The predictive value of brachial-ankle pulse wave velocity in coronary atherosclerosis and peripheral artery diseases in urban Chinese patients

Yuanxi Xu, Yongquan Wu, Jue Li, Wenlin Ma, Xiaoming Guo, Yingyi Luo, Dayi Hu
Hypertension Research: Official Journal of the Japanese Society of Hypertension 2008, 31 (6): 1079-85
Coronary artery disease (CAD) is one of the most common diseases throughout the world. To investigate the relationship between brachial-ankle pulse wave velocity (baPWV) and arterial atherosclerosis and peripheral artery disease (PAD) and its potential diagnostic value in diagnosing arterial sclerosis, a self-designed questionnaire and special machine designed by Colin Corp., Ltd. were implemented to measure the level of baPWV and the ankle-brachial index (ABI) and their relations to coronary and peripheral artery atherosclerosis. The results showed that baPWV and ABI were equally effective at predicting stenosis of the coronary arteries and stenosis of the arteries of the lower extremities. Different levels of baPWV with corresponding ABI can express different degrees of arterial sclerosis and peripheral artery lesion to a certain extent. Measurement of both baPWV and ABI is thus highly recommended in clinical investigation. Arterial wave reflection is a major determinant of left ventricular function, coronary perfusion, and cardiovascular risk. We investigated whether arterial wave velocity can detect atherosclerosis of the coronary arteries and peripheral arteries in patients with documented coronary artery diseases. Our goal was to investigate the relationship between baPWV and arterial atherosclerosis and PAD and their potential diagnostic value. Two hundred and seventy-two patients ranging in age from 45-92 years (mean: 66.87+/-11.42 years) were selected from the Department of Cardiology of our hospital. A carefully designed questionnaire was used to gather baseline data for each patient. All patients underwent cardioangiography and were divided into four groups according to their Gensini scores: a control group, and groups with a mild, moderate, or severe degree of stenosis. One hundred and five of these patients simultaneously underwent angiography of the lower extremities and were divided into four groups according to the degree of artery stenosis: a control group, and groups with a mild, moderate, or severe degree of stenosis. Grouping of baPWV levels was made according to Japanese surveys. Bilateral baPWV and ABI were measured using non-invasive arterial atherosclerosis measuring equipment. In the coronary artery groups based on Gensini score, ABI in the group with a high degree of stenosis was significantly lower than that in the control and moderate stenosis groups, while the baPWV was significantly higher than that in the control and mild stenosis groups. In the grouping of baPWV levels, it was indicated that the ABI level was significantly different between each group. The ABI<0.9 in groups with baPWV<1,400 cm/s and >2,100 cm/s was higher than that in other groups. In the grouping by angiography of the lower extremities, the ABI level was decreased with increasing degree of artery stenosis while the baPWV levels were increased under the same circumstance (p<0.05 or p<0.01). Logistic regression analysis indicated that relatively low ABI, high baPWV, abnormal fasting blood glucose, and smoking were independent risk factors for the development of cardiovascular diseases. The simultaneous measurement of bilateral baPWV and ABI using the newly developed equipment presented herein is highly recommended, and should play an important role in predicting the possibility of cardiovascular diseases and the degree of coronary artery lesions. It is important to note that baPWV is not only one of the risk factors in the presence of coronary stenosis, but also a substitute index of target-organ damage, another parameter in predicting PAD. The current study indicated that a baPWV>1,800 cm/s often follows a severe coronary artery event, while baPWV>2,100 cm/s may be related to potential PAD. baPWV measurement is helpful to make new standard of diagnosing PAD in Chinese cohorts.

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