To assess the aortic-brachial arterial stiffness gradient in patients with coronary artery disease (CAD), depending on the presence of atherosclerosis of lower limb arteries.
Material and methods
We studied 118 patients with stable CAD (72 male and 46 female, average age of 60.9 ± 7.1 years) who were distributed into two groups: 85 patients with CAD and atherosclerosis of lower limb arteries (1st group) and 33 patients with CAD and intact lower limb arteries (2nd group). We measured aortic stiffness and stiffness of muscular arteries by applanation tonometry and the pulse wave velocity in the carotid-femoral (cfPWV) and carotid-radial (crPWV) sections. All patients underwent triplex scanning of lower limb arteries on a digital ultrasound multifunctional diagnostic scanner “Samsung Medison EKO7” (Japan).
The mean aortic-brachial arterial stiffness gradient in the first group [1.07 (0.93, 1.21)] was significantly higher than in the second group [0.89 (0.81, 1.00); p=0.001]. In the first group, there were more patients with inversion of aorticbrachial arterial stiffness gradient – 63.7% versus 28.0% (p=0.002). An increase in the aortic-brachial arterial stiffness gradient was associated with the older age (r=0.259, p=0.012), a decrease in the glomerular filtration rate (r=-0.273, p=0.01), an increase in the intima-media thickness (IMT) (r=0.351, p=0.002), as well as the degree of stenosis of the femoral arteries (r=0.295, p=0.012) and the tibial arteries (r=0.305, p=0.01).
Patients with CAD and atherosclerosis of lower limb arteries had a statistically significantly higher gradient of vascular stiffness compared to patients with CAD and intact lower limb arteries. Aorto-brachial gradient of vascular stiffness is a promising marker of vascular remodeling, which carries additional diagnostic and prognostic information in patients with atherosclerotic cardiovascular diseases.
Vascular stiffness, pulse wave velocity, atherosclerosis of lower limb arteries, coronary artery disease, gradient of vascular stiffness, aortic-brachial stiffness gradient.