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Aortic Stiffness Is Associated with Coronary Microvascular Dysfunction in Patients with Non-obstructive Coronary

Takahiro Muroya1, Hiroaki Kawano2, Seiji Koga2

  • 1Circulatory Division, Sasebo City General Hospital, Japan.

Internal Medicine (Tokyo, Japan)
|December 3, 2020
PubMed

Insights

Aortic stiffness may cause coronary microvascular dysfunction (CMD) in patients with non-obstructive coronary artery disease (CAD). Increased aortic stiffness, measured by cardio-ankle vascular index (CAVI), is linked to higher hyperemic microvascular resistance index (hMVRI).

Area of Science:

  • Cardiovascular Physiology
  • Vascular Biology
  • Clinical Cardiology

Background:

  • Aortic stiffness is a known contributor to cardiovascular disease events.
  • The precise relationship between aortic stiffness and coronary microvascular dysfunction (CMD) is not fully understood.
  • Non-obstructive coronary artery disease (CAD) presents a unique population to study these vascular relationships.

Purpose of the Study:

  • To investigate if aortic stiffness is a causal factor for CMD.
  • To evaluate CMD using the hyperemic microvascular resistance index (hMVRI).
  • To assess this relationship in patients with non-obstructive CAD.

Main Methods:

  • Intracoronary physiological variables were assessed in 209 coronary arteries from 121 patients with non-obstructive CAD.
  • Cardio-ankle vascular index (CAVI), a measure of aortic stiffness, was recorded.
  • Risk factors, including eicosapentaenoic acid (EPA) and EPA/arachidonic acid (AA) ratio, were measured.

Main Results:

  • hMVRI showed significant correlations with age, EPA, EPA/AA ratio, and CAVI in univariate analyses.
  • Multivariate regression identified CAVI and the EPA/AA ratio as independent determinants of hMVRI.
  • A positive association was found between aortic stiffness (CAVI) and microvascular resistance (hMVRI).

Conclusions:

  • Aortic stiffness may directly contribute to CMD in patients with non-obstructive CAD.
  • Increased coronary microvascular resistance is a potential mechanism linking aortic stiffness to CMD.
  • Aortic stiffness is a significant factor associated with microvascular dysfunction in this patient group.

Keywords:
aortic stiffnesscardio-ankle vascular indexcoronary flow reservehyperemic microvascular resistance index

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