Abstract 15066: The Influence of Cardiovascular Risk Factors on Coronary Flow Reserve Measured by Doppler Echocardiography in Women With Angina Pectoris and No Obstructive Coronary Artery Disease
Background: Coronary microvessel dysfunction (CMD) is a possible explanation for angina pectoris when no obstructive CAD can be diagnosed. CMD can be assessed by transthoracic Doppler echocardiography (TTDE) with measurement of coronary flow reserve (CFR). CFR≤2.0 is considered diagnostic for CMD, and is associated with an adverse prognosis despite the absence of obstructive CAD. The aim of this study was to investigate the correlation between traditional cardiovascular risk factors and CFR measured with TTDE.
Methods: Women with angina pectoris assessed by CAG were invited to participate if the CAG revealed no significant stenosis. Assessment included demographic, clinical data, bloodsamples and TTE during rest and high-dose dipyridamole stress (0.84 mg/kg) with measurement of CFR by Doppler of the left anterior descending artery.
Results: CFR was measured in 763 patients; median (IQR) 2.36 (2.00-2.76). When dividing patients into 3 groups, the CFR level was related to age, history of hypertension, duration of smoking and postmenopausal status (Table 1). Multiple linear regression with lnCFR as dependent variable gave the following results for the independent variables (constant=3.597): Age (p<0.001; B=-0.006); History of hypertension (p=0.071; B=-0.040), Diabetes (p=0.052; B=-0.051), Active smoking (p=0.041; B=-0.050) and smoking duration (p=0.013; B=-0.002); Adjusted R2=0.076. Parameter estimates are adjusted reflecting standard values for the independent variables in the regression equation.
Conclusions: This is the largest study so far to describe microvascular function in women with angina pectoris and no obstructive CAD. CFR was impaired in a large proportion of the women, and associated with some traditional risk factors for CAD. CMD assessed by TTDE represents a relevant diagnostic and therapeutic target for strategies aiming at preventing adverse outcomes in women with angina pectoris and no obstructive CAD.
Author Disclosures: N.D. Mygind: None. A.A. Pena: None. M.M. Michelsen: None. N. Dose: None. J. Kastrup: None. E. Prescott: None.
- © 2014 by American Heart Association, Inc.