7. The Value of Pulse Wave Velocity as an Index for the Prediction of Coronary Atherosclerosis

Abstract

Background

Arterial stiffness has been known as an independent contributory factor for coronary artery disease (CAD). Pulse wave velocity (PWV) is widely accepted as a simple non-invasive measure of arterial stiffness. The aim of our study was to test whether abnormal PWV could identify patients with significant CAD

Methods

We enrolled 174 consecutive patients who were referred for evaluation of suspected CAD and underwent PWV measurement and cardiac CT for calcium scoring. Age-matched normative data was used to define subgroups with normal or abnormal PWV. The severity of CAD was categorized based on the coronary artery calcium score (CACS) and the number of obstructive CAD was also defined in patients who underwent subsequent invasive coronary angiogram.

Results

Brachial-ankle PWV (baPWV) was correlated with ln(CACS + 1) and the number of obstructive CAD (p <0.05). However, after adjustment for age, baPWV did no longer correlate with them. Furthermore, abnormal baPWV were neither sensitive nor specific index for detection of moderate to severe coronary calcification (CACS ??00, or ??75th percentile), and the presence of obstructive CAD (sensitivity: 0.61, 0.62 and 0.55; specificity: 0.56, 0.63 and 0.70, respectively).

Conclusion

Our findings suggest that PWV was associated with the severity of CAD, however, which may primarily attributed to common risk factors such as age. Furthermore, abnormal PWV failed to predict significant CAD. Therefore, PWV may be of limited value in identifying patients at increased risk of cardiovascular events.