Original Article Korean Circulation J 2004;34(7):677-683

Assessment of the Arterial Stiffness Index as a Clinical Parameter for Atherosclerotic Coronary Artery Disease

Seong-Mi Park, MD, Hon-Seog Seo, MD, Hong-Euy Lim, MD, Sung-Hee Shin, MD, Chang-Gyu Park, MD, Dong-Joo Oh, MD, Young-Moo Ro, MD

Division of Cardiology, Department of Internal Medicine, Korea University Medical College, Seoul, Korea

The Korean Circulation Journal, Vol. 34, No. 7, July, 2004

ABSTRACT___________________________________________________________________

Background: Arterial stiffening increases both the systolic blood and pulse pressures, which is known to be a major contributor to atherosclerosis and the most important cause of cardiovascular disease. The aims of this study were to assess the feasibility of the arterial stiffness index (ASI), using a computerized oscillometric device, by comparison with pulse wave velocity (PWV), and to investigate its usefulness to patients with clinical coronary artery disease. Methods: 60-consecutive patients, who underwent coronary angiography and who’s aorto-femoral PWV were obtained with a Judkins catheter, were the subjects of this study. The ASI was obtained for all patients, using CardioVision® MS-2000 (IMDP, Las Vegas, NV), with cuff pressure on the brachial artery. The ASI were obtained as follows: 1) at the baseline (ASI-B), 2) after hyperemia induced by compression of the arm with cuff pressure for 5 minutes (ASI-H), 3) after having taken sublingual nitroglycerin (ASI-N). Results: 34-patients had significant coronary artery disease (CAD) from the coronary angiography findings. All the ASI were positively correlated to the PWV, and were also higher in patients with CAD (ASI-B, 85.9±57.8 vs. 48.2±24.5 p=0.001: ASI-H, 98.1±49.8 vs. 48.1±21.3, p=0.00; ASI-N, 66.7±55.7 vs. 33.2±27.9, p=0.002). The ASI-H was mostly well correlated to the PWV and the severity of CAD (PWV, r=0.49, p=0.00; severity, r=0.52, p=0.00). The ASI was increased after hyperemia in patients with CAD (85.9±57.8 to 98.1±49.8, p=0.01), but was not significantly changed in those without CAD (48.2±24.5 to 48.1±21.3, p=0.68). The ASI-N was decreased in all patients. Conclusions: The Arterial Stiffness Index, measured non-invasively by computerized oscillometry, was feasible and useful for detection of atherosclerotic coronary disease. Especially, the difference in the ASI between patients with and without CAD was more apparent after hyperemia. These findings suggest that in addition to stiffening of the arterial wall itself, the impairment of flow mediated vasodilation, due to endothelial dysfunction, further increases the arterial stiffness. (Korean Circulation J 2004:34(7):677-683)

Excerpts from Original Publication:

“…The sensitivity, specificity, and diagnostic accuracy were 74.4, 88.2, and 78.3, respectively, which were not inferior to those of treadmill test.”

“Thus, the use of the ASI is suggested as an easy, non-invasive screening and risk stratification method for the assessment of clinical atherosclerotic coronary artery disease.”

“In conclusion, the ASI as measured by computerized oscillometry, provides a sensitive technique, which serves as a parameter for assessing the atherosclerotic changes in coronary vessels.”