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Impaired coronary microvascular and left ventricular diastolic function in patients with inflammatory bowel disease
Zuhal Caliskan1, Huseyin Savas Gokturk1, Mustafa Caliskan2
1Baskent University, Konya Teaching and Medical Research Center, Gastroenterology Department, Konya, Turkey.
Insights
Coronary microvascular function is impaired in patients with inflammatory bowel disease (IBD). Coronary flow reserve (CFR) is reduced, correlating with inflammatory markers like hs-CRP.
Area of Science:
- Cardiology
- Gastroenterology
- Vascular Biology
Background:
- Inflammatory bowel disease (IBD) is linked to increased coronary vascular events.
- Coronary microvascular function in IBD patients remains incompletely understood.
Purpose of the Study:
- To investigate coronary flow reserve (CFR) and left ventricular diastolic function in IBD patients.
- To determine if IBD is associated with impaired microvascular function.
Main Methods:
- Seventy-two IBD patients (ulcerative colitis and Crohn's disease) and 36 healthy controls were studied.
- Coronary flow reserve (CFR) was measured using transthoracic Doppler echocardiography.
- Disease activity was assessed using validated indices (TWAS, CDAI).
Main Results:
- IBD patients exhibited elevated hs-CRP and ESR compared to controls.
- IBD patients showed significantly lower CFR and impaired diastolic peak flow velocity.
- hs-CRP and left ventricular diastolic function parameters correlated independently with CFR.
Conclusions:
- Coronary microvascular function, assessed by CFR, is impaired in IBD patients.
- CFR and diastolic function are significantly correlated with hs-CRP levels in IBD.
Background And Aim:
Increased incidence of coronary vascular events in patients with inflammatory bowel disease (IBD) is known. However, the association between coronary microvascular function and IBD has not been fully defined. We aimed to investigate whether coronary flow reserve (CFR) and left ventricular diastolic function were impaired in IBD patients.
Methods:
Seventy-two patients with IBD (36 patients with ulcerative colitis [UC] and 36 Crohn's disease [CD]) were registered. Each subject was evaluated after a minimum 15-day attack-free period. For the control group, 36 age- and sex-matched healthy volunteers were included into the study. IBD clinical disease activity in UC was assessed by the Truelove-Witts Index (TWAS) and in CD by the Crohn's Disease Activity Index (CDAI). In each subject, CFR was measured through transthoracic Doppler echocardiography.
Results:
Compared to the controls, the CD group and UC group had significantly higher high-sensitivity C-reactive protein (hs-CRP) and erythrocyte sedimentation rate. Baseline diastolic peak flow velocity (DPFV) of the left anterior descending artery (LAD) was significantly higher in the IBD group (24.1±3.9 vs. 22. 4±2.9, p<0.05), and hyperemic DPFV (56.1±12.5 vs. 70.6±15.3, p<0.05) and CFR (2.34±0.44 vs. 3.14±0.54, p<0.05) were significantly lower in the IBD group than in the control group. In stepwise linear regression analysis, hs-CRP and lateral Em/Am ratio were independently correlated with CFR.
Conclusion:
CFR, reflecting coronary microvascular function, is impaired in patients with IBD. CFR and left ventricular diastolic function parameters are well correlated with hs-CRP.
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