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Relationship between coronary microvascular dysfunction and left ventricular diastolic function in patients with

Jeng Hwan Lam1,2, Jing Xian Quah3, Thomas Davies4,5

  • 1Department of Medicine, Sunshine Coast Hospital and Health Services, Birtinya, Qld, Australia.

Echocardiography (Mount Kisco, N.Y.)
|August 5, 2020
PubMed

Insights

This study found no link between diastolic dysfunction and coronary microvascular function in patients with chest pain. Further research is needed to understand heart failure with preserved ejection fraction mechanisms.

Area of Science:

  • Cardiology
  • Cardiovascular Physiology

Background:

  • Diastolic dysfunction (DD) affects up to 35% of adults, potentially leading to heart failure with preserved ejection fraction (HFpEF).
  • Coronary microvascular dysfunction (CMD) is a suspected contributor to HFpEF pathogenesis.
  • The relationship between CMD and diastolic function in patients with chest pain and unobstructed coronary arteries (CPUCA) requires investigation.

Purpose of the Study:

  • To determine the association between coronary microvascular function and resting echocardiographic indices of left ventricular diastolic function.
  • To explore potential links between CMD and DD in patients presenting with chest pain but without obstructive coronary artery disease.

Main Methods:

  • A retrospective observational study of 149 patients with chest pain assessed via CT coronary angiogram.
  • Coronary microvascular dysfunction assessed using myocardial blood flow reserve (MBFR < 2.0) via myocardial contrast echocardiography.
  • Echocardiographic diastolic function indices (septal mitral annular e', E/e', E/A ratio) measured from baseline transthoracic echocardiograms.

Main Results:

  • Mean MBFR was 2.2, with 37% of patients exhibiting CMD (MBFR < 2.0).
  • Age, not MBFR, was a significant predictor of increased septal mitral annular E/e' in univariate analysis.
  • Multivariable analysis revealed no association between septal mitral annular E/e' and MBFR after adjusting for cardiovascular risk factors.

Conclusions:

  • No significant relationship was identified between echocardiographic measures of left ventricular diastolic function and coronary microvascular function at rest.
  • These findings suggest that CMD may not be directly associated with diastolic dysfunction in this specific patient cohort.
Abstract

Keywords:
diastolic dysfunctionheart failureleft ventricular functionmyocardial blood volume and flow

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