Korean Circ J.  2004 Jul;34(7):677-683. 10.4070/kcj.2004.34.7.677.

Assessment of the Arterial Stiffness Index as a Clinical Parameter for Atherosclerotic Coronary Artery Disease

• Park SM
• Seo HS
• Lim HE
• Shin SH
• Park CG
• Oh DJ
• Ro YM

• KMID: 1858920
• DOI: http://doi.org/10.4070/kcj.2004.34.7.677

Abstract

BACKGROUND
Arterial stiffening increases both the systolic blood and pulse pressures, which is known to be a major contributor to atherosclerosis and the most important cause of cardiovascular disease. The aims of this study were to assess the feasibility of the arterial stiffness index (ASI), using a computerized oscillometric device, by comparison with the pulse wave velocity (PWV), and to investigate its usefulness to patients with clinical coronary artery disease.
METHODS
60-consecutive patients, who underwent coronary angiography and who's aorto-femoral PWV were obtained with a Judkins catheter, were the subjects of this study. The ASI was obtained for all patients, using CardioVision(R) MS-2000 (IMDP, Las Vegas, NV), with cuff pressure on the brachial artery. The ASI were obtained as follows; 1) at the baseline (ASI-B), 2) after hyperemia induced by compression of the arm with cuff pressure for 5 minutes (ASI-H), 3) after having taken sublingual nitroglycerin (ASI-N).
RESULTS
34-patients had significant coronary artery disease (CAD) from the coronary angiography findings. All the ASI were positively correlated to the PWV, and were also higher in patients with CAD (ASI-B, 85.9+/-57.8 vs. 48.2+/-24.5, p=0.001; ASI-H, 98.1+/-49.8 vs. 48.1+/-21.3, p=0.00; ASI-N, 66.7+/-55.7 vs. 33.2+/-27.9, p=0.002). The ASI-H was mostly well correlated to the PWV and the severity of CAD (PWV, r=0.49, p=0.00; severity, r=0.52, p=0.00). The ASI was increased after hyperemia in patients with CAD (85.9+/-57.8 to 98.1+/-49.8, p=0.01), but was not significantly changed in those without CAD (48.2+/-24.5 to 48.1+/-21.3, p=0.68). The ASI-N was decreased in all patients.
CONCLUSIONS
The Arterial Stiffness Index, measured non-invasively by computerized oscillometry, was feasible and useful for detection of atherosclerotic coronary disease. Especially, the difference in the ASI between patients with and without CAD was more apparent after hyperemia. These findings suggest that in addition to stiffening of the arterial wall itself, the impairment of flow mediated vasodilation, due to endothelial dysfunction, further increases the arterial stiffness.

Keyword

Compliance; Coronary atherosclerosis; Oscillometry

MeSH Terms

Arm
Atherosclerosis
Brachial Artery
Cardiovascular Diseases
Catheters
Compliance
Coronary Angiography
Coronary Artery Disease*
Coronary Disease
Coronary Vessels*
Humans
Hyperemia
Nitroglycerin
Oscillometry
Pulse Wave Analysis
Vascular Stiffness*
Vasodilation
Nitroglycerin