Plasma Lipidomic Patterns in Patients with Symptomatic Coronary Microvascular Dysfunction.

Area of Science:

• Cardiology
• Metabolomics
• Vascular Biology

Background:

• Coronary microvascular dysfunction (MVD) affects vascular tone regulation, especially under metabolic stress.
• While risk factors overlap with coronary artery disease (CAD), MVD's etiology remains unclear.
• This study investigates lipidomic profiles in symptomatic individuals without obstructive CAD.

Purpose of the Study:

• To identify specific lipidomic signatures associated with MVD in non-elderly patients.
• To correlate MVD, assessed by myocardial contrast echocardiography, with plasma lipid profiles.
• To differentiate MVD lipid profiles from those in non-obstructive CAD.

Main Methods:

• 20 patients (35-60 years) with chest pain but no obstructive CAD underwent computed tomography coronary angiography (CTA).
• Quantitative regadenoson stress-rest myocardial contrast echocardiography (MCE) assessed MVD.
• Plasma lipidomics was analyzed using liquid chromatography and high-resolution mass spectrometry.

Main Results:

• Nine out of 20 subjects exhibited MVD, characterized by reduced hyperemic perfusion (1.62 ± 0.44 vs. 2.63 ± 0.99 s⁻¹, p=0.009).
• No significant differences in non-obstructive CAD or CAD risk factors were found between MVD and non-MVD groups.
• MVD patients displayed lower long-chain triacylglycerols/diacylglycerols and higher short-chain triacylglycerols; a specific diacylglycerol distinguished all participants.

Conclusions:

• Distinct plasma lipidomic profiles, including saturated long-chain fatty acid-containing acylglycerols, are associated with MVD.
• These lipid patterns differ significantly from those in non-obstructive CAD.
• Lipidomic profiles may aid in characterizing MVD pathobiology and guiding treatment strategies.