Coronary Artery Disease Clinical Trial
Official title:
Aortic Root Distensibility And Stiffness Assessed By Echocardiography As Predictors Of Coronary Artery Lesion Severity In Coronary Artery Patients Undergoing Coronary Angiography
Assess the relationship of Aortic root distensibility and stiffness with the extent of coronary artery disease as assessed by SYNTAX score compared to a matched cohort of patients with normal coronary angiography
Cardiovascular disease leading cause of death, resulting in a number of annually deceased
people higher than from any other. The great incidence of cardiovascular diseases in the
world spurred the search for new solutions to enable an early detection of pathological
processes The early detection based in multi-parameters of pathological condition is the key
to the patient survival .The arterial stiffness is the first vessels modification,
responsible for several pathological processes, which can lead to cardiovascular diseases.
The normal aging process is associated with an increase in vascular stiffness which is
accelerated by atherosclerosis, hypertension, and diabetes mellitus. Several studies have
revealed that increased aortic stiffness is a risk factor for cardiovascular diseases and
also is a predictor of cardiovascular morbidity and mortality.
Interest in arterial stiffness waned in the early 1900s with the advent of the
sphygmomanometer, which offered a quantitative measure of blood pressure and risk prediction
.
Another factor is Aortic distensibility which is a measurement of vascular elasticity, and
reflects the stiffness of the aorta . Aortic distensibility is markedly decreased in patients
with known coronary artery disease . and is inversely proportional to the severity of
Coronary artery disease .
Two-dimensional and tissue Doppler imaging derived parameters of ascending aorta have been
found to be abnormal, indicating increased Aortic stiffness and impaired Aortic
distensibility in subjects with coronary artery disease, hypertension, and diabetes mellitus.
However, the direct correlation of Aortic stiffness with Coronary artery disease is hard to
examine as most of these patients are old and have comorbidities such as hypertension, So
Investigation of these parameters should be done in patients who are normotensive as most of
these patients do not have confounding factors that increase Aortic stiffness.
Although the relationship between Aortic distensibility and Aortic stiffness and
atherosclerosis is well known , the possible relation between them and the extent and
complexity of coronary artery disease. as assessed using SYNTAX score has not been clearly
determined yet.
The SYNTAX score is a lesion-based angiographic scoring system originally devised to grade
the complexity of coronary artery disease.
. It is related to adverse cardiovascular events and predicts mortality and morbidity in
patients with coronary artery disease.
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