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Endothelial dysfunction in patients with myocardial ischemia or infarction and nonobstructive coronary arteries

Ersin Cagri Simsek1, Cenk Sari1, Murat Kucukokur1

  • 1Department of Cardiology, Tepecik Training and Research Hospital, University of Health Science, Izmir, Turkey.

Journal of Clinical Ultrasound : JCU
|August 11, 2020
PubMed

Insights

Patients with myocardial infarction with no obstructive coronary artery disease (MINOCA) show worse endothelial dysfunction than those with ischemia with no obstructive coronary artery disease (INOCA). Cardiotrophin-1 levels did not differ between these groups.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Biomarkers

Background:

  • Myocardial infarction/ischemia with no obstructive coronary artery disease (MINOCA/INOCA) are increasingly diagnosed.
  • Endothelial dysfunction (ED) is implicated in MINOCA/INOCA pathogenesis.
  • Comparing ED and specific biomarkers in MINOCA vs. INOCA is crucial for understanding disease mechanisms.

Purpose of the Study:

  • To compare endothelial function, assessed by flow-mediated dilation (FMD), between MINOCA and INOCA patients.
  • To evaluate plasma cardiotrophin-1 (CT-1) levels in MINOCA and INOCA cohorts.
  • To investigate the relationship between ED and CT-1 in patients with ischemic events and normal coronary arteries.

Main Methods:

  • Enrolled 42 MINOCA patients and 38 INOCA patients.
  • Assessed endothelial function via brachial artery flow-mediated dilation (FMD%) and nitroglycerin-mediated dilation (NMD%).
  • Measured plasma CT-1 concentrations using enzyme-linked immunosorbent assay.

Main Results:

  • MINOCA patients exhibited significantly lower FMD% compared to INOCA patients (6.45% vs. 8.94%, P < .001).
  • No significant difference was observed in NMD% between the groups (P = .06).
  • Plasma CT-1 levels were comparable between MINOCA and INOCA patients (P = .53).

Conclusions:

  • Results indicate more severe endothelial dysfunction in MINOCA compared to INOCA.
  • Plasma CT-1 levels do not differentiate between stable and unstable ischemic heart disease with normal coronary arteries.
  • ED is a key factor in MINOCA, independent of CT-1 levels.
Abstract

Keywords:
brachial arterycardiotrophin-1coronary artery diseaseendothelial dysfunctionmyocardial ischemia

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