Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease | |
Coronary Microvascular Function and Cardiovascular Risk Factors in Women With Angina Pectoris and No Obstructive Coronary Artery Disease: The iPOWER Study | |
C. Noel Bairey Merz1  Eva Prescott2  Nynne Dose2  Naja Dam Mygind2  Rebekka Faber2  Marie Mide Michelsen2  Adam Pena3  Peter Riis Hansen3  Daria Frestad4  Ida Gustafsson4  Ahmed Aziz5  Henrik Steen Hansen5  Nis Høst6  Jens Kastrup6  | |
[1] Barbra Streisand Women's Heart Center, Cedars‐Sinai Heart Institute, Los Angeles, CA;Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Denmark;Department of Cardiology, Gentofte Hospital, University of Copenhagen, Denmark;Department of Cardiology, Hvidovre Hospital, University of Copenhagen, Denmark;Department of Cardiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark;Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark; | |
关键词: angina pectoris; coronary artery disease; echocardiography; microvascular dysfunction; women; | |
DOI : 10.1161/JAHA.115.003064 | |
来源: DOAJ |
【 摘 要 】
BackgroundThe majority of women with angina‐like chest pain have no obstructive coronary artery disease when evaluated with coronary angiography. Coronary microvascular dysfunction is a possible explanation and associated with a poor prognosis. This study evaluated the prevalence of coronary microvascular dysfunction and the association with symptoms, cardiovascular risk factors, psychosocial factors, and results from diagnostic stress testing. Methods and ResultsAfter screening 3568 women, 963 women with angina‐like chest pain and a diagnostic coronary angiogram without significant coronary artery stenosis (<50%) were consecutively included. Mean age (SD) was 62.1 (9.7). Assessment included demographic and clinical data, blood samples, questionnaires, and transthoracic echocardiography during rest and high‐dose dipyridamole (0.84 mg/kg) with measurement of coronary flow velocity reserve (CFVR) by Doppler examination of the left anterior descending coronary artery. CFVR was successfully measured in 919 (95%) women. Median (IQR) CFVR was 2.33 (1.98–2.76), and 241 (26%) had markedly impaired CFVR (<2). In multivariable regression analysis, predictors of impaired CFVR were age (P<0.01), hypertension (P=0.02), current smoking (P<0.01), elevated heart rate (P<0.01), and low high‐density lipoprotein cholesterol (P=0.02), but these variables explained only a little of the CFVR variation (r2=0.09). CFVR was not associated with chest pain characteristics or results from diagnostic stress testing. ConclusionImpaired CFVR was detected in a substantial proportion, which suggests that coronary microvascular dysfunction plays a role in the development of angina pectoris. CFVR was associated with few cardiovascular risk factors, suggesting that CFVR is an independent parameter in the risk evaluation of these women. Symptom characteristics and results from stress testing did not identify individuals with impaired CFVR.
【 授权许可】
Unknown