Curr Opin Cardiol. 2015 Jul;30(4):422-31. doi: 10.1097/HCO.0000000000000179.
Arterial stiffness and coronary artery disease.
Current opinion in cardiology
Ignatios Ikonomidis, George Makavos, John Lekakis
Affiliations
Affiliations
- Second Department of Cardiology, University of Athens Medical School, Attikon Hospital, Athens, Greece.
PMID: 26049393
DOI: 10.1097/HCO.0000000000000179
Abstract
PURPOSE OF REVIEW: The current traditional risk scores are not sufficient to predict the full incidence of cardiovascular disease. In this brief review, we discuss the pathophysiological mechanisms through which arterial stiffness affects cardiac function and the additive value of markers of arterial stiffness, to detect the presence of coronary artery disease (CAD) and predict adverse outcome in these patients.
RECENT FINDINGS: Arterial stiffness causes early arrival of wave reflections in systole instead of diastole and, thus, increases systolic afterload and reduces diastolic coronary perfusion pressure. Abnormal collagen turnover, cytokines, and metalloproteinase activity are common biochemical links between vascular and myocardial stiffness. Pulse wave velocity, augmentation index, and central pressures measured by simple noninvasive methods are related to atheromatic plaque vulnerability, incidence, severity, and extent of CAD. Recent meta-analyses have shown the additive value of markers of arterial stiffness, and particularly of pulse wave velocity, to detect CAD, predict cardiovascular events, and reclassify patients to a higher cardiovascular risk. Studies assessing whether reduction of arterial stiffness is associated with improved prognosis are lacking.
SUMMARY: Markers of arterial stiffness are useful tools to identify early atherosclerosis and adverse clinical outcomes in young adults and individuals with a modest risk factor profile. Assessing arterial stiffness may facilitate cardiovascular risk stratification beyond traditional risk scores.
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