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Published on: January 28, 2020
Relation between C reactive protein concentrations and coronary microvascular endothelial function
H Teragawa1, Y Fukuda, K Matsuda
1Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan 734-8551. hteraga@hiroshima-u.ac.jp
Insights
Elevated C-reactive protein (CRP), an inflammation marker, is linked to reduced coronary blood flow response to acetylcholine, indicating impaired endothelial function in resistance vessels.
Area of Science:
- Cardiology
- Vascular Biology
- Inflammation Research
Background:
- C-reactive protein (CRP) is a sensitive marker of inflammation.
- Endothelial dysfunction is a key factor in atherosclerosis.
- The relationship between CRP and coronary endothelial function requires further elucidation.
Purpose of the Study:
- To investigate the association between C-reactive protein (CRP) levels and coronary endothelial function.
- To assess the impact of inflammation on coronary blood flow and artery diameter in response to acetylcholine.
Main Methods:
- Quantitative coronary angiography and Doppler flow velocity measurements were used.
- Acetylcholine was infused into the left coronary ostium in patients with normal coronary arteries.
- Patients were stratified based on serum CRP concentrations (normal vs. increased).
Main Results:
- Increased CRP concentrations were observed in 15 out of 46 patients.
- Coronary artery diameter changes were similar between groups.
- Patients with increased CRP showed a significantly smaller increase in coronary blood flow (CBF) in response to acetylcholine.
Conclusions:
- Inflammation, indicated by elevated CRP, is associated with impaired coronary endothelial function in resistance vessels.
- The findings suggest a link between chronic vascular inflammation and endothelial dysfunction in the context of atherosclerosis.
Objective:
To determine how C reactive protein (CRP), a sensitive marker of inflammation, is related to coronary endothelial function.
Design:
Changes in quantitative coronary angiographic findings and Doppler flow velocity measurements in response to locally infused acetylcholine were assessed.
Setting:
Tertiary cardiology centre.
Patients:
46 patients with angiographically normal coronary arteries were divided into groups with normal (< or = 3 mg/l) or increased (> 3 mg/l) CRP concentrations.
Interventions:
Acetylcholine (3 and 30 microg/min) was infused into the left coronary ostium for two minutes.
Main Outcome Measures:
Percentage change in diameter of epicardial coronary arteries and coronary blood flow (CBF) in response to acetylcholine; and correlations between these parameters and serum CRP concentrations.
Results:
15 patients had increased CRP concentrations. The change in coronary artery diameter induced by acetylcholine infusion was similar between the groups but the increase in CBF induced by acetylcholine was smaller in patients with increased CRP concentrations (54.9% v 139.4% with acetylcholine 30 microg/min, p = 0.0030). Multivariate analysis identified increased CRP concentration as independently associated with attenuated CBF response to acetylcholine at 30 microg/min (p = 0.0078, R2 = 0.434).
Conclusions:
These findings suggest that inflammation appears to be associated with impaired coronary endothelial function in resistance but not conduit vessels. The data suggest a close relation between chronic vascular inflammation and endothelial dysfunction in atherosclerosis.
