Coronary atheroma burden predicts flow reserve in women with ischemia and nonobstructive coronary artery disease.
Am Heart J Plus
; 6: 100027, 2021 Jun.
Article
in En
| MEDLINE
| ID: mdl-38560556
ABSTRACT
Background:
Women with signs and symptoms of ischemia and no obstructive coronary artery disease often have coronary microvascular dysfunction (CMD) with reduced coronary flow reserve (CFR), and compensatory coronary remodeling. Angiographic measurements of epicardial coronary anatomy (AMCA) may improve understanding of relations between CFR and atherosclerosis. We investigated AMCA and CFR in women evaluated for CMD.Methods:
Women consecutively enrolled in the Women's Ischemia Syndrome Evaluation CVD Continuation (NCT00832702) were included. All underwent clinically indicated coronary function testing measuring CFR. AMCA included coronary angiographic atheroma burden (AB), percent diameter stenosis (PDS), and tapering reference diameter Z score (RDZ), derived for the left main and left anterior descending coronary epicardial segments.Results:
The 51 women were aged 55.8⯱â¯10.8â¯years, with 19(38%) hypertensive, 10(20.4%) hyperlipidemic, 4(7.8%) diabetic, 13(25.5%) prior smokers, and mean CFR 3.0⯱â¯0.8. Both average and maximal AB negatively correlated with CFR (râ¯=â¯-0.30 and -0.31, with pâ¯=â¯0.04 for both), as did average and maximal PDS (râ¯=â¯-0.38 and -0.41 with pâ¯=â¯0.009 and pâ¯=â¯0.005) while average RDZ was directly related (râ¯=â¯0.37, pâ¯=â¯0.01). Multiple linear regression analyses revealed that both average PDS (Units of CFR -0.03 95% CI -0.06, -0.002, pâ¯=â¯0.023) and maximal PDS (-0.04 95% CI -0.07, -0.01, pâ¯=â¯0.007) were negatively related to CFR.Conclusions:
Measures of epicardial coronary atheroma burden, size and tapering are related to CFR, suggesting that atherosclerotic anatomical findings may contribute to or be a consequence of CMD, with further work is needed to investigate these measures as treatment targets.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
Am Heart J Plus
Year:
2021
Document type:
Article
Affiliation country:
Canada