulin S, Pichard AD, Sheldon WC, Cohen M. Mortality related to cardiac catheterization and angiography. Cathet Cardiovasc Diagn1982;8(4):323-40.
8. Schroeder S, Achenbach S, Bengel F, et al., Working Group Nuclear Cardiology and Cardiac CT; European Society of Cardiology; European Council of Nuclear Cardiology. Cardiac computed tomography: indications, applications, limitations, and training requirements: report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuclear Cardiology. Eur Heart J 2008;29:531–56.
9. Fei X, Du X, Li P, Liao J, Shen Y, Li K. Effect of dose-reduced scan protocols on cardiac coronary image quality with 64-row MDCT: a cardiac phantom study. Eur J Radiol 2008;67:85–91.
10. Tsuchikura S, Shoji T, Kimoto E, et al. Brachial-ankle pulse wave velocity as an index of central arterial stiffness. J Atheroscler Thromb. 2010 Jun 30;17(6):658-65.
11. Vishnu A, Choo J, Wilcox B, et al. Brachial-ankle pulse wave velocity is associated with coronary calcification among 1131 healthy middle-aged men. Int J Cardiol. 2015;189:67-72.
12. Cainzos-Achirica M, Rampal S, Chang Y, et al. Brachial-ankle pulse wave velocity is associated with coronary calcium in young and middle-aged asymptomatic adults: The Kangbuk Samsung Health Study. Atherosclerosis. 2015 Aug;241(2):350-6.
13. Bainey KR, Jugdutt BI. Increased burden of coronary artery disease in South-Asians living in North America. Need for an aggressive management algorithm. Atherosclerosis. 2009 May;204(1):1-10.
14. Weinstein MC, Coxson PG, Williams LW, Pass TM, Stason WB, Goldman L. Forecasting coronary heart disease incidence, mortality, and cost: the Coronary Heart Disease Policy Model. Am J Public Health. 1987 Nov;77(11):1417-26.
15. Delahaye F, Roth O, de Gevigney G. Epidemiology of acute coronary syndrome. Rev Prat. 2003 Mar 15;53(6):607-10.
16. Koch CG, Weng YS, Zhou SX, et al. Prevalence of risk factors, and not gender per se, determines short- and long-term survival after coronary artery bypass surgery. J Cardiothorac Vasc Anesth. 2003 Oct;17(5):585-93.
17. Hansen T. W., Staessen JA,Torp-Pedersen C et al., “Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population,” Circulation, vol. 113, no. 5, pp. 664–670, 2006.
18. Mitchell G, Parise H, Benjamin EJ et al., “Changes in arterial stiffness and wave reflection with advancing age in healthy men
and women: the Framingham Heart Study,” Hypertension, vol. 43, no. 6, pp. 1239–1245, 2004.
19. Elias MF, Dore GA, Davey A, Abhayaratna WP, Goodell AL, and Robbins MA, “Norms and reference values for pulse wave velocity: one size does not fit all,” The Journal of Bioscience and Medicine, vol. 1, no. 1, pp. 1–10, 2011
20. Iino R, Yokoyama N, Konno K, Naito K, Isshiki T. Impact of combined assessment of coronary artery calcium score, carotid artery plaque score, and brachial-ankle pulse wave velocity for early coronary revascularization in patients with suspected coronary artery disease. Int Heart J. 2012;53(3):154-9.
21. Lee JY, Ryu S, Lee SH, et al. Association between brachial-ankle pulse wave velocity and progression of coronary artery calcium: a prospective cohort study. Cardiovasc Diabetol. 2015 Nov 4;14:147.
22. Liu CS, Li CI, Shih CM, et al. Arterial stiffness measured as pulse wave velocity is highly correlated with coronary atherosclerosis in asymptomatic patients. J Atheroscler Thromb. 2011;18(8):652-8.
23. Seo WW, Chang HJ, Cho I, et al. The value of brachial-ankle pulse wave velocity as a predictor of coronary artery disease in high-risk patients. Korean Circ J. 2010 May;40(5):224-9.
24. Torii S, Arima H, Ohkubo T, et al. Association between Pulse Wave Velocity and Coronary Artery Calcification in Japanese men. J Atheroscler Thromb. 2015 Dec 1;22(12):1266-77.
Iranian Heart Journal
Volume 21, Issue 2
April 2020
Pages 6-12

Files

Share

How to cite

Statistics