Aortic Stiffness: A risk factor for cardiovascular disease
Aortic stiffness is a recognised risk factor for cardiovascular disease. This may be related to alterations in the behaviour of the pulse pressure wave transmitted within the aorta that may then bear an unfavourable haemodynamic load on the coronary arterial system.
However, the relationship between aortic and coronary artery stiffness has thus far not been described. Providing insight into this relationship is of interest since it has been observed that those patients with increasingly stiff aortas experience more adverse cardiovascular events such as myocardial infarction. Conversely, relatively distensible (i.e. less stiff) coronaries are associated with an increased risk of plaque rupture and consequent events. A paradox therefore seems to exist when breaching the boundary between the aorta and coronary arterial system, despite their intimate anatomical relationship.
Aortic stiffness can be assessed easily by examining the pulse non-invasively at various sites of the body. Such techniques include digital volume pulse (DVP) photoplethysmography and aortic pulse wave velocity (PWV) obtained by applanation tonometry ( figure 4 and 5 ). Coronary artery stiffness can be measured invasively with the assessment of intracoronary pressure and dimensions, using an intracoronary pressure wire and intracoronary ultrasound.
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