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A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
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The association between coronary microvascular dysfunction and carotid intima media thickness in patients with

Vincenzo Sucato1, Salvatore Evola1, Giuseppina Novo1

  • 1Division of Cardiology, Biomedical Department of Internal Medicine and Specialties (DiBiMIS), Paolo Giaccone Hospital, University of Palermo, Italy.

International Journal of Cardiology
|April 17, 2016
PubMed

Insights

Patients with cardiac syndrome X and increased carotid intima-media thickness show greater microvascular dysfunction. This indicates a more significant involvement of the microcirculation in these individuals, impacting coronary blood flow and myocardial perfusion.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Diagnostic Imaging

Background:

  • Cardiac Syndrome X (CSX) is characterized by angina-like chest pain without obstructive coronary artery disease.
  • Microvascular dysfunction is a key pathophysiological mechanism in CSX.
  • Carotid intima-media thickness (C-IMT) is a marker of subclinical atherosclerosis.

Purpose of the Study:

  • To evaluate coronary blood flow and myocardial perfusion in patients with CSX.
  • To compare microvascular function between CSX patients with and without increased C-IMT.
  • To determine if increased C-IMT is associated with greater microvascular dysfunction in CSX.

Main Methods:

  • 124 CSX patients underwent coronary angiography and carotid ultrasound.
  • Patients were categorized based on increased C-IMT.
  • Angiographic indices including TIMI Frame Count (TFC), Myocardial Blush Grade (MBG), and Total Myocardial Blush Score (TMBS) were calculated.

Main Results:

  • Patients with increased C-IMT exhibited significantly longer TFC in all three major coronary arteries.
  • Lower MBG scores were observed in the three coronary arteries for patients with increased C-IMT.
  • These findings indicate impaired coronary microvascular function in CSX patients with increased C-IMT.

Conclusions:

  • Increased C-IMT in CSX patients is associated with greater microvascular dysfunction.
  • Angiographic indices reveal significant microcirculatory impairment in CSX patients with increased C-IMT.
  • This suggests a more pronounced involvement of the coronary microcirculation in this subgroup.
Abstract

Keywords:
C-reactive proteinCardiac syndrome XCarotid intima media thicknessCoronary angiographyUltrasound carotid

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