Τίτλος:
Incremental predictive value of carotid intima-media thickness to arterial stiffness for impaired coronary flow reserve in untreated hypertensives
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Tzortzis, S.
Ikonomidis, I.
Lekakis, J.
Papadopoulos, C.
Triantafyllidi, H.
Parissis, J.
Trivilou, P.
Paraskevaidis, I.
Anastasiou-Nana, M.
Kremastinos, D.T.
Περιοδικό:
Hypertension Research
Λέξεις-κλειδιά:
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
