TY - JOUR

T1 - Peripheral Endothelial Function and Coronary Flow Velocity Reserve Are Not Associated in Women with Angina and No Obstructive Coronary Artery Disease

T2 - The iPOWER Study

AU - Flintholm Raft, Kristoffer

AU - Frestad, Daria

AU - Michelsen, Marie Mide

AU - Suhrs, Hannah Elena

AU - Rask, Anna Bay

AU - Nilsson, Malin

AU - Hermann, Thomas Steffen

AU - Prescott, Eva

N1 - © 2017 S. Karger AG, Basel.

PY - 2017

Y1 - 2017

N2 - PURPOSE: We investigated whether impaired flow-mediated dilation (FMD) and plasma biomarkers reflecting endothelial dysfunction are associated with coronary microvascular dysfunction (CMD) in women with angina and no obstructive coronary artery disease (CAD).METHODS: Patients (n = 194) were randomly selected women with angina pectoris and no obstructive CAD (<50% stenosis). A reference population of asymptomatic women without CAD (n = 25) was included. We measured FMD in the brachial artery by high-resolution ultrasound. Coronary flow velocity reserve (CFVR) was assessed by transthoracic Doppler flow echocardiography (TTDE) of the left anterior descending artery during rest and high-dose dipyridamole infusion. CMD was defined as CFVR <2.RESULTS: FMD and CFVR were measured in 128 patients and 21 controls. Mean (SD) age was 64.5 (8.9) years, mean CFVR was 2.3 (2.0-2.7), and mean FMD was 8.4% (4.8%) in angina patients. Angina patients had a higher risk factor burden compared with the reference population. Measures of peripheral endothelial dysfunction and endothelial plasma biomarkers did not differ according to angina or CFVR. CFVR and FMD did not correlate (Spearman ρ = -0.07, p = 0.45).CONCLUSIONS: FMD and biomarkers of endothelial dysfunction did not identify individuals with CMD assessed as impaired CFVR by TTDE in women with angina and no obstructive CAD.

AB - PURPOSE: We investigated whether impaired flow-mediated dilation (FMD) and plasma biomarkers reflecting endothelial dysfunction are associated with coronary microvascular dysfunction (CMD) in women with angina and no obstructive coronary artery disease (CAD).METHODS: Patients (n = 194) were randomly selected women with angina pectoris and no obstructive CAD (<50% stenosis). A reference population of asymptomatic women without CAD (n = 25) was included. We measured FMD in the brachial artery by high-resolution ultrasound. Coronary flow velocity reserve (CFVR) was assessed by transthoracic Doppler flow echocardiography (TTDE) of the left anterior descending artery during rest and high-dose dipyridamole infusion. CMD was defined as CFVR <2.RESULTS: FMD and CFVR were measured in 128 patients and 21 controls. Mean (SD) age was 64.5 (8.9) years, mean CFVR was 2.3 (2.0-2.7), and mean FMD was 8.4% (4.8%) in angina patients. Angina patients had a higher risk factor burden compared with the reference population. Measures of peripheral endothelial dysfunction and endothelial plasma biomarkers did not differ according to angina or CFVR. CFVR and FMD did not correlate (Spearman ρ = -0.07, p = 0.45).CONCLUSIONS: FMD and biomarkers of endothelial dysfunction did not identify individuals with CMD assessed as impaired CFVR by TTDE in women with angina and no obstructive CAD.

KW - Aged

KW - Angina Pectoris/diagnosis

KW - Blood Flow Velocity

KW - Brachial Artery/diagnostic imaging

KW - Coronary Stenosis/complications

KW - Coronary Vessels/physiopathology

KW - Dipyridamole/administration & dosage

KW - Echocardiography, Doppler

KW - Endothelium, Vascular/physiopathology

KW - Female

KW - Fractional Flow Reserve, Myocardial

KW - Humans

KW - Microcirculation

KW - Middle Aged

KW - Predictive Value of Tests

KW - Regional Blood Flow

KW - Risk Factors

KW - Severity of Illness Index

KW - Vasodilation

KW - Vasodilator Agents/administration & dosage

U2 - 10.1159/000479374

DO - 10.1159/000479374

M3 - Journal article

C2 - 28942444

VL - 54

SP - 309

EP - 319

JO - Journal of Vascular Research

JF - Journal of Vascular Research

SN - 1018-1172

IS - 5

ER -