Abstract 3653: Aortic Compliance and Angina in Women without Coronary Artery Calcification: An Analysis from the Dallas Heart Study
Background: Angina in women without CAD (syndrome X) is a morbid illness that may be related to microvascular dysfunction. We sought to determine if there is an association between this entity and large artery dysfunction.
Methods: The Dallas Heart Study is a population-based study of subjects ages 30 – 65. MRI images through the ascending aorta were used to determine aortic compliance (AC), which was calculated as the change in aortic volume/ brachial artery pulse pressure. Angina was defined using the Rose Angina questionnaire and coronary artery calcium (CAC) was assessed using CT. The study was restricted to women with no CAC (scores ≤10 Agatston units) who had complete Rose Angina and AC data.
Results: Of the 1126 women in this study (mean age 44 ± 9 years, 48% black) 7% (n=83) had angina. Women with angina versus those without had lower AC (22.5 ± 10.6 v. 26.4 ± 12.1 mL/mmHg, p<0.01) (Figure⇓). Stratifying by the most relevant confounding variables, this association trended in the same direction among both blacks (20.8 v. 24.7, p=0.019) and non-blacks (25.2 v. 27.9, p=0.23); post-menopausal (15.5 v. 19.7, p=0.02) and premeno-pausal women (26.9 v. 29.6, p=0.11); normotensives (26.0 v. 29.3, p=0.06) and hypertensives (17.6 v. 18.2, p=0.69). AC was independently associated with angina after adjustment for age, race, traditional risk factors, CRP, physical activity, education, and menopausal status (OR=1.79, 95% CI 1.25–2.56 for 1 SD decrease in AC).
Conclusions: AC is inversely associated with angina in women without CAC. Further studies are needed to determine whether reduced AC contributes to angina directly, or if both reduced AC and syndrome X are the result of similar pathophysiology.