Abstract 13782: Effects of Serum Eicosapentaenoic Acid on Coronary Flow Reserve Evaluated by Phase Contrast Cine Magnetic Resonance Imaging in Patients with Coronary Artery Disease

Abstract

Background: Previous studies demonstrated the beneficial effects of dietary intake of eicosapentaenoic acid (EPA), a major omega-3 fatty acid, on the prevention of cardiovascular disease. However, it is still unclear whether serum level of EPA affects the coronary flow reserve (CFR) in patients with coronary artery disease (CAD). Phase contrast (PC) cine magnetic resonance imaging (MRI) can provide non-invasive and accurate assessment of CFR without radiation exposure. The purpose of this study was to investigate the effects of serum EPA level on CFR in patients with CAD. Materials and

Methods: Eighty patients with known or suspected CAD (mean age 70.2 ± 8.2 years) were studied with 1.5T MR scanner equipped with 32 channel cardiac coils. Serum levels of EPA, arachidonic acid (AA) and EPA/AA ratio were measured after overnight fasting. Breath-hold PC cine MR images of coronary sinus (CS) were obtained to assess the blood flow of CS both at rest and during ATP infusion. CFR was calculated as CS blood flow during ATP infusion divided by CS blood flow at rest. Late gadolinium enhancement (LGE) MRI was acquired to evaluate the presence or absence of MI and percentage myocardium affected by MI (%LGE). Patients were divided into two groups based on median of EPA/AA ratio: high EPA/AA group and low EPA/AA group.

Results: On LGE MRI, myocardial infarction was observed in 38 patients, and mean % LGE was 8.0 ± 12.8%. The serum EPA and EPA/AA ratio were positively correlated (r=0.33, P=0.003 and r=0.35, P=0.002) with the CFR by MRI. EPA/AA ratio ranged from 0.05 to 2.28, and its median was 0.47. CFR was significantly reduced in low EPA/AA group than high EPA/AA group (2.19 ± 0.67 vs 2.52 ± 0.76, p=0.046). In the multiple logistic regression analysis, EPA/AA ratio is an independent predictor for impaired CFR (impaired CFR was defined as CFR <3.0; odds ratio= 0.61, 95% confidence interval (CI): 0.45-0.83).

Conclusions: Significant positive correlation was observed between EPA/AA ratio and CFR. In addition, EPA/AA ratio was an independent variable for predicting impaired CFR evaluated by MRI. The results in the current study indicate that serum EPA/AA ratio plays a pivotal role for the regulation of coronary microcirculation in patients with CAD.