BACKGROUND: Aortic pulse pressure (APP) is related to arterial stiffness and associated with the presence and extent of coronary artery disease (CAD). Besides, the left coronary artery (LCA) has a predominantly diastolic flow while the right coronary artery (RCA) receives systolic and diastolic flow. Thus, we hypothesized that increased systolic-diastolic pressure difference had a greater atherogenic effect on the RCA than on the LCA. METHODS: A random sample of 433 CAD patients (145 females, 288 males, mean age 65.0 ± 11.1 years) undergoing coronary angiography at Staten Island University Hospital between January 2005 and May 2008 was studied. Coronary lesion was defined as a ≥50% luminal stenosis. Patients were divided into three groups, with isolated LCA lesions (n = 154), isolated RCA lesions (n = 36) or mixed LCA and RCA lesions (n = 243). RESULTS: APP differed significantly between groups, being highest when the RCA alone was affected (67.6 ± 20.3 mm Hg for LCA vs. 78.8 ± 22.0 for RCA vs. 72.7 ± 22.6 for mixed, P = 0.008 for analysis of variance (ANOVA)). Age and gender were not associated with CAD location. Heart rate was associated with CAD location, lowest in RCA group, and negatively correlated with APP. However, left ventricular ejection fraction (LVEF) was lower in the mixed CAD group and positively correlated with APP. The association between APP and right-sided CAD persisted in multivariate logistic regression adjusting for confounders, including heart rate, LVEF and medication use. A similar but less significant pattern was seen with brachial arterial pressures. CONCLUSIONS: Aortic pulse pressure may affect CAD along with coronary flow phasic patterns.
BACKGROUND: Aortic pulse pressure (APP) is related to arterial stiffness and associated with the presence and extent of coronary artery disease (CAD). Besides, the left coronary artery (LCA) has a predominantly diastolic flow while the right coronary artery (RCA) receives systolic and diastolic flow. Thus, we hypothesized that increased systolic-diastolic pressure difference had a greater atherogenic effect on the RCA than on the LCA. METHODS: A random sample of 433 CAD patients (145 females, 288 males, mean age 65.0 ± 11.1 years) undergoing coronary angiography at Staten Island University Hospital between January 2005 and May 2008 was studied. Coronary lesion was defined as a ≥50% luminal stenosis. Patients were divided into three groups, with isolated LCA lesions (n = 154), isolated RCA lesions (n = 36) or mixed LCA and RCA lesions (n = 243). RESULTS: APP differed significantly between groups, being highest when the RCA alone was affected (67.6 ± 20.3 mm Hg for LCA vs. 78.8 ± 22.0 for RCA vs. 72.7 ± 22.6 for mixed, P = 0.008 for analysis of variance (ANOVA)). Age and gender were not associated with CAD location. Heart rate was associated with CAD location, lowest in RCA group, and negatively correlated with APP. However, left ventricular ejection fraction (LVEF) was lower in the mixed CAD group and positively correlated with APP. The association between APP and right-sided CAD persisted in multivariate logistic regression adjusting for confounders, including heart rate, LVEF and medication use. A similar but less significant pattern was seen with brachial arterial pressures. CONCLUSIONS: Aortic pulse pressure may affect CAD along with coronary flow phasic patterns.
Authors: Robert C Hendel; Matthew J Budoff; John F Cardella; Charles E Chambers; John M Dent; David M Fitzgerald; John McB Hodgson; Elizabeth Klodas; Christopher M Kramer; Arthur E Stillman; Peter L Tilkemeier; R Parker Ward; Wm Guy Weigold; Richard D White; Pamela K Woodard Journal: J Am Coll Cardiol Date: 2009-01-06 Impact factor: 24.094
Authors: Julio A Chirinos; Juan P Zambrano; Simon Chakko; Anila Veerani; Alan Schob; Guido Perez; Armando J Mendez Journal: Am J Cardiol Date: 2005-09-01 Impact factor: 2.778
Authors: Michel E Safar; Jacques Blacher; Bruno Pannier; Alain P Guerin; Sylvain J Marchais; Pierre-Marie Guyonvarc'h; Gérard M London Journal: Hypertension Date: 2002-03-01 Impact factor: 10.190
Authors: Patrick W Serruys; Marie-Claude Morice; A Pieter Kappetein; Antonio Colombo; David R Holmes; Michael J Mack; Elisabeth Ståhle; Ted E Feldman; Marcel van den Brand; Eric J Bass; Nic Van Dyck; Katrin Leadley; Keith D Dawkins; Friedrich W Mohr Journal: N Engl J Med Date: 2009-02-18 Impact factor: 91.245