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Association of coronary microvascular dysfunction and cardiac bridge integrator 1, a cardiomyocyte dysfunction

Christine Pacheco1,2, Janet Wei3, Chrisandra Shufelt3

  • 1Hôpital Pierre-Boucher, Cardiology Service, Department of Medicine, Université de Montréal, Longueuil, Quebec, Canada.

Clinical Cardiology
|September 16, 2021
PubMed

Insights

Coronary microvascular dysfunction (CMD) in women with suspected ischemia with no obstructive coronary artery disease (INOCA) is linked to poorer cardiomyocyte health. This finding suggests CMD may progress to heart failure with preserved ejection fraction (HFpEF).

Area of Science:

  • Cardiology
  • Vascular Biology
  • Biomarkers

Background:

  • Coronary microvascular dysfunction (CMD) is linked to heart failure with preserved ejection fraction (HFpEF), but its underlying pathophysiology remains unclear.
  • Understanding CMD is crucial for managing HFpEF, particularly in women with ischemia with no obstructive coronary artery disease (INOCA).

Purpose of the Study:

  • To investigate the association between CMD in women with INOCA and cardiomyocyte dysfunction.
  • To evaluate plasma levels of cardiac bridge integrator 1 (cBIN1) as a biomarker for cardiomyocyte dysfunction in INOCA.

Main Methods:

  • Coronary function testing was performed in women with suspected INOCA.
  • Coronary flow reserve, vasodilation responses to nitroglycerin and acetylcholine (ΔAch), and change in coronary blood flow (ΔCBF) were assessed.
  • Plasma cBIN1 score (CS) levels were compared between INOCA patients (n=39), HFpEF (n=20), HFrEF (n=36), and reference controls (RC) (n=50).

Main Results:

  • Higher CS was significantly associated with impaired vasodilation to acetylcholine (r=-0.43, p=0.011) and a trend towards lower ΔCBF (r=0.30, p=0.086).
  • Women with INOCA exhibited higher CS compared to RC, but lower CS than women with HFpEF and HFrEF (p < 0.001).
  • Elevated CS in INOCA suggests an intermediate state of cardiomyocyte health between healthy individuals and those with HFpEF.

Conclusions:

  • Plasma cBIN1 score (CS) serves as a biomarker for cardiomyocyte health and is elevated in women with suspected INOCA.
  • The findings support the hypothesis that CMD may represent a progressive condition that can lead to HFpEF.
  • Further prospective studies are warranted to elucidate the pathophysiological link between cBIN1, CMD, and HFpEF.
Abstract

Keywords:
coronary microvascular dysfunctionheart failurewomen

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