Left ventricular circumferential strain and coronary microvascular dysfunction: A report from the Women's Ischemia Syndrome Evaluation Coronary Vascular Dysfunction (WISE-CVD) Project

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:327

Article

Tamarappoo, Balaji^1,2  Samuel, T. Jake³  Elboudwarej, Omeed⁴  Thomson, Louise E. J.¹  Aldiwani, Haider⁴  Wei, Janet⁴  Mehta, Puja⁵  Cheng, Susan⁴  Sharif, Behzad²  AlBadri, Ahmed^2,4  Handberg, Eileen M.⁶  Petersen, John⁶  Pepine, Carl J.⁶  Nelson, Michael D.^3,4  Merz, C. Noel Bairey⁴ 

[1] Cedars Sinai Med Ctr, Mark S Taper Imaging Ctr, Los Angeles, CA 90048 USA

[2] Cedars Sinai Med Ctr, Biomed Imaging Res Inst, Los Angeles, CA 90048 USA

[3] Univ Texas Arlington, Arlington, TX 76019 USA

[4] Cedars Sinai Med Ctr, Barbra Streisand Womens Heart Ctr, Los Angeles, CA 90048 USA

[5] Emory Clin Cardiovasc Res Inst, Emory Womens Heart Ctr, Atlanta, GA USA

[6] Univ Florida, Dept Med, Div Cardiol, Gainesville, FL USA

关键词: Circumferential strain;    Coronary microvascular dysfunction;    Coronary microvascular disease;    Mechanical dysfunction;    Subclinical dysfunction;   

DOI  :  10.1016/j.ijcard.2020.11.006

来源: Elsevier

【 摘 要 】

Aims: Women with ischemia but no obstructive coronary artery disease (INOCA) often have coronary microvascular dysfunction (CMD). Left ventricular (LV) circumferential strain (CS) is often lower in INOCA compared to healthy controls; however, it remains unclear whether CS differs between INOCA women with and without CMD. We hypothesized that CS would be lower in women with CMD, consistent with CMD-induced LV mechanical dysfunction. Methods and results: Cardiac magnetic resonance (cMR) images were examined from women enrolled in the Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction Project. CS by feature tracking in INOCA women with CMD, defined as myocardial perfusion reserve index (MPRI) <1.84 during adenosinestress perfusion cMR, was compared with CS in women without CMD. In a subset who had invasive coronary function testing (CFT), the relationship between CS and CFT metrics, LV ejection fraction (LVEF) and cardiovascular risk factors was investigated. Among 317 women with INOCA, 174 (55%) had CMD measured by MPRI. CS was greater in women with CMD compared to those without CMD (23.2 + 2.5% vs. 22.1 + 3.0%, respectively, P = 0.001). In the subset with CFT (n = 153), greater CS was associated with increased likelihood of reduced vasodilator capacity (OR = 1.33, 95%CI = 1.02-1.72, p = 0.03) and discriminated abnormal vs. normal coronary vascular function compared to CAD risk factors, LVEF and LV concentricity (AUC: 0.82 [0.73-0.96 95%CI] vs. 0.65 [0.60-0.71 95%CI], respectively, P = 0.007). Conclusion: The data indicate that LV circumferential strain is related to and predicts CMD, although in a direction contrary with our hypothesis, which may represent an early sign of LV mechanical dysfunction in CMD. <(c)> 2020 Elsevier B.V. All rights reserved.

【 授权许可】

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