Association of increased aortic pulse pressure and aortic pulsatility with coronary artery disease and metabolic syndrome

Amaç:Aortik nabız basıncı ve aortik pulsatilitenin kardiyovasküler riske dair bilgi verdiği bildirilmiştir. Biz bu çalışmada periferik kan basıncı değerlerinden daha güvenilir olan santral kan basıncı değerlerinin, koıoner arter hastalığı ve metabolik sendıom ile olan birlikteliğini ortaya koymayı amaçladık. Gereç ve Yöntem: Çalışmaya ilk defa kardiyak kateterizasyon işlemi uygulanan ardışık 204 hasta (129 erkek, 56.3± 11.1) dahil edildi. Çalışmaya alınan bütün hastalardan biyokimyasal parametreler çalışıldı, demografik verileri kaydedildi ve hemodinamik değerleri ölçüldü. Hastaların sistolik, diastolik ve ortalama aortik kan basıncı ölçümleri asendan aortadan sıvı dolu sistem kullanılarak ölçüldü. Aortik pulsatilite, santral aortik nabız basıncının, ortalama aortik kan basıncına oranı olarak hesaplanmıştır. Hastalar dört gruba ayrılmıştır. 1) koroner arter hastalığı ve metabolik sendromun olmadığı hastalar (kontrol grubu) 2) sadece metabolik sendromu olan hastalar 3) sadece koroner arter hastalığı olan hastalar 4) hem metabolik sendromun hem de koroner arter hastalığının olduğu hastalar. Bulgular: Gruplar arasında aortik diyastolik kan basıncı değerleri yönünden fark izlenmedi. Aortik pulsatilite kontrol grubuna kıyasla diğer 3 grupta da belirgin şekilde yüksek saptandı (p=0.003). Sonuç: Bulgularımız göstermiştir ki aterosklerozun göstergesi olan aortik pulsatilite ve santral aortik nabız basıncı, metabolik sendromlu hastalarda, koroner arter, hastaları kadar sık, hatta daha sıktır. Anjiografik koroner arter hastarıyla aortik nabız basıncı arasındaki göstermis olduğumuz bu ilişki daha önceki çalışmalarda da vurgulanmıştır.

Artmış aortik nabız basıncı ve aortik pulsatilitekin koroner arter hastalığı ve metabolik sendrom ile olan ilişki

Purpose: Aortic pulse pressure and aortic pulsatility are reported to predict cardiovascular risk. Here, we aimed to investigate the association of coronary artery disease and metabolic syndrome with central blood pressure values, which are more reliable than peripheral pressure measurements. Materials and Methods: Two hundred and four consecutive patients (129 men, mean age 56.3±11.1) who underwent cardiac catheterization for the first time were included in the study. All subjects also underwent biochemical investigations and hemodynamic measurements. Hemodynamic parameters like systolic and diastolic aortic pressures were measured during cardiac catheterization using a fluid-filled system in the ascending aorta. Parameters like aortic pulsatility and aortic pulse pressure were calculated and compared between four groups: I) control group, who did not have coronary artery disease or metabolic syndrome, II) patient group who had only metabolic syndrome, III) patient group who had only coronary artery disease, IV) patient group who had both coronary artery disease and metabolic syndrome. Results: Hemodynamic parameters like aortic diastolic blood pressure did not differ between the groups. Aortic pulsatility was significantly higher in all 3 patient groups compared to the control group (p< 0.001). This difference was most significant in patient group IV (p= 0.010). Aortic pulse pressure was highest in group II, followed by group III and group IV, compared to the control group (p=0.003). Conclusion: Our findings clearly show that high aortic pulsatility and aortic pulse pressure, which are evidence of atherosclerosis, are encountered as frequently or even more frequently in metabolic syndrome as they are in coronary artery disease. Secondly we demonstrated a close relationship between angiographically confirmed coronary artery disease and increased aortic pulse pressure, similar to previous reports.

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