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Obesity is independently associated with coronary endothelial dysfunction in patients with normal or mildly diseased
J Al Suwaidi1, S T Higano, D R Holmes
1Center for Coronary Physiology and Imaging, Department of Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.
Insights
Obesity is linked to impaired coronary endothelial function in patients with normal or mild coronary artery disease. This finding highlights obesity as an independent risk factor for endothelial dysfunction, impacting heart health.
Area of Science:
- Cardiology
- Vascular Biology
- Obesity Medicine
Background:
- Obesity is recognized by the American Heart Association (AHA) as a modifiable risk factor for coronary heart disease.
- Coronary endothelial dysfunction is an early indicator of cardiovascular disease.
Purpose of the Study:
- To evaluate the impact of obesity on coronary endothelial function.
- To assess endothelial function in patients with normal or mild coronary artery disease across different body mass index (BMI) categories.
Main Methods:
- 397 patients with normal or mild coronary artery disease underwent coronary vascular reactivity testing.
- Patients were categorized into normal weight (BMI <25), overweight (BMI 25-30), and obese (BMI >30) groups.
- Coronary blood flow response to intracoronary acetylcholine was measured.
Main Results:
- Obese patients exhibited significantly lower coronary blood flow response to acetylcholine compared to normal-weight individuals.
- Overweight and obesity were independently associated with impaired coronary endothelial function (OR 1.55 and 2.41, respectively).
- No significant differences in other cardiovascular risk factors were observed between groups, except for age in overweight patients.
Conclusions:
- Obesity is independently associated with coronary endothelial dysfunction.
- These findings suggest that weight management is crucial for maintaining endothelial health in patients with coronary artery disease.
Objectives:
This study evaluates the impact of obesity on coronary endothelial function in patients with normal or mild coronary artery disease.
Background:
The American Heart Association (AHA) has recently classified obesity as a modifiable risk factor for coronary heart disease.
Methods:
A total of 397 consecutive patients with normal or mildly diseased coronary arteries at angiography underwent coronary vascular reactivity evaluation using intracoronary adenosine, acetylcholine and nitroglycerin. Patients were divided into three groups based on the body mass index (BMI): Group 1, patients with a BMI <25 (n = 117, normal weight); Group 2, patients with a BMI 25-30 (n = 149, overweight) and Group 3, patients with a BMI >30 (n = 131, obese).
Results:
There were no significant differences among the groups in regard to other cardiovascular risk factors, except that overweight but not obese patients were significantly older than normal-weight patients (47 +/- 1 years in Group 1, 53 +/- 1 years in Group 2 and 50 +/- 1 years in Group 3, p < 0.001). The percent change of coronary blood flow to acetylcholine (%delta CBF Ach) was significantly lower in the obese patients than in the normal-weight group (85.2 +/- 12.0% in Group 1, 63.7 +/- 10.0% in Group 2 and 38.1 +/- 9.6% in Group 3, p = 0.009). By multivariate analysis, overweight (odds ratio, 1.55; 95% confidence interval, 1.2-2.0) and obesity (odds ratio, 2.41; 95% confidence interval, 1.5-4.0) status were independently associated with impaired coronary endothelial function.
Conclusions:
The study demonstrates that obesity is independently associated with coronary endothelial dysfunction in patients with normal or mildly diseased coronary arteries.