Document Detail

Radial augmentation index unmasks premature coronary artery disease in younger males.
MedLine Citation:
PMID:  19295416     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The augmentation index, a marker of arterial wave reflection, is considered to indicate cardiovascular risk burden, particularly in younger persons. We assessed whether the easily obtainable radial augmentation index (rAIx) is superior to systolic blood pressure (SBP) or pulse pressure (PP) in detecting atherosclerotic vascular disease at an early age. METHODS: We determined rAIx by applanation tonometry, SBP and PP in 152 male patients with or without invasively documented coronary artery disease (CAD). Ejection fraction (EF) was visually estimated by echocardiography or left ventricular angiography. RESULTS: In younger patients (age < or =60 years, EF > or =30%), rAIx was significantly higher in patients with CAD (79.8+/-13.5%, n=31) compared with patients without CAD (68.5+/-22.0%, n=21; P = 0.04), whereas SBP (121+/-16 vs. 131+/-18 mmHg, P=0.04) and PP (48.7+/-9.4 vs. 56.3+/-12.1 mmHg, P=0.01) were even lower in patients with CAD compared with patients without CAD. In patients aged < or =60 years, rAIx was highest when EF was less than 30% (90.0+/-9.2%) compared with patients with EF 30-54% (80.7+/-11.5%) or EF > or =55% (72.1+/-20.4%, P=0.01). In contrast, in patients above 60 years of age, rAIx, SBP or PP did not differ between patients with or without CAD and the rAIx tended to be lowest in patients with severely reduced EF (P=0.07). CONCLUSION: We conclude that premature vascular disease in younger patients with CAD is reflected only by an elevated rAIx, and not by SBP or PP. The rAIx is not suited to distinguish between older patients with high or low cardiovascular risk. Age seems to influence the interplay between rAIx and systolic heart function.
Ulrich Fischer-Rasokat; Felix Brenck; Andreas M Zeiher; Ioakim Spyridopoulos
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Blood pressure monitoring     Volume:  14     ISSN:  1473-5725     ISO Abbreviation:  Blood Press Monit     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-23     Completed Date:  2009-05-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9606438     Medline TA:  Blood Press Monit     Country:  England    
Other Details:
Languages:  eng     Pagination:  59-67     Citation Subset:  IM    
Department of Cardiology, J. W. Goethe University Hospital, Germany.
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MeSH Terms
Age Factors*
Blood Pressure
Blood Pressure Determination
Brachial Artery / physiology,  physiopathology
Cohort Studies
Coronary Artery Disease / diagnosis*,  physiopathology*
Heart Ventricles / radiography
Middle Aged

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