Impaired coronary flow velocity reserve and aortic distensibility in patients with untreated hypercholesterolemia - An echocardiographic study

Introduction: Hypercholesterolemia is a primary risk factor for the development of atherosclerosis and leading to severe stages of coronary artery disease (CAD) and aortic atherosclerosis (AA). The objective of this investigation was to measure elastic modulus [(E (p), in 10 mmHg] and Young's circumferential static elastic modulus [(E(s), in 10 mmHg] as aortic distensibility indices and coronary flow velocity reserve (CFR) in untreated hypercholesterolemic (HC) patients in the course of the same stress transesophageal echocardiography (TEE) and to compare their results to normochole-sterolemic (NC) subjects. Patients and methods: The following patient populations were compared: 17 NC subjects with negative coronary angiograms, 18 patients with untreated hypercholesterolemia with a negative coronary angiogram and 23 HC patients with significant left anterior descending coronary artery (LAD) disease. All patients underwent coronary angiography, transthoracic and stress TEE examinations. Results: CFR was significantly reduced in patients of both groups with hypercholesterolemia as compared to NC subjects (1.99±0.76 and 1.79±0.32 vs. 2.58±0.63, P < 0.05, respectively). E(p) was significantly increased in HC patients with negative coronary angiograms as compared to NC subjects (0.39±0.18 vs. 0.67±0.19, P < 0.05), while further increase was found in HC patients with LAD disease (0.67±0.19 vs. 1.09±0.52, P < 0.05). E(s) behaved similarly (4.06±2.73 vs. 7.60±3.70 vs. 11.38±6.91, P < 0.05, respectively). Conclusion: In conclusion it may be stated that CFR and aortic distensibility indices can be evaluated simultaneously by stress TEE in HC patients. CFR and aortic distensibility were impaired in HC patients as compared to NC subjects. © Springer Science+Business Media B.V. 2006.