Overlap between angina without obstructive coronary artery disease and left ventricular diastolic dysfunction with...

Area of Science:

• Cardiology
• Cardiovascular Medicine
• Echocardiography

Background:

• A potential link between angina with no obstructive coronary artery disease (CAD) and heart failure with preserved ejection fraction (HFpEF) is suggested but lacks robust evidence.
• Investigating left ventricular diastolic function in women with angina and no obstructive CAD is crucial for understanding this relationship.

Purpose of the Study:

• To compare left ventricular diastolic function in women with angina and no obstructive CAD against a reference population.
• To explore potential shared pathophysiological mechanisms between angina and HFpEF.

Main Methods:

• A cross-sectional study involving 956 women with angina and <50% coronary artery stenosis.
• A control group of 214 women with cardiovascular risk factors but no history of cardiac symptoms.
• Left ventricular diastolic function assessed using transthoracic echocardiography.

Main Results:

• Women with angina exhibited impaired diastolic function, including lower E/A ratio and higher left ventricular mass index, left atrial volume index, and E/e' ratio.
• A greater proportion of angina patients had elevated left ventricular filling pressures compared to controls.
• These differences remained significant after adjusting for cardiovascular risk factors.

Conclusions:

• Patients with angina and no obstructive CAD demonstrate significantly impaired left ventricular diastolic function compared to asymptomatic individuals.
• The findings suggest a common pathophysiological pathway linking angina with no obstructive CAD and heart failure with preserved ejection fraction.