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Am J Physiol Heart Circ Physiol. 2019 Aug 23. doi: 10.1152/ajpheart.00067.2019. [Epub ahead of print]

Aortic distensibility is associated with both resting and hyperemic coronary blood flow.

Author information

1
Cardiology, Royal Adelaide Hospital, Australia.
2
Department of Cardiovascular Medicine, Cleveland Clinic, United States.
3
Monash Health, Australia.
4
Department of Cardiology, Northern General Hospital, United Kingdom.
5
GenesisCare, Australia.
6
Department of Cardiology, Royal Adelaide Hospital, Australia.
7
Cardiology, University of Adelaide, United Kingdom.

Abstract

BACKGROUND:

A large body of evidence demonstrates an independent association between arterial stiffness and prospective risk of cardiovascular events. A reduction in coronary perfusion is presumed to underscore this association, however studies confirming this are lacking. This study compared invasive measures of coronary blood flow (CBF) with cardiac magnetic resonance (CMR) derived aortic distensibility (AD).

METHODS:

Following coronary angiography, a Doppler FloWire and infusion microcatheter were advanced into the study vessel. Average peak velocity (APV) was acquired at baseline and following intracoronary adenosine to derive coronary flow velocity reserve (CFVR = hyperemic APV/resting APV), and CBF (π x [Diameter]2 x APV x 0.125). Following angiography, patients underwent CMR to evaluate distensibility at the ascending aorta (AA), proximal descending aorta (PDA) and distal descending aorta (DDA).

RESULTS:

Fifteen subjects (53±13years) with minor epicardial disease (maximum stenosis <30%) were enrolled. Resting CBF was 44.1±11.9mL/min, hyperemic CBF was 143.8±37.4 mL/min and CFVR was 3.15±0.48. Aortic distensibility was 3.89±1.72·10-3mmHg-1 at the AA, 4.08±1.80·10-3mmHg-1 at the PDA and 4.42±1.67·10-3mmHg-1 at the DDA. All levels of distensibility correlated with resting CBF (R2 0.350-0.373, p<0.05), hyperemic CBF (R2 0.453-0.464, p<0.01), and CFVR (R2 0.442-0.511, p<0.01).

CONCLUSION:

This study demonstrates that hyperemic and, to a lesser extent resting coronary blood flow, are significantly associated with measures of aortic stiffness in patients with only minor angiographic disease. These findings provide further mechanistic support for the observed prognostic capacity of large artery function in cardiovascular event prediction.

KEYWORDS:

arterial stiffness; coronary blood flow; magnetic resonance imaging

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