Abstract 17031: Renal Microvascular Dysfunction is Related to Endothelial-Dependent Coronary Microvascular Dysfunction: a Report From the Women’s Ischemia Syndrome Evaluation
Introduction: Urine albumin-creatinine ratio (UACR) is a measure of renal microvascular endothelial dysfunction and predicts adverse cardiovascular events. Coronary microvascular dysfunction (CMD) is prevalent in symptomatic women with ischemia but no obstructive coronary artery disease (CAD), and predicts adverse cardiovascular events. We evaluated renal microvascular dysfunction and CMD measured by invasive coronary reactivity testing (CRT).
Methods: We measured UACR in 74 women with symptoms/signs of ischemia and no obstructive CAD who underwent (CRT). Coronary flow reserve response to intracoronary adenosine (nonendothelial-dependent function) and left anterior descending coronary artery diameter change in response to intracoronary acetylcholine and forearm cold pressor testing (endothelial-dependent function) were obtained. Univariate linear regression was used to evaluate log UACR and CMD parameters.
Results: The group mean age was 53 ± 11 years, BMI 30 ± 9 kg/m2, Caucasian (64%), hypertensive (42%), current or former smokers (41%), diabetic (14%), and dyslipidemic (8%), while 23% used ACE-inhibitor or angiotensin-receptor blockers. Mean UACR was 18 ± 59 mg/g. Coronary artery diameter responses to acetylcholine and to cold pressor had inverse relationships with UACR (Table). There was no significant relationship between UACR and nonendothelial-dependent CMD to adenosine.
Conclusions: Renal microvascular dysfunction, measured by UACR, is related to endothelial-dependent CMD. As both UACR and CMD predict clinical adverse cardiovascular events, these results may have prognostic and treatment implications. Improving preglomerular autoregulatory function and enhancing efferent arteriolar vasodilatation in both CMD and renal microvascular dysfunction pose potential targets for investigation and treatment.
Author Disclosures: S. Landes: None. J. Wei: None. P. Mehta: Research Grant; Modest; General Electric. Research Grant; Significant; Gilead. Honoraria; Modest; Little Company of Mary (lecture), Dignity Health (lecture), John F. Kennedy Hospital (lecture), Kaiser Permanente (lecture), San Diego Institue of Cardiology, Emory. C. Shufelt: Research Grant; Modest; Gilead. S. Dela Cruz: None. M. Minissian: None. C.J. Pepine: Research Grant; Modest; Gilead Sciences, Inc, Pfizer, Park-Davis, Sanofi-Aventis, Fujisawa HealthCare Inc, Baxter, Brigham & Women’s Hospital, AstraZeneca, NIH/NHLBI, Amorcyte/Neostem, Cytori, InfraReDx, NHLBI/NCRR CTSA grant 1UL1RR029890, AHA. Consultant/Advisory Board; Modest; NIH Study Section ofr Cardiovascular Sciences Small Business Activities 2RG1 CVS-K-10, Lilly/Cleveland Clinic DSMB Member for a Phase 2 Efficancy and Safety Study of Ly2484595, Medtelligence, NHLBI Study Section for Progenitor Cell Biology Consortium, NHLBI DSMB Chair for Freedom Trial. E. Handberg: Research Grant; Modest; Gilead. Other; Modest; AstraZeneca, Daiiehi Sankyo, Amarin, Daiichi, Mesoblast, ISIS pharmaceuticals, Esperion Therapeudics, Vessex, Genetech, Cytori, Daiichi-Sankyo, Medtronic, Baxter, United Therapeudics, Sanofi/Aventis, Amgen, Catabasis. X. Zhang: None. A. Rogatko: None. G. Sopko: None. N. Bairey Merz: Research Grant; Modest; WISE CVD, FAMRI, RWISE, Normal Control, Microvascular. Other Research Support; Modest; NIH-SEP (grant review Study Section), NIH-SEP. Speakers Bureau; Modest; Practice Pont Communications, Vox Media. Consultant/Advisory Board; Modest; Research Triangle Institute (RTI) International, UCSF, Kaiser, Gilead (grant review committee), Garden State AHA, Allegheny General Hospital, PCNA, Mayo Foundation (lectures; symposiums), Bryn Mawr Hospital, Victor Chang Cardiac Research Institute, Japanese Circ Society, University of New Mexico, Emory.
- © 2014 by American Heart Association, Inc.