Increased Arterial Stiffness in Patients with Cardiac Syndrome X: Pulse Wave Velocity in Cardiac Syndrome X

BACKGROUND AND OBJECTIVES: Up to 10% of coronary angiograms performed for the assessment of patients with chest pain show a normal coronary anatomy. Arterial dysfunction has been reported in patients with cardiac syndrome X (CSX). The Pulse Wave Velocity (PWV) has been shown to be an indicator of arterial stiffness. The aim of this study was to evaluate the atherosclerotic risk factors and arterial stiffness by measuring the pulse wave velocity in patients with CSX.

SUBJECTS AND METHODS: Sixty patients, with typical chest pain and a normal coronary anatomy, were enrolled, and divided into 2 groups; the CSX group, consisting of 34 patients (male: 14, mean age 57.1±11.5 years) with a positive stress tests, and the control group, which contained 26 patients (male: 7, mean age: 55.4±10.9 years), who were diagnosed with gastro-esophageal disorders. Arterial stiffness was assessed by measuring the carotid-radial PWV. The cardiovascular risk factors, including body mass index, lipid profile, left ventricular mass, pulse pressure, plasma homocysteine and C-reactive protein, were also measured.

RESULTS: The PWV was significantly higher in patients with CSX than in the controls (10.28±1.02 vs. 8.62±1.18 m/s, p<0.05). However, there was no difference in the other atherosclerotic risk factors between the groups. The cutoff value for PWV was 9.85 m/s, with sensitivity and specificity of 65 and 88%, respectively.

CONCLUSION: In patients with CSX, the arterial stiffness was increased compared to the controls, but no increase the cardiovascular risk factors were observed. PWV assessment might be a helpful tool in identifying CSX patients with chest pain of a noncardiac origin.