Aortic stiffness improves the prediction of both diagnosis and severity of coronary artery disease
Elective coronography has low diagnostic yield for obstructive coronary artery disease (CAD). We aim to determine whether non-invasive aortic stiffness assessment improves diagnostic accuracy of CAD screening by reducing the number of false-positive results from the cardiac stress test. A cross-sect...
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| Veröffentlicht in: | Hypertension research 2018-02, Vol.41 (2), p.118-125 |
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| creator | Yannoutsos, Alexandra Ahouah, Mathieu Dreyfuss Tubiana, Céline Topouchian, Jirar Safar, Michel E Blacher, Jacques |
| description | Elective coronography has low diagnostic yield for obstructive coronary artery disease (CAD). We aim to determine whether non-invasive aortic stiffness assessment improves diagnostic accuracy of CAD screening by reducing the number of false-positive results from the cardiac stress test. A cross-sectional study was conducted from January 2013 to September 2014 in our medical center. Electrocardiogram (ECG) stress test coupled with nuclear imaging was performed in 367 consecutive patients routinely followed for myocardial ischemia screening. Aortic pulse wave velocity (PWV) was assessed by applanation tonometry in the overall population. Forty-two patients underwent elective coronography because of ischemia. Theoretical PWV was calculated according to age, blood pressure and gender. The results were expressed as an index ((measured PWV-theoretical PWV)/theoretical PWV) for each patient. Ten patients presented with obstructive CAD, 16 patients had non-obstructive CAD and 16 patients had normal coronary angiography. PWV index and severity of CAD were positively correlated (P=0.001). All patients with obstructive CAD had a positive PWV index. When considering the PWV index retrospectively, the false positive results of cardiac stress test were significantly reduced (P |
| doi_str_mv | 10.1038/hr.2017.97 |
| format | Article |
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We aim to determine whether non-invasive aortic stiffness assessment improves diagnostic accuracy of CAD screening by reducing the number of false-positive results from the cardiac stress test. A cross-sectional study was conducted from January 2013 to September 2014 in our medical center. Electrocardiogram (ECG) stress test coupled with nuclear imaging was performed in 367 consecutive patients routinely followed for myocardial ischemia screening. Aortic pulse wave velocity (PWV) was assessed by applanation tonometry in the overall population. Forty-two patients underwent elective coronography because of ischemia. Theoretical PWV was calculated according to age, blood pressure and gender. The results were expressed as an index ((measured PWV-theoretical PWV)/theoretical PWV) for each patient. Ten patients presented with obstructive CAD, 16 patients had non-obstructive CAD and 16 patients had normal coronary angiography. PWV index and severity of CAD were positively correlated (P=0.001). All patients with obstructive CAD had a positive PWV index. When considering the PWV index retrospectively, the false positive results of cardiac stress test were significantly reduced (P<0.001). Twenty-three procedures may have been avoided in the present study cohort. The salient finding of this study was that in patients with known or suspected CAD, routinely followed aortic PWV index may be considered clinically useful for reducing the rate of unnecessary invasive angiographies. The clinical relevance of this individualized decision approach should be confirmed in a large-scale study. Prospective studies have the potential to evaluate the PWV index as a marker of CAD.</description><identifier>ISSN: 0916-9636</identifier><identifier>EISSN: 1348-4214</identifier><identifier>DOI: 10.1038/hr.2017.97</identifier><identifier>PMID: 29118329</identifier><language>eng</language><publisher>England: Nature Publishing Group</publisher><subject>Aged ; Aged, 80 and over ; Aorta - physiopathology ; Arterial Occlusive Diseases - physiopathology ; Atherosclerosis ; Cardiac stress tests ; Cardiovascular disease ; Cohort Studies ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - physiopathology ; Coronary vessels ; Cross-Sectional Studies ; Electrocardiography ; Exercise Test ; False Positive Reactions ; Female ; Humans ; Hypertension ; Ischemia ; Male ; Manometry ; Medical diagnosis ; Middle Aged ; Myocardial Ischemia - diagnosis ; Myocardial Ischemia - physiopathology ; Precision Medicine ; Predictive Value of Tests ; Pulse Wave Analysis ; Retrospective Studies ; Vascular Stiffness ; Vein & artery diseases</subject><ispartof>Hypertension research, 2018-02, Vol.41 (2), p.118-125</ispartof><rights>Copyright Nature Publishing Group Feb 2018</rights><rights>The Japanese Society of Hypertension 2018.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c433t-4896dafb4c0bd9c764987de6be8818a6935d6bc803074426b8a4dee39c1805b63</citedby><cites>FETCH-LOGICAL-c433t-4896dafb4c0bd9c764987de6be8818a6935d6bc803074426b8a4dee39c1805b63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29118329$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yannoutsos, Alexandra</creatorcontrib><creatorcontrib>Ahouah, Mathieu</creatorcontrib><creatorcontrib>Dreyfuss Tubiana, Céline</creatorcontrib><creatorcontrib>Topouchian, Jirar</creatorcontrib><creatorcontrib>Safar, Michel E</creatorcontrib><creatorcontrib>Blacher, Jacques</creatorcontrib><title>Aortic stiffness improves the prediction of both diagnosis and severity of coronary artery disease</title><title>Hypertension research</title><addtitle>Hypertens Res</addtitle><description>Elective coronography has low diagnostic yield for obstructive coronary artery disease (CAD). We aim to determine whether non-invasive aortic stiffness assessment improves diagnostic accuracy of CAD screening by reducing the number of false-positive results from the cardiac stress test. A cross-sectional study was conducted from January 2013 to September 2014 in our medical center. Electrocardiogram (ECG) stress test coupled with nuclear imaging was performed in 367 consecutive patients routinely followed for myocardial ischemia screening. Aortic pulse wave velocity (PWV) was assessed by applanation tonometry in the overall population. Forty-two patients underwent elective coronography because of ischemia. Theoretical PWV was calculated according to age, blood pressure and gender. The results were expressed as an index ((measured PWV-theoretical PWV)/theoretical PWV) for each patient. Ten patients presented with obstructive CAD, 16 patients had non-obstructive CAD and 16 patients had normal coronary angiography. PWV index and severity of CAD were positively correlated (P=0.001). All patients with obstructive CAD had a positive PWV index. When considering the PWV index retrospectively, the false positive results of cardiac stress test were significantly reduced (P<0.001). Twenty-three procedures may have been avoided in the present study cohort. The salient finding of this study was that in patients with known or suspected CAD, routinely followed aortic PWV index may be considered clinically useful for reducing the rate of unnecessary invasive angiographies. The clinical relevance of this individualized decision approach should be confirmed in a large-scale study. Prospective studies have the potential to evaluate the PWV index as a marker of CAD.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aorta - physiopathology</subject><subject>Arterial Occlusive Diseases - physiopathology</subject><subject>Atherosclerosis</subject><subject>Cardiac stress tests</subject><subject>Cardiovascular disease</subject><subject>Cohort Studies</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Artery Disease - physiopathology</subject><subject>Coronary vessels</subject><subject>Cross-Sectional Studies</subject><subject>Electrocardiography</subject><subject>Exercise Test</subject><subject>False Positive Reactions</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Ischemia</subject><subject>Male</subject><subject>Manometry</subject><subject>Medical diagnosis</subject><subject>Middle Aged</subject><subject>Myocardial Ischemia - diagnosis</subject><subject>Myocardial Ischemia - physiopathology</subject><subject>Precision Medicine</subject><subject>Predictive Value of Tests</subject><subject>Pulse Wave Analysis</subject><subject>Retrospective Studies</subject><subject>Vascular Stiffness</subject><subject>Vein & artery diseases</subject><issn>0916-9636</issn><issn>1348-4214</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kc1rVDEUxYNY7Fjd-AdIwE0R3pivyctdlmJVKLip65CP-5yUmZcxN1Pof-8bWl24cHUW98c5h3sYeyfFWgrtPm3bWgk5rmF8wVZSGzcYJc1LthIg7QBW23P2muheCOU2IF-xcwVSOq1gxeJVbb0kTr1M04xEvOwPrT4g8b5FfmiYS-qlzrxOPNa-5bmEn3OlQjzMmRM-YCv98XROtdU5tEceWsdFciEMhG_Y2RR2hG-f9YL9uPl8d_11uP3-5dv11e2QjNZ9MA5sDlM0ScQMabQG3JjRRnROumBBb7KNyQktRmOUjS6YjKghSSc20eoLdvnku_T_dUTqfl8o4W4XZqxH8hKsMsoJUAv64R_0vh7bvLTzatzAaJwB_T9KAhihDcAp9uMTlVolajj5Qyv75Q1eCn_ax2-bP-3jYVzg98-Wx7jH_Bf9M4j-DXYWiqI</recordid><startdate>20180201</startdate><enddate>20180201</enddate><creator>Yannoutsos, Alexandra</creator><creator>Ahouah, Mathieu</creator><creator>Dreyfuss Tubiana, Céline</creator><creator>Topouchian, Jirar</creator><creator>Safar, Michel E</creator><creator>Blacher, Jacques</creator><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20180201</creationdate><title>Aortic stiffness improves the prediction of both diagnosis and severity of coronary artery disease</title><author>Yannoutsos, Alexandra ; Ahouah, Mathieu ; Dreyfuss Tubiana, Céline ; Topouchian, Jirar ; Safar, Michel E ; Blacher, Jacques</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c433t-4896dafb4c0bd9c764987de6be8818a6935d6bc803074426b8a4dee39c1805b63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aorta - physiopathology</topic><topic>Arterial Occlusive Diseases - physiopathology</topic><topic>Atherosclerosis</topic><topic>Cardiac stress tests</topic><topic>Cardiovascular disease</topic><topic>Cohort Studies</topic><topic>Coronary Artery Disease - diagnosis</topic><topic>Coronary Artery Disease - physiopathology</topic><topic>Coronary vessels</topic><topic>Cross-Sectional Studies</topic><topic>Electrocardiography</topic><topic>Exercise Test</topic><topic>False Positive Reactions</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Ischemia</topic><topic>Male</topic><topic>Manometry</topic><topic>Medical diagnosis</topic><topic>Middle Aged</topic><topic>Myocardial Ischemia - diagnosis</topic><topic>Myocardial Ischemia - physiopathology</topic><topic>Precision Medicine</topic><topic>Predictive Value of Tests</topic><topic>Pulse Wave Analysis</topic><topic>Retrospective Studies</topic><topic>Vascular Stiffness</topic><topic>Vein & artery diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yannoutsos, Alexandra</creatorcontrib><creatorcontrib>Ahouah, Mathieu</creatorcontrib><creatorcontrib>Dreyfuss Tubiana, Céline</creatorcontrib><creatorcontrib>Topouchian, Jirar</creatorcontrib><creatorcontrib>Safar, Michel E</creatorcontrib><creatorcontrib>Blacher, Jacques</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Hypertension research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yannoutsos, Alexandra</au><au>Ahouah, Mathieu</au><au>Dreyfuss Tubiana, Céline</au><au>Topouchian, Jirar</au><au>Safar, Michel E</au><au>Blacher, Jacques</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Aortic stiffness improves the prediction of both diagnosis and severity of coronary artery disease</atitle><jtitle>Hypertension research</jtitle><addtitle>Hypertens Res</addtitle><date>2018-02-01</date><risdate>2018</risdate><volume>41</volume><issue>2</issue><spage>118</spage><epage>125</epage><pages>118-125</pages><issn>0916-9636</issn><eissn>1348-4214</eissn><abstract>Elective coronography has low diagnostic yield for obstructive coronary artery disease (CAD). We aim to determine whether non-invasive aortic stiffness assessment improves diagnostic accuracy of CAD screening by reducing the number of false-positive results from the cardiac stress test. A cross-sectional study was conducted from January 2013 to September 2014 in our medical center. Electrocardiogram (ECG) stress test coupled with nuclear imaging was performed in 367 consecutive patients routinely followed for myocardial ischemia screening. Aortic pulse wave velocity (PWV) was assessed by applanation tonometry in the overall population. Forty-two patients underwent elective coronography because of ischemia. Theoretical PWV was calculated according to age, blood pressure and gender. The results were expressed as an index ((measured PWV-theoretical PWV)/theoretical PWV) for each patient. Ten patients presented with obstructive CAD, 16 patients had non-obstructive CAD and 16 patients had normal coronary angiography. PWV index and severity of CAD were positively correlated (P=0.001). All patients with obstructive CAD had a positive PWV index. When considering the PWV index retrospectively, the false positive results of cardiac stress test were significantly reduced (P<0.001). Twenty-three procedures may have been avoided in the present study cohort. The salient finding of this study was that in patients with known or suspected CAD, routinely followed aortic PWV index may be considered clinically useful for reducing the rate of unnecessary invasive angiographies. The clinical relevance of this individualized decision approach should be confirmed in a large-scale study. Prospective studies have the potential to evaluate the PWV index as a marker of CAD.</abstract><cop>England</cop><pub>Nature Publishing Group</pub><pmid>29118329</pmid><doi>10.1038/hr.2017.97</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Hypertension research, 2018-02, Vol.41 (2), p.118-125 |
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| subjects | Aged Aged, 80 and over Aorta - physiopathology Arterial Occlusive Diseases - physiopathology Atherosclerosis Cardiac stress tests Cardiovascular disease Cohort Studies Coronary Artery Disease - diagnosis Coronary Artery Disease - physiopathology Coronary vessels Cross-Sectional Studies Electrocardiography Exercise Test False Positive Reactions Female Humans Hypertension Ischemia Male Manometry Medical diagnosis Middle Aged Myocardial Ischemia - diagnosis Myocardial Ischemia - physiopathology Precision Medicine Predictive Value of Tests Pulse Wave Analysis Retrospective Studies Vascular Stiffness Vein & artery diseases |
| title | Aortic stiffness improves the prediction of both diagnosis and severity of coronary artery disease |
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