Late systolic wave on brachial artery blood flow velocity pattern in patients with coronary artery disease and its relation to vascular stiffness

Duplex-Doppler study typically exhibits triphasic brachial artery blood flo w velocity pattern in subjects classified as normal without clinically evid ent atherosclerotic complications, heart disease, hypertension, or diabetes mellitus. In this study, the authors described the late systolic wave on t he brachial artery blood flow velocity pattern in patients with coronary ar tery disease and investigated the relation between late systolic wave and v ascular stiffness. Blood flow profile and velocity of the brachial artery were determined noni nvasively by ultrasound pulsed-Doppler technique under the guidance of a B- mode ultrasound image in 96 patients with coronary artery disease (CAD). Th e control group consisted of 23 healthy subjects with no or maximally 2 ris k factors (only among age, cigarette smoking, obesity, and gender) for vasc ular disease. None of the patients and controls had clinical evidence of ar terial disorders at upper extremities. In 32 patients (33%) with CAD, a lat e systolic wave was observed in the brachial artery Doppler study. On the o ther hand, no late systolic wave was observed in the healthy subjects. In a ddition, multivessel disease, hypertension, advanced age, diabetes, and smo king were significantly more frequent in patients with the late systolic wa ve. In conclusion, peripheral arterial abnormalities induced by vascular stiffn ess may produce alterations in regional wave reflections, and the normal tr iphasic pattern of the brachial artery blood flow may change by the appeara nce of the late systolic wave.