Aortic stiffness is increased in positive adenosine stress cardiac magnetic resonance

Abstract

© 2018, Medical Association of Thailand. All rights reserved. Background: Arterial stiffness is an independent predictor as well as a poor prognosticator for cardiovascular disease. Although abnormal arterial stiffness has been established in patients with ischemic cardiomyopathy, there are limited data on patients with less severe coronary artery disease. Adenosine stress cardiac magnetic resonance (CMR) imaging is a non-invasive test for the diagnosis of coronary artery disease. Objective: To compare aortic stiffness of patients with positive and negative adenosine stress CMR. Materials and Methods: Prospectively, 180 patients who were undergoing adenosine stress CMR were consecutively enrolled. Using CMR, aortic stiffness was measured as pulse wave velocity (PWV) by distance propagation divided by time delay between mid-ascending and mid-descending thoracic aorta. Adenosine stress CMR was evaluated as positive or negative along with the number of ischemic segments. The mean PWV of two groups was determined. Results: The mean age was 66.8±10.8 years and 56.7% were female. Adenosine stress CMR was positive in 51 patients (28.3%). The mean PWV of all patients was 9.77±4.29 m/second and the mean ischemic segments from positive adenosine stress CMR patients was 6.35±3.81 segments. The mean PWV of positive adenosine stress CMR group was higher than negative adenosine stress CMR group significantly (11.13±5.40 m/second versus 9.23±3.65 m/second, p-value 0.01). As for the secondary outcomes, no correlation was found between PWV and the numbers of ischemic segments (r = 0.18, p-value 0.21). Nevertheless, after adjustment of other risk factors, PWV remained a significant predictor of myocardial ischemia (p-value 0.02, 95% CI 1.02 to 1.20). Conclusion: Aortic stiffness measured by PWV is associated with positive adenosine stress CMR in patients with known or suspected coronary artery disease. PWV may become an integral part of coronary artery risk stratification and may affect future treatment.