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Updated: Aug 14, 2026
Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats
Published on: June 28, 2019
Relation between peripheral vascular endothelial function and coronary flow reserve in patients with chest pain and
Insights
Peripheral vascular endothelial function, measured by brachial artery flow-mediated dilation (FMD), is linked to coronary flow reserve (CFR). Brachial FMD can help diagnose microvascular dysfunction in patients with chest pain and normal coronary angiograms.
Area of Science:
- Cardiology
- Vascular Biology
- Diagnostic Imaging
Background:
- Investigated the relationship between peripheral endothelial function and coronary flow reserve (CFR) in patients presenting with chest pain and normal coronary angiograms.
- Assessed brachial artery flow-mediated dilation (FMD) and carotid artery intima-media thickness (IMT) in 32 subjects.
- Utilized transthoracic echocardiography to measure CFR in the distal left anterior descending coronary artery.
Discussion:
- Found significantly decreased % FMD in subjects with CFR < 2.1 compared to those with CFR ≥ 2.1.
- Demonstrated a positive correlation between CFR and peripheral FMD.
- Observed no significant difference in IMT between the two groups, suggesting microvascular dysfunction is not driven by advanced atherosclerosis.
Key Insights:
- Microvascular dysfunction in patients with chest pain and normal coronary angiograms is primarily associated with endothelial dysfunction.
- Peripheral endothelial function, assessed via brachial FMD, serves as a potential diagnostic marker for microvascular dysfunction.
- Endothelial dysfunction appears to be a generalized arterial process.
Outlook:
- Brachial FMD measurement offers a non-invasive tool for evaluating microvascular dysfunction in specific patient populations.
- Further research could explore the therapeutic implications of targeting endothelial dysfunction in these patients.
- This study highlights the importance of assessing peripheral vascular function in understanding coronary microvascular disease.
Abstract:
To evaluate the relation between peripheral vascular endothelial function and coronary flow reserve (CFR), we assessed flow mediated dilation (FMD) of brachial artery and the intima-media thickness (IMT) of the carotid artery in 32 subjects (mean age 58+/-9 years, M/F=9:23 ) with chest pain and normal coronary angiogram. The subjects were divided into 2 groups according to CFR >or=2.1 or <2.1 measured with transthoracic echocardiography in distal left anterior descending coronary artery. We found % FMD was decreased in the group with CFR <2.1 than those of CFR >or=2.1 and CFR was correlated with peripheral FMD. However, IMT was not different between two groups. These results suggest that microvascular dysfunction is primarily related to endothelial dysfunction rather than advanced atherosclerosis and because it is a generalized process that involves the whole arteries, the measurement of brachial FMD can be a useful diagnostic tool to evaluate microvascular dysfunction in patients with chest pain and normal coronary angiogram.
