Search

BackgroundAlthough it has been documented that low socioeconomic status (SES) is associated with increased risk of mortality and cardiovascular disease (CVD), this issue has not been addressed in patients at high CVD risk. This study was performed to investigate the association of the patient’s SES with the presence of obstructive coronary artery disease (CAD) and long-term cardiovascular outcomes who undergo invasive coronary angiography (ICA).MethodsA total of 9,530 patients who underwent ICA for the evaluation and treatment of CAD (66.0±12.3 years and 60.2% male) were retrospectively reviewed. The patients were divided into two groups according to the health insurance type: those with low SES who had the Medical aid program (Medical aid beneficiary [MAB] group; n=1,436) and those with high SES who had the National Health Insurance program (National Health Insurance beneficiary [NHIB] group; n=8,094). The primary outcome was a composite of cardiac death, acute myocardial infarction, coronary revascularization, and ischemic stroke.ResultsOf the study patients, 1,436 (15.1%) were in the MAB group. The prevalence of cardiovascular risk factors was higher in the MAB group compared to the NHIB group. However, the prevalence of obstructive CAD was similar between the two groups (62.8% vs. 64.2%;P=0.306). During a median follow-up period of 3.5 years (interquartile range, 1.0 to 5.9 years), the incidence of the composite cardiovascular event was significantly higher in the MAB group than in the NHIB group (20.2% vs. 16.2%,PP=0.006).ConclusionsAlthough CAD prevalence was similar, MABs showed an increased risk of composite cardiovascular events than NHIBs in Korean adults undergoing ICA. This provides additional evidence for the association between low SES and an increased risk of CVD, even in high-risk subjects.Clinical perspectiveWhat is new?This study provided evidence for a relationship between low socioeconomic status and increased cardiovascular disease risk in a high-risk population.What are the clinical implications?Subjects with low socioeconomic status are more likely to develop cardiovascular disease and to have a higher frequency of related risk factors, so cardiovascular disease tests and treatments should be performed more aggressively.Appropriate risk stratification of low socioeconomic status patients with traditional risk factors for cardiovascular disease is important for identifying high-risk patients.

Ticagrelor-based dual antiplatelet therapy (TDAPT) provides potent antiplatelet inhibition but may increase the bleeding risk in Asian populations. We investigated the impact of the early use of low-dose TDAPT (l-TDAPT; 120 mg) on clinical outcomes in Korean patients undergoing percutaneous coronary intervention (PCI). A multicenter prospective clinical cohort study was conducted with patients on standard-dose TDAPT (s-TDAPT; 180 mg) after PCI for complex lesions. A major adverse cardiovascular event (MACE) was defined as a composite of cardiovascular death, myocardial infarction, stroke, and repeat revascularization. A net clinical event (NCE) was defined as a composite of bleeding events and MACEs. Among the 772 patients on s-TDAPT, 115 (14.8%) switched to l-TDAPT within 6 months. Common reasons for the regimen changes were switching as planned (38.8%), dyspnea (25.5%), and bleeding (23.6%). A multivariate Cox proportional hazard model (CPH) showed that the risks of MACE, bleeding events, and NCE were not different between the l-TDAPT and s-TDAPT groups during the entire follow-up period and beyond 6 months after PCI. Multivariate time-varying CPH also showed similar results. De-escalation with low-dose ticagrelor within 6 months after PCI is feasible and safe even in patients with complex lesions harboring a high ischemic event risk.

Given the high prevalence and poor prognosis of heart failure (HF), finding prognostic factors for patients with HF is crucial. This study investigated the prognostic value of reactive hyperemia index (RHI), a measure of endothelial function, in HF. A total of 90 HF patients (mean age, 63.7 ± 13.2 years; female, 25.6%) with a history of hospitalization for HF treatment were prospectively enrolled. RHI was measured using digital arterial tonometry in a stable condition. Clinical events, including all-cause death and HF admission, were assessed. During the median follow-up of 3.66 years (interquartile range, 0.91–4.94 years), 26 clinical events (28.9%) occurred. Although there were no significant differences in risk factors and laboratory findings according to the occurrence of clinical events, the RHI value was significantly lower in patients with clinical events than in those without (1.21 ± 0.34 vs. 1.68 ± 0.48; P P P

It is not clear whether the influence of arterial stiffness depends on the subject’s cardiovascular risk status. This study was performed to assess the prognostic value of arterial stiffness according to different cardiovascular risk profiles. A total of 11,767 subjects (61 years and 58% males) who underwent brachial-ankle pulse wave velocity (baPWV) measurement were retrospectively analyzed. Subjects were stratified into three groups: (1) those with traditional risk factor ≤1 and without atherosclerotic cardiovascular disease (ASCVD), (2) those with traditional risk factors ≥2 and without ASCVD, or (3) those with documented ASCVD. Composite events of cardiac death, non-fatal myocardial infarction, coronary revascularization and stroke were assessed during the clinical follow-up period. Compared to patients with risk factor ≤1, those with risk factor ≥2 and those with ASCVD were older, and more frequently had unfavorable laboratory findings, and higher baPWV values. During the median follow-up of 1329 days (interquartile range, 570–1,965 days), there were 350 composite events (3.0%). In multivariable Cox regression analyses, higher baPWV value was independently associated with higher incidence rate of composite events even after controlling for potential confounders in all three groups (P

Background: Identification of subclinical target organ damage (TOD) at early stage is important for the reduction in cardiovascular risk. This study was performed to assess the association between ...

Background The association between oxidized low-density lipoprotein (OxLDL) and plaque instability in coronary and carotid artery disease is well established. However, the association between OxLDL and the histologic changes of plaque in peripheral artery disease has not been clearly elucidated. This study aims to investigate the association between plasma OxLDL and histologic plaque instability in patients with peripheral artery disease. Methods Prospectively obtained plaques from 48 patients who underwent endovascular atherectomy (n = 20), surgical endarterectomy (n = 9), or bypass surgery (n = 19) for treatment of atherosclerotic femoropopliteal artery disease were evaluated for histologic fibrosis, sclerosis, calcification, necrosis, cholesterol cleft, and foamy macrophages using hematoxylin and eosin, oil red O, and immunohistochemical staining. Unstable plaques were defined as plaques that were positive for foamy macrophages and with lipid content of more than 10% of the total plaque area. Plasma OxLDL levels were measured using an enzyme-linked immunosorbent assay (Mercodia AB, Uppsala, Sweden). Results Of the 48 patients, 26 (54%) had unstable plaques. The unstable plaque group was younger, had fewer angiographic total occlusions, less calcification, and more CD68-positive and LOX-1-positive cells than the stable plaque group. Plasma OxLDL levels were significantly higher in the unstable plaque group than in the stable plaque group (57.4 ± 13.9 vs. 47.2 ± 13.6 U/L, P = 0.014). Multivariate analysis revealed that plasma OxLDL level, smoking, angiographic nontotal occlusion, and statin nonuse were independent predictors of unstable plaque. Conclusions Among patients with peripheral artery disease, the histologic instability of femoropopliteal plaque was independently associated with high plasma OxLDL, smoking, nontotal occlusion, and statin nonuse. Further large-scale studies are necessary to evaluate the role of noninvasive OxLDL measurement for predicting plaque instability and future adverse vascular event.

Because menopausal women have an increased cardiovascular risk, risk stratification is very crucial in this population. This study aimed to verify the prognostic value of arterial stiffness in menopausal women.We retrospectively analyzed 2,917 menopausal women (age55y) without overt cardiovascular disease who underwent brachial-ankle pulse wave velocity measurement. The primary endpoint was a composite of clinical events, including all-cause death, nonfatal myocardial infarction, coronary revascularization, and stroke, hereafter referred to as major adverse cardiovascular events. Propensity score matching and inverse probability-treatment weighting analysis were used to balance differences in baseline participant characteristics.The mean participant age was 66.8 ± 7.7 years. During a median follow-up period of 4.0 (interquartile range of 1.9-6.3) years, the primary outcome was noted in 56 cases (1.9%). Pulse wave velocity was significantly higher in participants with the primary outcome than in those without (1,947 ± 388 vs 1,690 ± 348 cm/s; P 0.001). For every 100 cm/s increase in pulse wave velocity, the hazard ratio for the primary endpoint increased by 1.15 times (95% confidence interval, 1.08-1.22; P 0.001) in multivariable Cox regression analysis. A pulse wave velocity1,613 cm/s was associated with increased risk of the primary endpoint in the same multivariable analysis (hazard ratio, 3.06; 95% confidence interval, 1.40-6.68; P = 0.005). The results were consistent after propensity score matching and inverse probability-treatment weighting analysis.Elevated brachial-ankle pulse wave velocity was associated with the occurrence of major adverse cardiovascular events in menopausal women without cardiovascular disease and may represent a useful screening tool.

The prognostic value of arterial stiffness in patients with diabetes mellitus (DM) remains unclear. The aim of this study was to investigate the association between brachial-ankle pulse wave velocity (baPWV) and the occurrence of cardiovascular events in people with DM. A total of 2714 subjects (mean age, 63.6 years; males, 59.3%) with type 2 DM and without documented cardiovascular disease and stroke were analyzed. The primary end-point of this study was composite cardiovascular events of cardiac death, non-fatal myocardial infarction, coronary revascularization and stroke. There were 118 composite events (4.3%) during a median follow-up period of 3.84 years (interquartile range, 1.60-5.52 years). In multivariable Cox regression analysis, higher baPWV (≥1672 cm/s) was associated with composite events even after controlling for potential confounders (hazard ratio [HR], 2.00; 95% confidence interval [CI], 1.31-3.07; P = .001). Compared to the lowest baPWV tertile, both middle (HR, 1.84; 95% CI, 1.03-3.27; P = .037) and the highest (HR, 2.97; 95% CI, 1.69-5.22; P .001) tertile of baPWV were associated with increased risk of cardiovascular events in the same multivariable model. In conclusion, the baPWV was associated with cardiovascular events in people with type 2 DM. Considering the simplicity and convenience of baPWV measurement, baPWV may be useful for risk stratification of people with type 2 DM.

Background: Both C-reactive protein (CRP) and arterial stiffness are associated with the development of cardiovascular disease (CVD). This study was performed to investigate whether a combination of these two measurements could improve cardiovascular risk stratification. Methods: A total of 6572 consecutive subjects (mean age, 60.8 ± 11.8 years, female, 44.2%) who underwent both high-sensitivity CRP (hs-CRP) and brachial–ankle pulse wave velocity (baPWV) measurement within 1 week were retrospectively analyzed. Major adverse cardiovascular events (MACE), including cardiovascular death, acute myocardial infarction, coronary revascularization, and stroke were assessed during the clinical follow-up. Results: During a mean follow-up period of 3.75 years (interquartile range, 1.78–5.31 years), there were 182 cases of MACE (2.8%). The elevated baPWV (≥1505 cm/s) (hazard ratio (HR), 4.21, 95% confidence interval (CI), 2.73–6.48, p &lt, 0.001) and hs-CRP (≥3 mg/L) (HR, 1.57, 95% CI, 1.12–2.21, 0.001) levels were associated with MACE even after controlling for potential confounders. The combination of baPWV and hs-CRP further stratified the subjects’ risk (subjects with low baPWV and hs-CRP vs. subjects with high baPWV and hs-CRP, HR, 7.08, 95% CI, 3.76−13.30, 0.001). Adding baPWV information to clinical factors and hs-CRP had an incremental prognostic value (global Chi-square score, from 126 to 167, p &lt, 0.001). Conclusions: The combination of hs-CRP and baPWV provided a better prediction of future CVD than either one by itself. Taking these two simple measurements simultaneously is clinically useful in cardiovascular risk stratification.

Characteristics of subjects with reduced GLS but no overt left ventricular dysfunction have been poorly characterized. We sought to find clinical factors associated with reduced GLS despite having normal LVEF. Subjects without documented cardiovascular disease who underwent measurement of GLS using 2D speckle-tracking echocardiography were retrospectively reviewed. All subjects had normal LVEF (≥ 55%). Because GLS is a negative value, we took the absolute value |x| for a simpler interpretation. Reduced GLS was defined as

Background Although the inter-arm blood pressure (BP) difference has been advocated to be associated with cardiovascular events, the implication of inter-leg BP difference has not been well established. This study was conducted to investigate whether inter-arm and -leg BP differences have prognostic value in patients undergoing percutaneous coronary intervention (PCI). Methods In this prospective study, we consecutively enrolled 667 patients who underwent PCI. Both arm and leg BPs were measured at the day after PCI. The primary outcome was a major adverse cardiovascular event (MACE) including cardiac death, acute coronary syndrome, coronary revascularization, stroke, and hospitalization for heart failure during the follow-up period. Results Mean age was 64.0±11.1 years old, and males were predominant (70.5%). During a mean follow-up period of 3.0 years, MACE occurred in 209 (31.3%) patients. The inter-leg systolic BP difference (ILSBPD) was significantly higher in patients with MACE than those without (9.9±12.3 vs. 7.2±7.5 mmHg, P = 0.004). The inter-arm systolic BP difference was not significantly different between patients with and without MACE (P = 0.403). In multivariable Cox regression analysis, increased ILSBPD was independently associated with the development of MACE (per 5 mmHg; hazard ratio, 1.07; 95% confidence interval, 1.01–1.14). The inter-arm systolic BP difference was not associated with MACE in the multivariable analysis. Conclusion Increased ILSBPD was independently associated with worse cardiovascular outcomes after PCI. As ILSBPD is easy to measure, it may be helpful in the risk stratification of patients undergoing PCI.

PURPOSE There has been limited evidence for the association between socioeconomic status (SES) and arterial stiffness. This study was performed to investigate the association between household income and brachial pulse pressure (PP) in the general Korean population. MATERIALS AND METHODS This study was based on data acquired in the 2018 Korea National Health and Nutrition Examination Survey (2018 KNHANES). A total of 13004 subjects at the age of 20 years or older analysed. The information on monthly household income was obtained through the questionnaire, and was stratified into 5 groups for each quintile. Brachial blood pressure (BP) was measured 3 times, and the average of the second and third measured BPs were used. PP was calculated as the difference between systolic and diastolic BPs. RESULTS A lower household income was associated with a higher prevalence of cardiovascular risk factors. As household income increased, PP decreased proportionally (p

BACKGROUND There is little data as to whether osteoprotegerin (OPG) is associated with target organ damage (TOD), so we evaluated the association in patients at high risk of coronary artery disease (CAD).Methods and Results:A total of 349 patients who underwent invasive coronary angiography (ICA) for suspected CAD were prospectively recruited. During the index admission, 6 TOD parameters were collected: extent of CAD, glomerular filtration rate (GFR), left ventricular mass index (LVMI), E/e', brachial-ankle pulse wave velocity (baPWV), and ankle-brachial index (ABI). Serum OPG levels were measured using enzyme-linked immunosorbent assay. The OPG level was significantly higher in patients with ≥1 TOD parameter than in those without (314±186 vs. 202±74 pg/mL, P

The prognostic value of arterial stiffness in Korean hypertensive patients has not been specified. This study was performed to evaluate the prognostic value of brachial-ankle pulse wave velocity (baPWV) in Korean hypertensive patients and to propose a cutoff value of baPWV predicting future cardiovascular events. A total of 2561 hypertensive patients without documented cardiovascular disease (mean age, 63 years; 47% females) who underwent baPWV measurement were retrospectively analyzed. Composite events of cardiac death, non-fatal myocardial infarction, coronary revascularization, and ischemic stroke were assessed during the clinical follow-up period. During a median follow-up period of 4.14 years (interquartile range, 2.18-5.48 years), there were 69 cases of composite events (2.7%). In receiver operating characteristic curve analysis, the best cutoff value of baPWV predicting composite events was 1630 cm/s (sensitivity, 79.7%; specificity, 49.1%; area under curve, 0.674; 95% confidence interval [CI], 0.613-0.735; P < .001). In multivariable Cox regression analysis, higher baPWV (≥1630 cm/s) was independently associated with higher risk of the occurrence of composite events even after controlling for potential confounders (hazard ratio, 2.83; 95% confidence interval, 1.49-5.36; P = .001). In conclusion, increased baPWV in Korean hypertensive patients was associated with an increased risk of future cardiovascular events. In addition, we suggested 1630 cm as a cutoff value of baPWV for predicting cardiovascular events, which will be helpful in guiding the treatment strategy of Korean hypertensive patients.

Background There is no general agreement on underlying pathophysiology explaining the high burden of cardiovascular disease on people at low socioeconomic status (SES). This study was conducted to investigate the association between healthcare systems and arterial stiffness. Methods A total of 8,929 subjects (60 years old and 55% were male) who underwent brachial-ankle pulse wave velocity (baPWV) measurement were retrospectively analyzed. There were 8,237 National Health Insurance (NHI) beneficiaries (92.2%) and 692 medical aid (MA) beneficiaries (7.8%). The median value of baPWV was 1,540 cm/s. Results Subjects with higher baPWV values (≥1,540 cm/s) were older, and more frequently had cardiovascular risk factors and unfavorable laboratory findings than those with lower values baPWV ( Conclusions The baPWV values were significantly higher in MA beneficiaries than in NHI beneficiaries. The result of this study provides additional evidence on the association between low SES and arterial stiffening.

Previous studies have focused on only 1 or 2 echocardiographic parameters as prognostic markers in patients with acute ischemic stroke (AIS). A total of 900 patients with AIS who underwent transthoracic echocardiography (72.6 ± 12.0 years and 60% males) were retrospectively reviewed. Composite clinical events, including all-cause mortality, non-fatal stroke, non-fatal myocardial infarction, and coronary revascularization, were assessed during clinical follow-ups. During a median follow-up of 3.3 years (interquartile range 0.6–5.1 years), there were 151 (16.8%) composite events. In the multivariable analyses after controlling for potential confounders, left ventricular ejection fraction (LVEF)

BACKGROUND Aortic knob width (AKW), which can be measured easily in simple radiography, is associated with the degree of dilatation and tortuosity of the aortic arch. Pulsatile stress influences aortic geometry. This study was carried out to investigate whether AKW can represent invasively measured aortic pulse pressure (APP). METHODS A total of 252 patients who underwent invasive coronary angiography (ICA) for the evaluation of coronary artery disease were enrolled. AKW was defined as the perpendicular length from the lateral margin of the main bronchus to the most prominent edge of the aortic knob on chest radiography. APP was measured at the ascending aorta using a pigtail catheter immediately before ICA. RESULTS When patients were divided into two groups according to the median value of APP (69 mmHg), AKW was significantly greater in patients with higher APP (≥69 mmHg) than in those with lower APP (

This study sought to evaluate the impact of triple antiplatelet therapy on clinical outcomes in patients treated with second-generation drug-eluting stents (DES) for coronary artery disease. There are limited data regarding the impact of triple antiplatelet therapy in patients who underwent implantation of second-generation DES. We planned to randomly assign 2,110 patients treated with second-generation DES to triple (aspirin, clopidogrel, and cilostazol) and dual (aspirin, clopidogrel, and placebo) antiplatelet therapy groups. The primary end point was a composite of death, myocardial infarction, ischemic stroke, or target vessel revascularization (TVR) at 1 year since randomization. The study was stopped early owing to slow enrollment. In total, 404 patients (202 patients each in the triple and dual antiplatelet therapy groups) were finally enrolled. At 1 year, the primary end point had occurred in 3.6% and 9.4% of patients in the triple and dual antiplatelet therapy groups, respectively (hazard ratio [HR] of the triple group 0.396; 95% confidence interval [CI] 0.166 to 0.949; p = 0.038). There was no significant difference between the 2 groups regarding the occurrence of a composite of all-cause death, myocardial infarction, or ischemic stroke (HR 0.583; 95% CI 0.229 to 1.481; p = 0.256). However, the rates of TVR were significantly lower in the triple antiplatelet therapy group than in the dual antiplatelet therapy group (HR 0.118; 95% CI 0.015 to 0.930; p = 0.043). In conclusion, triple antiplatelet therapy with cilostazol after implantation of second-generation DES improved clinical outcomes, mainly by reducing TVR.

Metabolically healthy obese (MHO) individuals generally show better cardiovascular prognosis compared with metabolically unhealthy counterparts, which may be related to different patterns of target organ damage (TOD). We aimed to investigate the patterns of TOD related to obesity and metabolic unhealthiness.A total of 659 Korean adults (mean age, 60.0 ± 11.8 years; male, 51.1%) undergoing health examinations were stratified into four groups according to obesity (body mass index ≥25.0 kg/mIn multivariable analyses, compared with the MHNO group, the MHO group showed 2.31 times higher odds for LVH, whereas, the MUNO group showed 3.14 and 6.28 times higher odds for increased arterial stiffness and renal dysfunction, respectively. Metabolic unhealthiness was associated with increased arterial stiffness [odds ratio (OR) 2.73; confidence interval (95% CI) 1.72-4.34], renal dysfunction (OR 4.02; 95% CI 1.54-10.49), and LV diastolic dysfunction (OR 2.28; 95% CI 1.14-4.55). Meanwhile, obesity showed weaker association with LVH and LV diastolic dysfunction, and was not associated with increased arterial stiffness and renal dysfunction in multivariable analyses.Metabolic unhealthiness shows more association with TOD than obesity, which may contribute to the higher risk of cardiometabolic abnormalities in MUNO compared with MHO.

Although brachial-ankle pulse wave velocity (baPWV) has been widely used as an index of arterial stiffness, no consensus exists about whether baPWV can reflect central aortic stiffness. The authors investigated the association between baPWV and invasively measured aortic pulse pressure (APP) in a total of 109 consecutive patients (mean age, 62.3 ± 11.3 years; 67.9% men). Most patients (91%) had obstructive coronary artery disease, and mean baPWV and APP values were 1535 ± 303 cm/s and 66.8 ± 22.5 mm Hg, respectively. In univariate analysis, there was a significant linear correlation between baPWV and APP (r = .635, P < .001). The correlation between baPWV and APP remained significant even after controlling for potential confounders (β = 0.574, P < .001; R2 = .469). Arterial stiffness measured by baPWV showed a strong positive correlation with invasively measured APP, independent of clinical confounders. Therefore, baPWV can be a good marker of central aortic stiffness.

Due to the complex profile of atherosclerotic risk factors, an integrated analysis of a specific individual is difficult. Endothelial function reflects a composite of various risk factors, and may be used as an optimal tool to estimate the overall atherosclerotic risk. In this study, we investigated the value of digital Reactive Hyperemia Index (RHI) in an actual population with multiple atherosclerotic risk factors or coronary artery disease (CAD). A total of 417 patients from the Seoul National University Boramae Medical Center RHI registry were enrolled in this study. Patients were enrolled from January, 2013 to July, 2016. RHI was measured using the EndoPAT2000 system (Itamiar Medical Inc. Israel). The mean value of RHI was 1.67 ± 0.48 in total study population. Among various atherosclerotic risk factors, RHI was significantly lower in older (> 60 years) patients, diabetics, smokers’ patients on statin therapy, and those with coronary or cerebrovascular disease. Most of these findings were consistent after adjustment with multiple regression analysis. RHI was significantly associated with CAD, with a hazard ratio of 1.80 (95% confidence interval 1.15–2.80, p = 0.010). In the subgroup with CAD, current smoking was the only finding showing a lower RHI. Brachial–ankle pulse wave velocity, which is a surrogate marker of arterial atherosclerotic change, was not correlated with RHI in patients with clinically significant atherosclerotic disease. RHI was significantly reduced by major atherosclerotic risk factors and in clinical atherosclerotic disease. RHI may reflect a composite effect of risk factors pertaining to the endothelial function.

Increased arterial stiffness is associated with a higher risk of future cardiovascular events. We aimed to investigate whether information about arterial stiffness provides additional prognostic value to coronary computed tomography angiography (CCTA) findings.A total of 523 consecutive patients (mean age, 58.0 ± 10.3 years; male, 60.6%) with suspected coronary artery disease (CAD), who underwent CCTA and brachial-ankle pulse wave velocity (baPWV) measurement within a month, were retrospectively analyzed. A composite of cardiovascular death, nonfatal myocardial infarction (MI), coronary revascularization, nonfatal stroke, and hospitalization for cardiovascular causes was assessed.During a median 43.9 months of follow-up (interquartile range, 11.6-66.9 months), the composite endpoint occurred in 66 patients (3 cardiovascular deaths, 1 nonfatal MI, 35 coronary revascularizations, 16 nonfatal strokes, and 45 hospitalizations for cardiovascular causes). After adjustment for clinical risk factors and CCTA findings, higher baPWV was an independent prognostic factor for the composite endpoint (adjusted hazard ratio, 4.717; 95% confidence interval, 2.675-8.319; p 0.001). The addition of baPWV to clinical risk factors and CCTA findings significantly improved the prediction of cardiovascular events (global χArterial stiffness provides additional prognostic information to CCTA findings in patients with suspected CAD. The baPWV can serve as a useful clinical tool for risk stratification in this population.

The aim of this study was to investigate whether arterial stiffness plays a role in retaining normal diastolic function in a middle-aged and elderly Korean population. A total of 267 patients without documented cardiovascular disease, 50 years and older (mean age, 57.3±6.3 years; 69.8% men) were retrospectively analyzed. All patients underwent both transthoracic echocardiography and brachial-ankle pulse wave velocity measurement on the same day. Patients with septal annular peak velocity (e') ≥8 cm/s and left atrial volume index

Objective Data on ventricular-arterial coupling using invasive hemodynamic studies are limited. This study was performed to clarify the interaction between aortic pressures and left ventricular end-diastolic pressure (LVEDP) using invasive catheterization. Patients and methods A total of 104 consecutive stable patients (mean age, 65.8 ± 10.0 years; 56% men) undergoing invasive coronary angiography (ICA) were prospectively evaluated. LVEDP and central aortic pressures [systolic blood pressure (aSBP) and diastolic blood pressure (aDBP)] were sequentially measured using a pigtail catheter before ICA. Aortic pulse pressure (aPP) was defined by the difference between aSBP and aDBP. Results A total of 82 patients (79%) had obstructive coronary artery disease (≥50% stenosis). The mean LVEDP value was 18.7 ± 6.4 mmHg. Univariable analyses showed that aSBP (r = 0.309, P = 0.001) and aPP (r = 0.286, P = 0.003) significantly correlated with LVEDP, whereas aDBP was not correlated with LVEDP (P > 0.05). Multivariable analysis revealed that aSBP (β = 0.345, P = 0.001) and aPP (β = 0.276, P = 0.018) remained independent predictors of LVEDP even after controlling for potential confounders. Conclusion Invasively measured aSBP and aPP were independently associated with invasively measured LVEDP in patients undergoing ICA. This result provides additional evidence of a close interaction between central aortic pressure and LV diastolic function in this population.