Coronary vasodilator reserve and Framingham risk scores in subjects at risk for coronary artery disease

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Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats
06:32

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats

Published on: June 28, 2019

Sharmila Dorbala1, Alita Hassan, Therese Heinonen

  • 1Division of Nuclear Medicine/PET, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass, USA. sdorbala@partners.org

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|December 19, 2006
PubMed

Insights

Coronary flow reserve (CFR) decreases as coronary heart disease (CHD) risk increases in individuals without diagnosed coronary artery disease (CAD). This finding highlights CFR as a potential indicator for early CHD risk assessment.

Area of Science:

  • Cardiovascular Imaging
  • Nuclear Cardiology
  • Preventive Cardiology

Background:

  • The predictive value of coronary vasodilator reserve for coronary heart disease (CHD) risk in individuals without established coronary artery disease (CAD) remains unclear.
  • Assessing subclinical cardiovascular disease is crucial for refining risk stratification and guiding preventive strategies.

Purpose of the Study:

  • To investigate the relationship between coronary flow reserve (CFR) and estimated 10-year CHD risk in a cohort of subjects without clinical CAD.
  • To determine if measures of coronary microvascular function correlate with established CHD risk scores.

Main Methods:

  • Positron emission tomography (PET) with adenosine and N-13 ammonia was used to measure CFR and coronary vascular resistance (CVR) at rest and during hyperemia.
  • 289 subjects without overt CAD, stratified by Framingham CHD risk scores (low vs. intermediate), were analyzed.
  • Correlations between CFR, CVR, and Framingham-estimated CHD risk were calculated.

Main Results:

  • Subjects with intermediate CHD risk exhibited significantly lower CFR (2.5 ± 0.8) and higher minimal CVR (52.4 ± 16.4) compared to low-risk subjects (CFR 2.8 ± 1.0, CVR 49.3 ± 17.41).
  • CFR showed a significant inverse relationship with CHD risk (R = -0.2, P = .006).
  • CVR demonstrated a significant direct relationship with CHD risk (R = 0.2, P < .001).

Conclusions:

  • In individuals without clinical CAD but with low to intermediate CHD risk, CFR measured by PET is inversely associated with estimated 10-year CHD risk.
  • These findings suggest that impaired coronary microvascular function, as indicated by reduced CFR, may be an early marker of increased CHD risk.
Abstract

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