Role of increased central arterial stiffness in macro and microvascular damage in patients with coronary artery disease.

Background: Patients with heart disease frequently have renal dysfunction manifested by a decrease in glomerular filtration rate (GFR) and / or increase of albuminuria.

Objectives: The objective was to study the possible role of increased aortic stiffness in the presence and extent of coronary artery disease (CAD) and kidney dysfunction in a group of patients with suspected CAD.

Patients And Methods: We studied forty-eight patients undergoing coronariography for suspected coronary disease (CAD). Using applanation tonometry on the radial artery and applying a transfer function, central blood pressure values were calculated. The study of aortic stiffness was done by determining the carotid-femoral pulse velocity (Pv).

Results: Of the 48 patients, 11 had no significant coronary lesions, 24 showed significant lesions in 1 or 2 coronary arteries and 13 in ≥ 3 arteries. The group with a higher degree of CD had significantly higher cPP values than the group without CD. The Pv increased progressively and significantly with the degree of CD. The logistic regression showed that Pv independently predicted the presence of CD. The relative risk of CD increased 2.5 times for each meter of increase in Pv. The GFR was negatively and significantly correlated with age and Pv was associated with albuminuria.

Conclusions: In patients with stable CD, Pv, expression of aortic stiffness, is independently associated with the existence of CD and its degree of extension. The increase in arterial stiffness also participates in the decrease in GFR and in the increase in albuminuria.