TY - JOUR
TI - Incremental predictive value of carotid intima-media thickness to arterial stiffness for impaired coronary flow reserve in untreated hypertensives
AU - Tzortzis, S.
AU - Ikonomidis, I.
AU - Lekakis, J.
AU - Papadopoulos, C.
AU - Triantafyllidi, H.
AU - Parissis, J.
AU - Trivilou, P.
AU - Paraskevaidis, I.
AU - Anastasiou-Nana, M.
AU - Kremastinos, D.T.
JO - Hypertension Research
PY - 2010
VL - 33
TODO - 4
SP - 367-373
PB - 
SN - 0916-9636, 1348-4214
TODO - 10.1038/hr.2010.2
TODO - adult;  arterial stiffness;  arterial wall thickness;  article;  cardiovascular risk;  carotid artery;  controlled study;  coronary flow reserve;  essential hypertension;  female;  femoral artery;  human;  major clinical study;  male;  prediction;  pulse wave;  receiver operating characteristic, Adult;  Aged;  Arteries;  Compliance;  Coronary Circulation;  Diagnostic Techniques, Cardiovascular;  Female;  Humans;  Hypertension;  Male;  Microcirculation;  Middle Aged;  Predictive Value of Tests;  Tunica Intima
TODO - Coronary microcirculation is disturbed in patients with arterial hypertension. Carotid intima-media thickness (IMT) and arterial stiffness are markers of subclinical atherosclerosis with prognostic significance. We investigated whether the combination of increased carotid IMT and arterial stiffness has a greater predictive value for the presence of impaired coronary flow reserve (CFR) than each index alone in never-treated hypertensives. We studied 110 untreated patients (age: 54.5±12 years) with newly diagnosed arterial hypertension. We measured (1) carotid-to-femoral artery pulse wave velocity (PWV), (2) carotid IMT and (3) CFR by means of color-guided Doppler echocardiography after adenosine infusion. Among other confounders, arterial stiffness and IMT were independent determinants of CFR (coefficient B=0.146 and B=0.006, P<0.05). Arterial stiffness and IMT had an incremental value for the determination of CFR when added to a model including other confounders (x 2 change=4.423, P for change=0.038 after addition of IMT; and x 2 change=5.369, P for change=0.020 after addition of PWV). Receiver operating curve analysis showed that PWV>10.2 m s-1 and IMT1 mm were the optimal cutoff values to predict a CFR2.5. Patients with IMT >1 mm, PWV >10.2 m s-1 or their combination had an odds ratio of 3.5, 5.0 and 11.2, P<0.05, for a CFR<2.5, respectively. The combination of increased carotid IMT and arterial stiffness has a greater predictive value for impaired CFR than each index alone in never-treated hypertensives. © 2010 The Japanese Society of Hypertension All rights reserved.
ER -