The role of serum asprosin levels in predicting the severity of coronary artery disease in patients with diabetes mellitus.

BACKGROUND: Asprosin is an emerging biomarker that plays a role in metabolic diseases. This study investigates asprosin as a predictive marker for coronary artery disease (CAD) severity in diabetic patients. METHODS: Diabetic patients (n = 181) and healthy controls (n = 60) were analyzed. CAD severity was assessed using SYNTAX score. Diabetic patients were divided into 3 groups. Group 1 = patients without CAD, group 2 = patients with low SYNTAX score, and group 3 = patients with moderate-high SYNTAX score. Asprosin levels were measured for all participants using an enzyme-linked immunosorbent assay (ELISA). RESULTS: Asprosin levels were significantly higher in patient group compared to control group (p < 0.001). Asprosin levels were significantly higher in group 3 compared to group 1 and group 2 (p = 0.002). In logistic regression analysis, asprosin levels independently predicted patients with moderate-high SYNTAX scores. According to this analysis, 1 ng/mL increase in asprosin level was found to increase the risk of having moderate-high SYNTAX score by 14.1%. When the threshold value of asprosin level was set as 22.17 ng/mL, it predicted patients with moderate-high SYNTAX score with 63.6% sensitivity and 62.6% specificity. In multivariate regression analysis, SYNTAX score independently correlated with asprosin level. CONCLUSION: This is the first study in the literature to demonstrate a positive correlation between asprosin levels and SYNTAX scores in diabetic patients with CAD. More comprehensive studies with larger groups are needed.

Effectiveness of Device-Guided Breathing in Chronic Coronary Syndrome: A Randomized Controlled Study.

Background: Chronic coronary syndrome (CCS) is one of the most life-restricting coronary artery diseases, and symptom relief is the main goal in CCS patients who suffer from angina. Objectives: To assess the potential benefits of device-guided breathing in CCS patients with angina in this randomized, controlled, single-blinded study. Methods: Fifty-one patients with CCS received device-guided breathing for 7 days/8 weeks. Exercise capacity [exercise stress test], cardiac function [transthoracic echocardiography], and angina severity [Canadian Cardiovascular Society Classification] were evaluated initially and after the training. Device-guided breathing was performed at the lowest resistance of the device (POWERbreathe® Classic LR) for the control group (n = 17). The low load training group (LLTG; n = 18) and high load training group (HLTG; n = 16) were trained at 30% and 50% of maximal inspiratory pressure. Baseline characteristics were compared using one-way ANOVA and Kruskal-Wallis test. Categorical data were compared using the chi-square test. ANCOVA was performed to compare changes between three groups. A p value < 0.05 was considered statistically significant. Results: Metabolic equivalent values were significantly improved in both HLTG and LLTG groups (p < 0.001, p = 0.003). The Duke treadmill score significantly improved and shifted to low-risk both in the HLTG (p < 0.001) and LLTG (p < 0.001) groups. Angina severity significantly alleviated after the training in both HLTG and LLTG groups (p < 0.001, p = 0.002). Conclusions: An 8-week long program of short-term respiratory muscle training provided positive gains in exercise capacity and angina severity in CCS patients with angina. The effects of long-term training programs on CCS patients should be investigated clinically because of the possibility of helping to decrease the need for invasive treatments.

Thromboembolic risk scores in patients with non-obstructive coronary architecture with and without coronary slow flow: A case-control study.

AIM: Coronary slow flow phenomenon (CSFP) detected on coronary angiography (CA) has been related to poor prognosis. We sought to examine the relationship between thromboembolic risk scores, routinely used in cardiology practice, and CSFP. METHODS: This single-center, retrospective, case-control study comprised 505 individuals suffering from angina and had verified ischemia between January 2021 and January 2022. Demographic and laboratory parameters were obtained from the hospital database. The following risk scores were calculated; CHA2DS2-VASc, M-CHA2DS2-VASc, CHA2DS2-VASc-HS, R2-CHA2DS2-VASc, M-R2-CHA2DS2-VASc, ATRIA, M-ATRIA, M-ATRIA-HSV. The overall population was divided into two groups; coronary slow flow and coronary normal flow. Multivariable logistic regression was performed to compare risk scores between patients with and without CSFP. Pairwise comparisons were then undertaken to test performance in determining CSFP. RESULTS: The mean age was 51.7 ± 10.7 years, of whom 63.2% were male. CSFP was detected in 222 patients. Those with CSFP had higher rates of male gender, diabetes, smoking, hyperlipidemia, and vascular disease. All scores were higher in CSFP patients. Multivariable logistic regression analysis found that CHA2DS2-VASc-HS score was the most powerful determinant of CSFP among all risk schemes (for each one-point increase in score OR = 1.90, p < 0.001; for score of 2-3 OR = 5.20, p < 0.001; for score of >4 OR = 13.89, p < 0.001). Also, the CHA2DS2-VASc-HS score provided the best discriminative performance, with a cut-off value of ≥2 in identifying CSFP (AUC = 0.759, p < 0.001). CONCLUSION: We showed that thromboembolic risk scores may be associated with CSFP in patients with non-obstructive coronary architecture who underwent CA. The CHA2DS2-VASc-HS score had the best discriminative ability.

The Relationship Between PRECISE-DAPT Score and Spontaneous Reperfusion of Infarct-Related Artery in Patients with ST-Segment Elevation Myocardial Infarction.

OBJECTIVE: Spontaneous reperfusion (SR) presence and a low PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Anti Platelet Therapy (PRECISE-DAPT) score in patients with acute coronary syndrome have been associated with favorable clinical outcomes. This study aimed to investigate the relationship between SR and this score. METHODS: The study included 436 patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). Thrombolysis in myocardial infarction (TIMI) III blood flow presence in the infarct-related artery (IRA) before primary percutaneous coronary intervention (PCI) was defined as SR. Patients were categorized into two groups based on the presence (n = 49) or absence (n = 387) of SR. The PRECISE-DAPT score was computed for each patient using the web-based calculator. RESULTS: The group with SR had a lower frequency of hyperlipidemia and a higher ejection fraction (EF) at admission. Conversely, the group without SR presented with higher values of glucose, troponin, creatine kinase-myocardial band (CK-MB), and PRECISE-DAPT score. The no-reflow phenomenon and elevated SYNergy between PCI with TAXUS and Cardiac Surgery (SYNTAX-I) scores were higher in the group without SR than in the one with SR. Multivariate regression analysis indicated that a high PRECISE-DAPT score was an independent predictor of the absence of SR (odds ratio: 0.96, P = 0.04). CONCLUSION: The PRECISE-DAPT score is an independent predictor of the presence of spontaneous reperfusion in patients who experienced STEMI.

The Relationship Between H2FPEF Score and Coronary Slow Flow Phenomenon.

OBJECTIVE: Diastolic dysfunction plays an important role in the pathophysiology of both coro- nary slow flow phenomenon and heart failure with preserved ejection fraction, which could be predicted by the H2FPEF score. We sought to investigate the association of H2FPEF score with coronary slow flow phenomenon in subjects undergoing coronary angiography for suspected stable ischemic heart disease. METHODS: The study included 228 consecutive individuals [60.5% male, mean age 52.6 (10.1)]. Subjects with non-obstructive coronary artery disease were classified as coronary nor- mal flow (n = 112) and coronary slow flow (n = 116) after confirmation of coronary angiography results. H2FPEF score of each participant was calculated. RESULTS: Subjects with coronary slow flow phenomenon were more likely to be male (75% vs. 45.5%, P < .001) and have a higher body mass index than that of normal flow group [30.5 (2.9) vs. 29.3 (2.8), P=.001]. H2FPEF score was significantly higher in the former group [2 (2-4) vs. 0 (0-1), P < .001]. H2FPEF score was also positively correlated with mean corrected thrombolysis in myocardial infarction frame count (r = 0.725, P < .001). On multivariate logistic regression analysis, male gender [odds ratio: 4.580, 95% CI: 1.700-12.336, P = .003], current smoker [OR: 2.398, 95% CI: 1.064-5.408, P=.035], total cholesterol [OR: 1.011, 95% CI: 1.001-1.021, P=.026], and H2FPEF score [OR: 3.111, 95% CI: 2.160-4.480, P < .001] were found to be the independent predictors of coronary slow flow phenomenon. CONCLUSION: We found that the H2FPEF score, which is useful in demonstrating diastolic dysfunction, is independently associated with coronary slow flow pattern in suspected ischemic heart disease.

The relationship between serum rheumatoid factor level and SYNTAX score I in patients with acute myocardial infarction.

OBJECTIVE: Rheumatoid factor (RF) has been associated with an increased likelihood of developing coronary artery disease and cardiovascular mortality. This study aimed to evaluate the relationship between serum RF levels and SYNTAX score I (SSI) in patients with acute myocardial infarction. METHODS: This study included 418 consecutive patients who were diagnosed with acute myocardial infarction and underwent coronary angiography. The baseline serum RF levels of all patients were measured. The study population was divided into 2 groups, namely, ST-segment elevation myocardial infarction (STEMI) group (218 patients) and non-ST-segment elevation myocardial infarction (NSTEMI) group (200 patients). Each group was further divided into 2 subgroups, namely, SSI ≤22 group and SSI >22 group. RESULTS: In the STEMI group, RF levels were significantly higher in the SSI >22 group than that in the SSI ≤22 group (13.0 IU/mL [7.0-51.0 IU/mL] versus 11.0 IU/mL [4.0-37.0 IU/mL], respectively, p=0.002). In the NSTEMI group, RF levels were significantly higher in the SSI >22 group than that in the SSI ≤22 group (15.5 IU/mL [8.0-69.5 IU/mL] versus 13.0 IU/mL [4.0-36.0 IU/mL, respectively], p<0.001). Forward conditional logistic regression analysis demonstrated that neutrophil-to-lymphocyte ratio, total cholesterol level, positive RF, and left ventricular ejection fraction were independently associated with intermediate and high SSI in patients with STEMI. Furthermore, cardiac troponin T levels and positive RF were independently associated with intermediate and high SSI in patients with NSTEMI. CONCLUSION: Serum RF concentrations are independently associated with SSI in patients with acute myocardial infarction.

D-dimers are associated with coronary artery disease severity assessed using Syntax and Syntax II scores in patients with ST elevation myocardial infarction.

INTRODUCTION AND OBJECTIVES: D-dimers are a determinant of hypercoagulable state and have been found to be related to acute coronary syndromes. We aimed to establish the association between increased D-dimer levels and coronary artery disease (CAD) severity using SYNTAX Score (SS) II in patients with ST elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). METHODS: This retrospective study included 300 consecutive patients (81.7% males, mean age 55±12 years) with STEMI who underwent a primary PCI. Patients were divided into two groups according to their median SSII [SSII<25 as a low group (n=151) and SSII≥25 as a high group (n=149)]. Blood samples for D-dimers and the other biochemical parameters were obtained from each patient at admission. RESULTS: When compared with the low SSII group, frequency of female gender, no-reflow phenomenon, D-dimer levels, thrombus score, creatine kinase MB and troponin were significantly higher, whereas left ventricular ejection fraction (LVEF) and glomerular filtration rate (GFR) were lower in the high SSII group (p<0.05, for all). D-dimer levels, thrombus score, LVEF, GFR and no-reflow phenomenon were independent predictors of CAD severity (p<0.05, for all). Receiver operating characteristic curve analysis showed that the D-dimer cut-off value for predicting the severity of CAD was 0.26 µg/ml (69.8% sensitivity and 65.6% specificity, p<0.001). CONCLUSION: Increased D-dimer levels are associated with the severity of CAD based on Syntax Score II, in patients with STEMI who successfully underwent revascularization with a primary PCI.

The relationship between visible thrombus aspiration material with no-reflow and in-hospital mortality ratio in patients with anterior ST-elevation myocardial infarction treated with primary percutaneous coronary intervention.

OBJECTIVE: The benefit of intracoronary thrombus aspiration (TA) during primary percutaneous coronary intervention (pPCI) in patients with ST-segment elevation myocardial infarction (STEMI) is not yet fully clear. The aim of this study was to investigate the clinical impact of visible thrombus aspiration (VTA) material. METHODS: A total of 295 patients with a Thrombolysis in Myocardial Infarction (TIMI) flow score of 0 or 1 after an anterior STEMI were included in the study. Manual TA devices were used before performing PCI. The patients were divided into 2 groups: (1) visible thrombus aspiration (VTA) group and (2) non-visible thrombus aspiration (non-VTA) group. No-reflow was defined as TIMI grade 0, 1, or 2 flow, or TIMI grade 3 with a myocardial blush of grade 0 or 1. The primary endpoint was the occurrence of no-reflow. RESULTS: VTA was retrieved in 178 (60.3%) of the patients. A no-reflow determination was significantly less frequent in the VTA group (p<0.001). The ejection fraction and ST-segment resolution values were higher, and the in-hospital mortality, Killip class II-IV rating, and post-pPCI TIMI frame count were lower in the VTA group (p<0.05 for each). CONCLUSION: VTA predicted a lower rate of in-hospital mortality and no-reflow in patients with anterior STEMI who underwent pPCI.

Epicardial Fat Thickness is Associated with Abnormal Left Ventricle Geometry in Newly Diagnosed Hypertension.

BACKGROUND: Epicardial adipose tissue is an emerging cardio metabolic risk factor. Although an association between epicardial fat thickness (EFT) and left ventricle (LV) hypertrophy in hypertensive patients is known, the relationship between abnormal LV geometric patterns and EFT has yet to be investigated. The aim of the present study was to investigate the relationship between EFT and abnormal LV geometric patterns in hypertensive patients. METHODS: Measurements were obtained from 343 patients with untreated essential hypertension (mean age 51.6 ± 5.5 years) and 52 healthy control subjects (mean age 51.8 ± 4.5 years). Four different geometric patterns (NG; normal geometry, CR; concentric remodeling, EH; eccentric hypertrophy, and CH; concentric hypertrophy) were determined according to LV mass index (LVMI) and relative wall thickness (RWt). EFT was measured using transthoracic echocardiography. High sensitive C-reactive protein (hs-CRP) and other biochemical markers were measured in all participants. RESULTS: The highest EFT and hs-CRP values were determined in the CH group (EFT = 8.9 ± 2.1 mm) compared with the controls (EFT = 5.7 ± 1.5 mm), followed by the NG (EFT = 5.9 ± 1.6 mm), CR (EFT = 5.9 ± 1.3 mm) and EH groups (EFT = 6.5 ± 1.6 mm) (all p < 0.05). In addition, the EFT values of the EH group were higher than the control, NG and CR groups (all p < 0.05). Multivariate linear regression analysis showed that EFT was independently associated with LV geometry (ß = 0.161, p = 0.032), total cholesterol level (ß = -0.129, p = 0.003), triglyceride level (ß = 0.266, p < 0.001), hs-CRP level (ß = 0.349, p < 0.001), and creatinine level (ß = 0.108, p = 0.010). CONCLUSIONS: EFT is independently associated with abnormal LV geometry, LV hypertrophy, creatinine level, and low grade chronic inflammation.

The impact of diabetes on the association between epicardial fat thickness and extent and complexity of coronary artery disease in patients with non-ST elevation myocardial infarction.

BACKGROUND: Epicardial fat thickness (EFT) is associated with increased cardio metabolic risk. Recent studies have suggested that there is a strong relationship between diabetes and EFT. Although the relationship between EFT and coronary artery disease (CAD) is well known, the possible impact of diabetes on the relationship between EFT and extent and complexity of CAD was not fully investigated. AIM: We aimed to investigate the relationship between EFT and extent and complexity of CAD in patients with non-ST elevation myocardial infarction (NSTEMI) with and without diabetes. METHODS: We prospectively included 454 patients with NSTEMI (mean age: 61.8 ± 10.4 years) in the present study. Patients were classified into two groups according to their diabetes status (diabetic group and non-diabetic group). EFT was measured by transthoracic echocardiography on the right ventricle in individuals having the left lateral decubitus position. SYNTAX score was used to define the extent and complexity of CAD. High-sensitivity C-reactive protein (hs-CRP) and other biochemical markers were measured in all participants. RESULTS: Diabetic patients had higher EFT values compared with non-diabetics (p < 0.05). EFT is independently associated with diabetes, SYNTAX score, and hs-CRP in all patients (p < 0.05, for all). When patients were divided into two groups, as diabetic and non-diabetic, the association between EFT and SYNTAX score was stronger in diabetic patients compared with non-diabetics (r = 0.635; p < 0.001 vs. r = 0.179; p = 0.003). CONCLUSIONS: Epicardial fat thickness is associated with SYNTAX score in both diabetic and non-diabetic patients. Furthermore, there is a stricter relationship between EFT and SYNTAX score in diabetic patients.

High morning blood pressure surge is associated with oxidative stress and paraoxonase 1 activity in newly diagnosed hypertensive patients.

BACKGROUND: Both oxidative stress and morning surge (MS) of blood pressure (BP) were found to be closely related with cardiovascular and cerebrovascular diseases. We investigated the association between MS of BP and oxidative stress in newly diagnosed hypertensive patients. METHODS: We prospectively included 237 newly diagnosed hypertensive patients in the present study (mean age: 51.6 ± 11.7 years). The patients were classified according to the extent of the sleep-through surge as follows: the top decile of sleep-through surge (>47.2 mmHg, n = 27; EMShigh group), versus all others (n = 210, EMSlow group). Total antioxidant capacity (TAC) and total oxidant status (TOS) levels were determined by using an automated measurement method. The oxidative stress index (OSI) was calculated as the ratio of TOS to TAC. Serum paraoxonase 1 (PON-1) activity was measured spectrophotometrically. RESULTS: Patients in EMShigh group were found to have higher hs-CRP, TOS, and OSI values and lower TAC and PON-1 values (p < 0.01, for all). MS of BP was associated with hs-CRP, PON-1, TOS, TAC, and OSI levels in bivariate analysis. Multivariate linear regression analysis showed that MS of BP was significantly associated with PON-1(ß = -0.206, p < 0.001), OSI (ß = 0.602, p < 0.001) and hs-CRP (ß = 0.210, p < 0.001). CONCLUSION: Present study shows that OSI is increased and antioxidant PON-1 activity is decreased in patients with enhanced MS of BP. There is a close association between high MS of BP and oxidative stress markers in newly diagnosed hypertensive patients.

The predictive value of M30 and oxidative stress for left ventricular remodeling in patients with anterior ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention.

BACKGROUND: Left ventricular (LV) remodeling is an important pathophysiological event that develops following acute myocardial infarction and causes LV systolic dysfunction. Mechanisms such as apoptosis, necrosis, and oxidative stress play an important role in LV remodeling. OBJECTIVES: This study aimed to determine the relationship between the development of LV remodeling and the apoptosis marker M30 in patients with anterior ST-segment elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention (PCI). MATERIALS AND METHODS: This retrospective study included 255 consecutive patients (210 men, 45 women, mean age 54.9±11.8 years) with anterior STEMI who were treated with primary PCI. Blood samples were obtained from each patient at admission and 24 h after admission for measurements of M30, M65, oxidative parameters, and biochemical parameters. Transthoracic echocardiography was performed in each patient within 24 h of infarction and 6 months after infarction. LV remodeling was defined as greater than or equal to 20% increase in end-diastolic volume 6 months after primary PCI. The patients were divided into two groups on the basis of 6 months of post-primary PCI follow-up findings: LV remodeling group and non-LV remodeling group. RESULTS: In all, 60 patients received LV remodeling and 195 did not receive LV remodeling at 6 months after primary PCI. Total oxidative stress, M30 and M65 levels, and the oxidative stress index were significantly higher and the total antioxidant capacity and M65/M30 ratio were lower in the LV remodeling group (P<0.05, for all). Brain natriuretic peptide, M30, and oxidative stress index were independent predictors of LV remodeling (P<0.05 for all). Receiver operating characteristic curve analysis showed that the M30 cut-off value for predicting LV remodeling was 144.9 U/l (80% sensitivity and 77% specificity, P<0.001). CONCLUSION: In patients with anterior STEMI treated with primary PCI, the apoptosis marker M30 might be useful for predicting LV remodeling and subsequent LV systolic dysfunction.

The assessment of non culprit coronary artery lesions in patients with ST segment elevated myocardial infarction and multivessel disease by control angiography with quantitative coronary angiography.

Conflicting data is present in the literature about patients who are treated with percutaneous coronary intervention (PCI) due to the exaggeration of the non culprit artery. The precise understanding of the non culprit artery in the setting of ST segment elevated myocardial infarct (STEMI) is important since the time and modality of the treatment is planned accordingly. The aim of this study is to evaluate the lesions in the non culprit coronary artery during primary PCI and control coronary angiography (CAG) using quantitative coronary angiography (QCA) in multivessel STEMI patients. In this study, multivessel disease STEMI patients whom underwent primary PCI between January 2010 and March 2011 were included. Critical stenosis degree was accepted as ≥70 % in the non culprit artery. All patients were evaluated with control CAG 1 month after primary PCI. Assessment with CAG was performed by two blinded cardiologists. QCA program was used to evaluate reference artery diameter (RAD), minimum luminal diameter (MLD) and degree of stenosis. With regard to the degree of stenosis, significant reduction was accepted as ≥15 % while % 5-15 decrease was accepted as moderate. Of the 81 patients, 61 were males and 20 were females (mean age 58.1 ± 10). In the control CAG, the degree of non culprit artery stenosis was found to be decreased (p < 0.001) while RAD and MLD were increased (p < 0.001 and p < 0.001 respectively). Significant decrease in critical non culprit artery lesions was detected in 22 patients (20.9 %) meanwhile moderate reduction was observed in 26 patients (24.7 %). In 14 patients (13.3 %), non culprit artery lesions accepted as critical during primary PCI were found to be non critical during the control CAG. Planned intervention was cancelled and medical treatment was initiated in those 14 patients. Our data indicated using QCA, approximately the half of non culprit lesions were found less critical during control CAG when compared to primary PCI. Therefore, it is concluded that complete revascularization during primary PCI should be avoided in multivessel STEMI patients and critical non culprit artery lesions should be re-evaluated with later control CAG.

Biventricular Myocardial Performance Is Impaired in Proportion to Severity of Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) is an independent risk factor for cardiovascular morbidity and death. Little information is available regarding the relationship between the severity of OSA and myocardial performance in OSA patients who have normal ejection fractions. We prospectively investigated this relationship, using the tissue-Doppler myocardial performance index (TD-MPI). We conducted overnight, full-laboratory polysomnographic examinations of 116 patients, and calculated the left and right ventricular TD-MPIs. Patients were classified into 3 groups in accordance with their apnea-hypopnea index (AHI) levels: AHImild (≥5 to <15), AHImoderate (≥15 to <30), and AHIsevere (≥30). Left and right ventricular TD-MPI values were higher in the AHIsevere group than in the AHImild and AHImoderate groups (all P <0.05). In addition, right ventricular TD-MPI values in the AHImoderate group were higher than those in the AHImild group (P <0.05). Right ventricular TD-MPI was significantly associated with AHI (ß=0.468, P <0.001), left ventricular TD-MPI, and right ventricular early-to-late filling velocities (E/A ratio) in multiple linear regression analysis. On the other hand, left ventricular TD-MPI was significantly associated with right ventricular TD-MPI and left ventricular E/A ratio (both P <0.05). Our results show that OSA severity, determined by means of AHI, is independently associated with impaired right and left ventricular function as indicated by TD-MPI in patients who have OSA and normal ejection fractions.

Assessment of myocardial performance index and its association with aortic elasticity in patients with ascending aortic aneurysm.

OBJECTIVE: Ascending aortic aneurysms (AAA) are a leading cause of morbidity and mortality. Nevertheless, their effects on global cardiac functions are yet to be fully understood. Myocardial performance index (MPI) has been widely used to quantitatively assess myocardial functions. The aim of this study was to evaluate left ventricular (LV) functions in patients with AAA using tissue Doppler (TD) echocardiography and MPI in addition to conventional echocardiographic methods. METHODS: Fifty patients with AAA (33 men, 17 woman; mean age 55.5±7.90 years) were included, and 106 patients without aortic dilatation (mean age 54.1±8.18 years) were included as the control group. LV systolic and diastolic functions were analyzed using 2-dimensional, M-mode, and TD echocardiography. RESULTS: Patients with AAA had significantly higher MPI (0.5±0.04 vs 0.4±0.05, p<0.001), TD-MPI (0.5±0.02 vs 0.4±0.03, p<0.001), and reduced aortic elasticity, as indicated by reduced aortic distensibility (AD) (1.7±1.27 vs 3.1±1.25, p<0.001). Multivariate linear regression analysis showed that TD-MPI was independently correlated with reduced aortic distensibility (B=-0.006, p=0.019, 95% confidence interval,-0.011 to -0.001). CONCLUSION: MPI and TD-MPI indicated impairment of global cardiac functions in patients with AAA, which may be attributed to reduced aortic elasticity.