• Maurizio Cusmà-Piccione, Concetta Zito, Bijoy K Khandheria, Fausto Pizzino, Gianluca Di Bella, Francesco Antonini-Canterin, Olga Vriz, Vito Antonio Di Bello, Carmelo Zimbalatti, Salvatore La Carrubba, Giuseppe Oreto, and Scipione Carerj.
• aClinical and Experimental Department of Medicine, University of Messina, Messina, Italy bAurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin, USA cCardiology Unit, ARC, S. Maria degli Angeli Hospital, Pordenone dCardiology Unit, O.C. San Antonio, San Daniele del Friuli, Udine eCardiac Thoracic and Vascular Department, University of Pisa, Pisa fInternal Medicine, Villa Sofia Hospital, Palermo, Italy.
• J Cardiovasc Med (Hagerstown). 2014 Nov 1; 15 (11): 797-802.

AimsA relationship between arterial stiffening and coronary flow abnormalities, although not fully elucidated, has been observed. The purpose of this study was to investigate the relationship among carotid stiffness, measured using echo-tracking, and Doppler parameters of coronary blood flow, sampled at the left anterior descending (LAD) artery.MethodsWe studied 88 consecutive patients (49 men, mean age 51.2 ± 16.2 years) with cardiovascular risk factors but without history of cardiovascular diseases. Each patient underwent echocardiographic evaluation for measurement of the diastolic velocity time integral (DVTI) and calculation of the diastolic velocity time integral coronary index (DVTICI), the ratio between DVTI and total velocity time integral of LAD artery flow × 100, and carotid ultrasound for measurement of carotid intima media thickness (IMT) and stiffness parameters such as β index and elastic modulus (Ep).ResultsDVTICI was significantly greater in men than in women (median 82, interquartile range 78-86 vs. median 80, interquartile range 73-83, respectively; P < 0.016). After correlating DVTICI with other variables, a significant inverse relation was obtained with β index (Rho = -0.449, P < 0.001), Ep (Rho = -0.478, P < 0.001), age (Rho = -0.52, P < 0.001), left ventricular mass index (Rho = -0.543, P < 0.001), E/E' (Rho = -0.411, P < 0.001), pulse pressure (Rho = -0.417, P < 0.001) and IMT (Rho = -0.480, P < 0.001). With linear multiple regression analysis, only β index (P < 0.001), Ep (P < 0.001), male sex (P < 0.001) and left ventricular mass index (P = 0.008) were independently associated with reduction of DVTICI.ConclusionIncreased arterial stiffness, directly affecting coronary perfusion, is associated with reduced diastolic coronary flow. Echo-tracking for feasible measurement of carotid artery stiffness parameters may be valuable in more accurate cardiovascular risk stratification.

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