Prediction of Coronary Artery Disease Extent and Severity Using Pulse Wave Velocity

BackgroundPulse-wave velocity (PWV) measures aortic stiffness. It is an independent predictor of cardiovascular events and mortality, yet there is paucity in the literature on its association with the severity and extent of coronary artery disease (CAD).MethodsTo examine the utility of PWV in predicting CAD burden in men and women the PWV was determined in 344 patients (Men = 266, Women = 78) presenting for invasive coronary angiography for the assessment of suspected CAD. Pearson correlations and multivariate analysis were used to evaluate the relationship between these coronary scores, PWV and traditional cardiovascular risk factors.ResultsCompared to men, women with chest pain had lower mean Extent scores (19.2 vs. 35.6; p = 0.0001) and Gensini scores (23.6 vs. 41.9; p = 0.0001). PWV was similar between men and women (12.35 ± 3.74 vs. 12.43 ± 4.58; p = 0.88) and correlated with Extent score (r = 0.21, p = 0.0001) but not Gensini or vessel score (r = 0.03, p = 0.64 and r = 0.06, p = 0.26, respectively). PWV was associated with Extent score in men (B = 2.25 ± 0.78, p = 0.004 for men and B = 1.50 ± 0.88, p = 0.09 for women). It was not a predictor of Gensini score (B = -0.10, P = 0.90).ConclusionPWV correlates with the extent of CAD, as measured by the ‘Extent’ score in men more than women. However, it does not correlate with the severity of obstructive CAD in either gender.背景 脉搏波速度（Pulse-wave velocity, PWV）是评估主动脉僵硬度的指标，可独立预测心血管事件与全因死亡率，但目前文献中关于其与冠状动脉粥样硬化性心脏病（Coronary Artery Disease, CAD）严重程度及病变范围的关联研究较为匮乏。 方法 为探究脉搏波速度（PWV）在预测男女冠状动脉粥样硬化性心脏病（CAD）负荷中的应用价值，本研究纳入344例因疑似CAD接受有创冠状动脉造影检查的患者（男性266例，女性78例），检测其PWV水平。采用Pearson相关分析及多变量分析，评估上述冠状动脉评分、PWV与传统心血管危险因素之间的关联。 结果 与男性患者相比，伴胸痛的女性患者平均病变范围评分更低（19.2 vs. 35.6；p=0.0001），Gensini评分亦更低（23.6 vs. 41.9；p=0.0001）。男女患者的PWV水平无显著差异（12.35±3.74 vs. 12.43±4.58；p=0.88）；PWV与病变范围评分呈正相关（r=0.21，p=0.0001），但与Gensini评分及血管评分无显著关联（分别为r=0.03，p=0.64；r=0.06，p=0.26）。在男性患者中，PWV与病变范围评分呈独立相关（男性：B=2.25±0.78，p=0.004；女性：B=1.50±0.88，p=0.09）。PWV无法预测Gensini评分（B=-0.10，P=0.90）。 结论 脉搏波速度（PWV）与冠状动脉粥样硬化性心脏病（CAD）的病变范围呈正相关，且该关联在男性患者中较女性更为显著。但无论男性还是女性，PWV均无法预测阻塞性CAD的严重程度。