Indices of aortic distensibility and coronary flow velocity reserve in patients with different grades of aortic atherosclerosis.

Objective: The purpose of this study was to evaluate the correlation of the elastic properties of the descending aorta, the coronary flow velocity reserve (CFR) and the grade of aortic atherosclerosis (AA) in patients who have undergone coronary angiography.

Methods: A total of 113 consecutive patients (77 men and 36 women, aged 31-80 years) underwent stress transoesophageal echocardiographic (STEE) assessment of the CFR. The grade of AA and the indices of aortic distensibility were evaluated during the same session of STEE. All patients had chest pain without previous myocardial infarction. Coronary angiography was performed in all cases.

Results: The resting systolic and diastolic coronary flow velocities increased, while the coronary flow velocities measured at the peak of stress and the ratio Smax/Srest decreased in parallel with the aortic grade. The CFR and mean CFR were impaired in patients who exhibited aortic intimal thickening, but no further decrease was found in the event of aortic plaque. The elastic moduli E(p) and E(s) increased in parallel with the grade of AA. The occurance of a negative coronary angiogram was more common in patients without AA, but significant left anterior descending coronary artery disease or multivessel disease were more frequent at a higher grade of AA (in cases with aortic plaque).

Conclusions: The CFR was decreased in patients with aortic intimal thickening, but no further decrease was observed in the presence of aortic plaque. The indices of aortic distensibility increased continuously in parallel with the aortic grade.