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Related Experiment Videos

Abnormal coronary microvascular endothelial function in humans with asymptomatic left ventricular dysfunction.

Abhiram Prasad1, Stuart T Higano, Jassim Al Suwaidi

  • 1Division of Cardiovascular Diseases and Department of Internal Medicine, Center for Coronary Physiology and Imaging, Mayo Clinic and Mayo Foundation, Rochester, Minn 55905, USA.

American Heart Journal
|August 30, 2003
PubMed
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Coronary microvascular endothelial dysfunction is present in patients with asymptomatic left ventricular dysfunction (ALVD). This suggests endothelial dysfunction may be an early indicator in heart failure development.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Heart Failure Research

Background:

  • Coronary endothelial dysfunction is linked to myocardial ischemia and heart failure progression.
  • The temporal relationship between endothelial dysfunction and heart failure remains unclear.
  • This study investigated endothelial function in asymptomatic left ventricular dysfunction (ALVD).

Purpose of the Study:

  • To determine if coronary endothelial dysfunction exists in patients with asymptomatic left ventricular dysfunction (ALVD).
  • To explore the role of endothelial dysfunction in the early stages of heart failure.

Main Methods:

  • Evaluated coronary vascular reactivity in 300 patients using intracoronary adenosine, acetylcholine (ACH), and nitroglycerin.
  • Grouped patients into ALVD (ejection fraction <45%) and controls (ejection fraction >=45%).

Related Experiment Videos

  • Assessed changes in epicardial diameter and coronary blood flow in response to ACH.

    • Main Results:

    • Patients with ALVD showed significantly attenuated coronary blood flow response to ACH compared to controls (P <.013).
    • No significant difference in epicardial diameter response to ACH between groups.
    • Left ventricular ejection fraction was an independent predictor of coronary microvascular dilation with ACH (P <.001).

    Conclusions:

    • Coronary microvascular endothelial dysfunction is present in patients with ALVD.
    • Endothelial dysfunction may represent an early pathophysiological event in heart failure.