Skip to main content
Top
Published in: The International Journal of Cardiovascular Imaging 3/2011

Open Access 01-03-2011 | Original Paper

Impaired aortic distensibility measured by computed tomography is associated with the severity of coronary artery disease

Authors: Naser Ahmadi, Vahid Nabavi, Fereshteh Hajsadeghi, Ferdinand Flores, Shahdad Azmoon, Hussain Ismaeel, David Shavelle, Song S. Mao, Ramin Ebrahimi, Matthew J. Budoff

Published in: The International Journal of Cardiovascular Imaging | Issue 3/2011

Login to get access

Abstract

Impaired aortic distensibility index (ADI) is associated with cardiovascular risk factors. This study evaluates the relation of ADI measured by computed tomographic angiography (CTA) with the severity of coronary atherosclerosis in subjects with suspected coronary artery disease (CAD). Two hundred and twenty-nine subjects,age 63 ± 9 years, 42% female, underwent coronary artery calcium (CAC) scanning and CTA, and their ADI and Framingham risk score (FRS) were measured. End-systolic and end-diastolic (ED) cross-sectional-area(CSA) of ascending-aorta (AAo) was measured 15-mm above the left-main coronary ostium. ADI was defined as: [(Δlumen-CSA)/(lumen-CSA in ED × systemic-pulse-pressure) × 103]. ADI measured by 2D-trans-thoracic echocardiography (TTE) was compared with CTA-measured ADI in 26 subjects without CAC. CAC was defined as 0, 1–100, 101–400 and 400+. CAD was defined as luminal stenosis 0, 1–49% and 50%+. There was an excellent correlation between CTA- and TTE-measured ADI (r 2 = 0.94, P = 0.0001). ADI decreased from CAC 0 to CAC 400+; similarly from FRS 1–9% to FRS 20% + (P < 0.05). After adjustment for risk factors, the relative risk for each standard deviation decrease in ADI was 1.66 for CAC 1–100, 2.26 for CAC 101–400 and 2.32 for CAC 400+ as compared to CAC 0; similarly, 2.36 for non-obstructive CAD and 2.67 for obstructive CAD as compared to normal coronaries. The area under the ROC-curve to predict significant CAD was 0.68 for FRS, 0.75 for ADI, 0.81 for CAC and 0.86 for the combination (P < 0.05). Impaired aortic distensibility strongly correlates with the severity of coronary atherosclerosis. Addition of ADI to CAC and traditional risk factors provides incremental value to predict at-risk individuals.
Literature
1.
go back to reference Fuster V, Badimon L, Badimon JJ, Chesebro JH (1992) The pathogenesis of coronary artery disease and the acute coronary syndromes (1). N Engl J Med 326(4):242–250PubMedCrossRef Fuster V, Badimon L, Badimon JJ, Chesebro JH (1992) The pathogenesis of coronary artery disease and the acute coronary syndromes (1). N Engl J Med 326(4):242–250PubMedCrossRef
2.
go back to reference Griendling KK, Ushio-Fukai M, Lassegue B, Alexander RW (1997) Angiotensin II signaling in vascular smooth muscle. New concepts. Hypertension 29(1 Pt 2):366–373PubMed Griendling KK, Ushio-Fukai M, Lassegue B, Alexander RW (1997) Angiotensin II signaling in vascular smooth muscle. New concepts. Hypertension 29(1 Pt 2):366–373PubMed
3.
go back to reference Vane JR, Anggard EE, Botting RM (1990) Regulatory functions of the vascular endothelium. N Engl J Med 323(1):27–36PubMedCrossRef Vane JR, Anggard EE, Botting RM (1990) Regulatory functions of the vascular endothelium. N Engl J Med 323(1):27–36PubMedCrossRef
4.
go back to reference Bogren HG, Mohiaddin RH, Klipstein RK, Firmin DN, Underwood RS, Rees SR, Longmore DB (1989) The function of the aorta in ischemic heart disease: a magnetic resonance and angiographic study of aortic compliance and blood flow patterns. Am Heart J 118(2):234–247PubMedCrossRef Bogren HG, Mohiaddin RH, Klipstein RK, Firmin DN, Underwood RS, Rees SR, Longmore DB (1989) The function of the aorta in ischemic heart disease: a magnetic resonance and angiographic study of aortic compliance and blood flow patterns. Am Heart J 118(2):234–247PubMedCrossRef
5.
go back to reference Laurent S, Caviezel B, Beck L, Girerd X, Billaud E, Boutouyrie P, Hoeks A, Safar M (1994) Carotid artery distensibility and distending pressure in hypertensive humans. Hypertension 23(6 Pt 2):878–883PubMed Laurent S, Caviezel B, Beck L, Girerd X, Billaud E, Boutouyrie P, Hoeks A, Safar M (1994) Carotid artery distensibility and distending pressure in hypertensive humans. Hypertension 23(6 Pt 2):878–883PubMed
6.
go back to reference Eren M, Gorgulu S, Uslu N, Celik S, Dagdeviren B, Tezel T (2004) Relation between aortic stiffness and left ventricular diastolic function in patients with hypertension, diabetes, or both. Heart 90(1):37–43PubMedCrossRef Eren M, Gorgulu S, Uslu N, Celik S, Dagdeviren B, Tezel T (2004) Relation between aortic stiffness and left ventricular diastolic function in patients with hypertension, diabetes, or both. Heart 90(1):37–43PubMedCrossRef
7.
go back to reference Lehmann ED, Gosling RG, Sonksen PH (1992) Arterial wall compliance in diabetes. Diabet Med 9(2):114–119PubMedCrossRef Lehmann ED, Gosling RG, Sonksen PH (1992) Arterial wall compliance in diabetes. Diabet Med 9(2):114–119PubMedCrossRef
8.
go back to reference Dart AM, Lacombe F, Yeoh JK, Cameron JD, Jennings GL, Laufer E, Esmore DS (1991) Aortic distensibility in patients with isolated hypercholesterolaemia, coronary artery disease, or cardiac transplant. Lancet 338(8762):270–273PubMedCrossRef Dart AM, Lacombe F, Yeoh JK, Cameron JD, Jennings GL, Laufer E, Esmore DS (1991) Aortic distensibility in patients with isolated hypercholesterolaemia, coronary artery disease, or cardiac transplant. Lancet 338(8762):270–273PubMedCrossRef
9.
go back to reference Lehmann ED, Watts GF, Gosling RG (1992) Aortic distensibility and hypercholesterolaemia. Lancet 340(8828):1171–1172PubMedCrossRef Lehmann ED, Watts GF, Gosling RG (1992) Aortic distensibility and hypercholesterolaemia. Lancet 340(8828):1171–1172PubMedCrossRef
10.
go back to reference Oliver JJ, Webb DJ (2003) Noninvasive assessment of arterial stiffness and risk of atherosclerotic events. Arterioscler Thromb Vasc Biol 23(4):554–566PubMedCrossRef Oliver JJ, Webb DJ (2003) Noninvasive assessment of arterial stiffness and risk of atherosclerotic events. Arterioscler Thromb Vasc Biol 23(4):554–566PubMedCrossRef
11.
go back to reference Bank AJ, Wang H, Holte JE, Mullen K, Shammas R, Kubo SH (1996) Contribution of collagen, elastin, and smooth muscle to in vivo human brachial artery wall stress and elastic modulus. Circulation 94(12):3263–3270PubMed Bank AJ, Wang H, Holte JE, Mullen K, Shammas R, Kubo SH (1996) Contribution of collagen, elastin, and smooth muscle to in vivo human brachial artery wall stress and elastic modulus. Circulation 94(12):3263–3270PubMed
12.
go back to reference Sudhir K, Mullen WL, Hausmann D, Fitzgerald PJ, Chou TM, Yock PG, Chatterjee K (1995) Contribution of endothelium-derived nitric oxide to coronary arterial distensibility: an in vivo two-dimensional intravascular ultrasound study. Am Heart J 129(4):726–732PubMedCrossRef Sudhir K, Mullen WL, Hausmann D, Fitzgerald PJ, Chou TM, Yock PG, Chatterjee K (1995) Contribution of endothelium-derived nitric oxide to coronary arterial distensibility: an in vivo two-dimensional intravascular ultrasound study. Am Heart J 129(4):726–732PubMedCrossRef
13.
go back to reference Hironaka K, Yano M, Kohno M, Tanigawa T, Obayashi M, Konishi M, Umemoto S, Matsuzaki M (1997) In vivo aortic wall characteristics at the early stage of atherosclerosis in rabbits. Am J Physiol 273(3 Pt 2):H1142–H1147PubMed Hironaka K, Yano M, Kohno M, Tanigawa T, Obayashi M, Konishi M, Umemoto S, Matsuzaki M (1997) In vivo aortic wall characteristics at the early stage of atherosclerosis in rabbits. Am J Physiol 273(3 Pt 2):H1142–H1147PubMed
14.
go back to reference Tentolouris N, Liatis S, Moyssakis I, Tsapogas P, Psallas M, Diakoumopoulou E, Voteas V, Katsilambros N (2003) Aortic distensibility is reduced in subjects with type 2 diabetes and cardiac autonomic neuropathy. Eur J Clin Invest 33(12):1075–1083PubMedCrossRef Tentolouris N, Liatis S, Moyssakis I, Tsapogas P, Psallas M, Diakoumopoulou E, Voteas V, Katsilambros N (2003) Aortic distensibility is reduced in subjects with type 2 diabetes and cardiac autonomic neuropathy. Eur J Clin Invest 33(12):1075–1083PubMedCrossRef
15.
go back to reference Cruickshank K, Riste L, Anderson SG, Wright JS, Dunn G, Gosling RG (2002) Aortic pulse-wave velocity and its relationship to mortality in diabetes and glucose intolerance: an integrated index of vascular function? Circulation 106(16):2085–2090PubMedCrossRef Cruickshank K, Riste L, Anderson SG, Wright JS, Dunn G, Gosling RG (2002) Aortic pulse-wave velocity and its relationship to mortality in diabetes and glucose intolerance: an integrated index of vascular function? Circulation 106(16):2085–2090PubMedCrossRef
16.
go back to reference Kingwell BA, Waddell TK, Medley TL, Cameron JD, Dart AM (2002) Large artery stiffness predicts ischemic threshold in patients with coronary artery disease. J Am Coll Cardiol 40(4):773–779PubMedCrossRef Kingwell BA, Waddell TK, Medley TL, Cameron JD, Dart AM (2002) Large artery stiffness predicts ischemic threshold in patients with coronary artery disease. J Am Coll Cardiol 40(4):773–779PubMedCrossRef
17.
go back to reference Belz GG (1995) Elastic properties and windkessel function of the human aorta. Cardiovasc Drugs Ther 9(1):73–83PubMedCrossRef Belz GG (1995) Elastic properties and windkessel function of the human aorta. Cardiovasc Drugs Ther 9(1):73–83PubMedCrossRef
18.
go back to reference Kelly RP, Tunin R, Kass DA (1992) Effect of reduced aortic compliance on cardiac efficiency and contractile function of in situ canine left ventricle. Circ Res 71(3):490–502PubMed Kelly RP, Tunin R, Kass DA (1992) Effect of reduced aortic compliance on cardiac efficiency and contractile function of in situ canine left ventricle. Circ Res 71(3):490–502PubMed
19.
go back to reference Ohtsuka S, Kakihana M, Watanabe H, Sugishita Y (1994) Chronically decreased aortic distensibility causes deterioration of coronary perfusion during increased left ventricular contraction. J Am Coll Cardiol 24(5):1406–1414PubMedCrossRef Ohtsuka S, Kakihana M, Watanabe H, Sugishita Y (1994) Chronically decreased aortic distensibility causes deterioration of coronary perfusion during increased left ventricular contraction. J Am Coll Cardiol 24(5):1406–1414PubMedCrossRef
20.
go back to reference Detrano R, Guerci AD, Carr JJ, Bild DE, Burke G, Folsom AR, Liu K, Shea S, Szklo M, Bluemke DA, O’Leary DH, Tracy R, Watson K, Wong ND, Kronmal RA (2008) Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 358(13):1336–1345PubMedCrossRef Detrano R, Guerci AD, Carr JJ, Bild DE, Burke G, Folsom AR, Liu K, Shea S, Szklo M, Bluemke DA, O’Leary DH, Tracy R, Watson K, Wong ND, Kronmal RA (2008) Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 358(13):1336–1345PubMedCrossRef
21.
go back to reference Brown ER, Kronmal RA, Bluemke DA, Guerci AD, Carr JJ, Goldin J, Detrano R (2008) Coronary calcium coverage score: determination, correlates, and predictive accuracy in the Multi-Ethnic Study of Atherosclerosis. Radiology 247(3):669–675PubMedCrossRef Brown ER, Kronmal RA, Bluemke DA, Guerci AD, Carr JJ, Goldin J, Detrano R (2008) Coronary calcium coverage score: determination, correlates, and predictive accuracy in the Multi-Ethnic Study of Atherosclerosis. Radiology 247(3):669–675PubMedCrossRef
22.
go back to reference Budoff MJ, Nasir K, McClelland RL, Detrano R, Wong N, Blumenthal RS, Kondos G, Kronmal RA (2009) Coronary calcium predicts events better with absolute calcium scores than age-sex-race/ethnicity percentiles: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol 53(4):345–352PubMedCrossRef Budoff MJ, Nasir K, McClelland RL, Detrano R, Wong N, Blumenthal RS, Kondos G, Kronmal RA (2009) Coronary calcium predicts events better with absolute calcium scores than age-sex-race/ethnicity percentiles: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol 53(4):345–352PubMedCrossRef
23.
go back to reference Ahmadi N, Hajsadeghi F, Gul K, Vane J, Usman N, Flores F, Nasir K, Hecht H, Naghavi M, Budoff M (2008) Relations between digital thermal monitoring of vascular function, the Framingham risk score, and coronary artery calcium score. J Cardiovasc Comput Tomogr 2(6):382–388PubMedCrossRef Ahmadi N, Hajsadeghi F, Gul K, Vane J, Usman N, Flores F, Nasir K, Hecht H, Naghavi M, Budoff M (2008) Relations between digital thermal monitoring of vascular function, the Framingham risk score, and coronary artery calcium score. J Cardiovasc Comput Tomogr 2(6):382–388PubMedCrossRef
24.
go back to reference Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB (1998) Prediction of coronary heart disease using risk factor categories. Circulation 97(18):1837–1847PubMed Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB (1998) Prediction of coronary heart disease using risk factor categories. Circulation 97(18):1837–1847PubMed
25.
go back to reference Becker CR, Knez A, Jakobs TF, Aydemir S, Becker A, Schoepf UJ, Bruening R, Haberl R, Reiser MF (1999) Detection and quantification of coronary artery calcification with electron-beam and conventional CT. Eur Radiol 9(4):620–624PubMedCrossRef Becker CR, Knez A, Jakobs TF, Aydemir S, Becker A, Schoepf UJ, Bruening R, Haberl R, Reiser MF (1999) Detection and quantification of coronary artery calcification with electron-beam and conventional CT. Eur Radiol 9(4):620–624PubMedCrossRef
26.
go back to reference Mao S, Lu B, Takasu J, Oudiz RJ, Budoff MJ (2003) Measurement of the RT interval on ECG records during electron-beam CT. Acad Radiol 10(6):638–643PubMedCrossRef Mao S, Lu B, Takasu J, Oudiz RJ, Budoff MJ (2003) Measurement of the RT interval on ECG records during electron-beam CT. Acad Radiol 10(6):638–643PubMedCrossRef
27.
go back to reference McLeod AL, Newby DE, Northridge DB, Fox KA, Uren NG (2003) Influence of differential vascular remodeling on the coronary vasomotor response. Cardiovasc Res 59(2):520–526PubMedCrossRef McLeod AL, Newby DE, Northridge DB, Fox KA, Uren NG (2003) Influence of differential vascular remodeling on the coronary vasomotor response. Cardiovasc Res 59(2):520–526PubMedCrossRef
28.
go back to reference Yamagishi M, Umeno T, Hongo Y, Tsutsui H, Goto Y, Nakatani S, Miyatake K (1997) Intravascular ultrasonic evidence for importance of plaque distribution (eccentric vs circumferential) in determining distensibility of the left anterior descending artery. Am J Cardiol 79(12):1596–1600PubMedCrossRef Yamagishi M, Umeno T, Hongo Y, Tsutsui H, Goto Y, Nakatani S, Miyatake K (1997) Intravascular ultrasonic evidence for importance of plaque distribution (eccentric vs circumferential) in determining distensibility of the left anterior descending artery. Am J Cardiol 79(12):1596–1600PubMedCrossRef
29.
go back to reference Stefanadis C, Stratos C, Boudoulas H, Kourouklis C, Toutouzas P (1990) Distensibility of the ascending aorta: comparison of invasive and non-invasive techniques in healthy men and in men with coronary artery disease. Eur Heart J 11(11):990–996PubMed Stefanadis C, Stratos C, Boudoulas H, Kourouklis C, Toutouzas P (1990) Distensibility of the ascending aorta: comparison of invasive and non-invasive techniques in healthy men and in men with coronary artery disease. Eur Heart J 11(11):990–996PubMed
30.
go back to reference Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1(8476):307–310PubMedCrossRef Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1(8476):307–310PubMedCrossRef
31.
go back to reference Halcox JP, Schenke WH, Zalos G, Mincemoyer R, Prasad A, Waclawiw MA, Nour KR, Quyyumi AA (2002) Prognostic value of coronary vascular endothelial dysfunction. Circulation 106(6):653–658PubMedCrossRef Halcox JP, Schenke WH, Zalos G, Mincemoyer R, Prasad A, Waclawiw MA, Nour KR, Quyyumi AA (2002) Prognostic value of coronary vascular endothelial dysfunction. Circulation 106(6):653–658PubMedCrossRef
32.
33.
go back to reference Binggeli C, Spieker LE, Corti R, Sudano I, Stojanovic V, Hayoz D, Luscher TF, Noll G (2003) Statins enhance postischemic hyperemia in the skin circulation of hypercholesterolemic patients: a monitoring test of endothelial dysfunction for clinical practice? J Am Coll Cardiol 42(1):71–77PubMedCrossRef Binggeli C, Spieker LE, Corti R, Sudano I, Stojanovic V, Hayoz D, Luscher TF, Noll G (2003) Statins enhance postischemic hyperemia in the skin circulation of hypercholesterolemic patients: a monitoring test of endothelial dysfunction for clinical practice? J Am Coll Cardiol 42(1):71–77PubMedCrossRef
34.
go back to reference Celermajer DS (2003) Statins, skin, and the search for a test of endothelial function. J Am Coll Cardiol 42(1):78–80PubMedCrossRef Celermajer DS (2003) Statins, skin, and the search for a test of endothelial function. J Am Coll Cardiol 42(1):78–80PubMedCrossRef
35.
go back to reference Charbonneau F, Anderson TJ, Title L, Jobin J, Poirier P, Huyhn T, Chan S, Walling A, Hutchison S, Tran T, Lonn E, Buithieu J, Genest J (2008) Modulation of arterial reactivity using amlodipine and atorvastatin measured by ultrasound examination (MARGAUX). Atherosclerosis 197(1):420–427PubMedCrossRef Charbonneau F, Anderson TJ, Title L, Jobin J, Poirier P, Huyhn T, Chan S, Walling A, Hutchison S, Tran T, Lonn E, Buithieu J, Genest J (2008) Modulation of arterial reactivity using amlodipine and atorvastatin measured by ultrasound examination (MARGAUX). Atherosclerosis 197(1):420–427PubMedCrossRef
36.
go back to reference Stulc T, Kasalova Z, Prazny M, Vrablik M, Skrha J, Ceska R (2003) Microvascular reactivity in patients with hypercholesterolemia: effect of lipid lowering treatment. Physiol Res 52(4):439–445PubMed Stulc T, Kasalova Z, Prazny M, Vrablik M, Skrha J, Ceska R (2003) Microvascular reactivity in patients with hypercholesterolemia: effect of lipid lowering treatment. Physiol Res 52(4):439–445PubMed
37.
go back to reference Warnholtz A, Wild P, Ostad MA, Elsner V, Stieber F, Schinzel R, Walter U, Peetz D, Lackner K, Blankenberg S, Munzel T (2008) Effects of oral niacin on endothelial dysfunction in patients with coronary artery disease: results of the randomized, double-blind, placebo-controlled INEF study. Atherosclerosis Warnholtz A, Wild P, Ostad MA, Elsner V, Stieber F, Schinzel R, Walter U, Peetz D, Lackner K, Blankenberg S, Munzel T (2008) Effects of oral niacin on endothelial dysfunction in patients with coronary artery disease: results of the randomized, double-blind, placebo-controlled INEF study. Atherosclerosis
38.
go back to reference van Popele NM, Grobbee DE, Bots ML, Asmar R, Topouchian J, Reneman RS, Hoeks AP, van der Kuip DA, Hofman A, Witteman JC (2001) Association between arterial stiffness and atherosclerosis: the Rotterdam study. Stroke 32(2):454–460PubMed van Popele NM, Grobbee DE, Bots ML, Asmar R, Topouchian J, Reneman RS, Hoeks AP, van der Kuip DA, Hofman A, Witteman JC (2001) Association between arterial stiffness and atherosclerosis: the Rotterdam study. Stroke 32(2):454–460PubMed
39.
go back to reference Sun H, Zhong M, Miao Y, Ma X, Gong HP, Tan HW, Zhang Y, Zhang W (2009) Impaired elastic properties of the aorta in fat-fed, streptozotocin-treated rats. Vascular remodeling in diabetic arteries. Cardiology 114(2):107–113PubMedCrossRef Sun H, Zhong M, Miao Y, Ma X, Gong HP, Tan HW, Zhang Y, Zhang W (2009) Impaired elastic properties of the aorta in fat-fed, streptozotocin-treated rats. Vascular remodeling in diabetic arteries. Cardiology 114(2):107–113PubMedCrossRef
40.
go back to reference Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, Ducimetiere P, Benetos A (2001) Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 37(5):1236–1241PubMed Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, Ducimetiere P, Benetos A (2001) Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 37(5):1236–1241PubMed
41.
go back to reference Haluska BA, Jeffries L, Carlier S, Marwick TH (2009) Measurement of arterial distensibility and compliance to assess prognosis. Atherosclerosis Haluska BA, Jeffries L, Carlier S, Marwick TH (2009) Measurement of arterial distensibility and compliance to assess prognosis. Atherosclerosis
42.
go back to reference Shechter M, Issachar A, Marai I, Koren-Morag N, Freinark D, Shahar Y, Shechter A, Feinberg MS (2009) Long-term association of brachial artery flow-mediated vasodilation and cardiovascular events in middle-aged subjects with no apparent heart disease. Int J Cardiol 134(1):52–58PubMedCrossRef Shechter M, Issachar A, Marai I, Koren-Morag N, Freinark D, Shahar Y, Shechter A, Feinberg MS (2009) Long-term association of brachial artery flow-mediated vasodilation and cardiovascular events in middle-aged subjects with no apparent heart disease. Int J Cardiol 134(1):52–58PubMedCrossRef
43.
go back to reference Papathanassiou K, Naka KK, Kazakos N, Kanioglou C, Makriyiannis D, Pappas K, Katsouras CS, Liveris K, Kolettis T, Tsatsoulis A, Michalis LK (2009) Pioglitazone vs glimepiride: differential effects on vascular endothelial function in patients with type 2 diabetes. Atherosclerosis 205(1):221–226PubMedCrossRef Papathanassiou K, Naka KK, Kazakos N, Kanioglou C, Makriyiannis D, Pappas K, Katsouras CS, Liveris K, Kolettis T, Tsatsoulis A, Michalis LK (2009) Pioglitazone vs glimepiride: differential effects on vascular endothelial function in patients with type 2 diabetes. Atherosclerosis 205(1):221–226PubMedCrossRef
44.
go back to reference Ostad MA, Eggeling S, Tschentscher P, Schwedhelm E, Boger R, Wenzel P, Meinertz T, Munzel T, Warnholtz A (2009) Flow-mediated dilation in patients with coronary artery disease is enhanced by high dose atorvastatin compared to combined low dose atorvastatin and ezetimibe: results of the CEZAR study. Atherosclerosis 205(1):227–232PubMedCrossRef Ostad MA, Eggeling S, Tschentscher P, Schwedhelm E, Boger R, Wenzel P, Meinertz T, Munzel T, Warnholtz A (2009) Flow-mediated dilation in patients with coronary artery disease is enhanced by high dose atorvastatin compared to combined low dose atorvastatin and ezetimibe: results of the CEZAR study. Atherosclerosis 205(1):227–232PubMedCrossRef
45.
go back to reference Wood D, De Backer G, Faergeman O, Graham I, Mancia G, Pyorala K (1998) Prevention of coronary heart disease in clinical practice. Summary of recommendations of the second joint task force of European and other societies on coronary prevention. J Hypertens 16(10):1407–1414PubMedCrossRef Wood D, De Backer G, Faergeman O, Graham I, Mancia G, Pyorala K (1998) Prevention of coronary heart disease in clinical practice. Summary of recommendations of the second joint task force of European and other societies on coronary prevention. J Hypertens 16(10):1407–1414PubMedCrossRef
46.
go back to reference Fedder DO, Koro CE, L’Italien GJ (2002) New National Cholesterol Education Program III guidelines for primary prevention lipid-lowering drug therapy: projected impact on the size, sex, and age distribution of the treatment-eligible population. Circulation 105(2):152–156PubMedCrossRef Fedder DO, Koro CE, L’Italien GJ (2002) New National Cholesterol Education Program III guidelines for primary prevention lipid-lowering drug therapy: projected impact on the size, sex, and age distribution of the treatment-eligible population. Circulation 105(2):152–156PubMedCrossRef
47.
go back to reference Third Report of the National Cholesterol Education Program (NCEP) (2002) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation 106(25):3143–3421 Third Report of the National Cholesterol Education Program (NCEP) (2002) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation 106(25):3143–3421
48.
go back to reference Grundy SM, Cleeman JI, Merz CN, Brewer HB Jr, Clark LT, Hunninghake DB, Pasternak RC, Smith SC Jr, Stone NJ (2004) Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation 110(2):227–239PubMedCrossRef Grundy SM, Cleeman JI, Merz CN, Brewer HB Jr, Clark LT, Hunninghake DB, Pasternak RC, Smith SC Jr, Stone NJ (2004) Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation 110(2):227–239PubMedCrossRef
49.
go back to reference Smith SC Jr, Greenland P, Grundy SM (2000) AHA conference proceedings. Prevention conference V: beyond secondary prevention: identifying the high-risk patient for primary prevention: executive summary. American heart association. Circulation 101(1):111–116 Smith SC Jr, Greenland P, Grundy SM (2000) AHA conference proceedings. Prevention conference V: beyond secondary prevention: identifying the high-risk patient for primary prevention: executive summary. American heart association. Circulation 101(1):111–116
50.
go back to reference Khot UN, Khot MB, Bajzer CT, Sapp SK, Ohman EM, Brener SJ, Ellis SG, Lincoff AM, Topol EJ (2003) Prevalence of conventional risk factors in patients with coronary heart disease. JAMA 290(7):898–904PubMedCrossRef Khot UN, Khot MB, Bajzer CT, Sapp SK, Ohman EM, Brener SJ, Ellis SG, Lincoff AM, Topol EJ (2003) Prevalence of conventional risk factors in patients with coronary heart disease. JAMA 290(7):898–904PubMedCrossRef
51.
go back to reference Scridon T, Novaro GM, Bush HS, Asher CR, Dandes E, Kabirdas D, Scridon C, Kuo BT, Whiteman M, Shen MY (2008) Reclassification of patients for aggressive cholesterol treatment: additive value of multislice coronary angiography to the National Cholesterol Education Program guidelines. Clin Cardiol 31(9):419–423PubMedCrossRef Scridon T, Novaro GM, Bush HS, Asher CR, Dandes E, Kabirdas D, Scridon C, Kuo BT, Whiteman M, Shen MY (2008) Reclassification of patients for aggressive cholesterol treatment: additive value of multislice coronary angiography to the National Cholesterol Education Program guidelines. Clin Cardiol 31(9):419–423PubMedCrossRef
52.
go back to reference Gokce N, Holbrook M, Hunter LM, Palmisano J, Vigalok E, Keaney JF Jr, Vita JA (2002) Acute effects of vasoactive drug treatment on brachial artery reactivity. J Am Coll Cardiol 40(4):761–765PubMedCrossRef Gokce N, Holbrook M, Hunter LM, Palmisano J, Vigalok E, Keaney JF Jr, Vita JA (2002) Acute effects of vasoactive drug treatment on brachial artery reactivity. J Am Coll Cardiol 40(4):761–765PubMedCrossRef
Metadata
Title
Impaired aortic distensibility measured by computed tomography is associated with the severity of coronary artery disease
Authors
Naser Ahmadi
Vahid Nabavi
Fereshteh Hajsadeghi
Ferdinand Flores
Shahdad Azmoon
Hussain Ismaeel
David Shavelle
Song S. Mao
Ramin Ebrahimi
Matthew J. Budoff
Publication date
01-03-2011
Publisher
Springer Netherlands
Published in
The International Journal of Cardiovascular Imaging / Issue 3/2011
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-010-9680-6

Other articles of this Issue 3/2011

The International Journal of Cardiovascular Imaging 3/2011 Go to the issue