Sex differences in coronary microvascular resistance measured by a computational fluid dynamics model

Area of Science:

• Cardiovascular Physiology
• Medical Imaging Analysis
• Computational Fluid Dynamics

Background:

• Increased coronary microvascular resistance (CMVR) is linked to coronary microvascular dysfunction (CMD).
• Coronary microvascular dysfunction (CMD) is more prevalent in women, but sex-specific differences in CMVR were previously unestablished.
• Understanding sex-specific differences in CMVR is crucial for diagnosing and managing CMD.

Purpose of the Study:

• To investigate and compare coronary microvascular resistance (CMVR) between men and women undergoing evaluation for chest pain.
• To determine if sex is a significant factor influencing CMVR in patients with suspected coronary artery disease.

Main Methods:

• Utilized a computational fluid dynamics (CFD) model to analyze human coronary physiology.
• Calculated absolute CMVR using invasive coronary angiographic images and pressure data from 203 coronary arteries in 144 patients.
• Employed advanced modeling techniques to derive physiological parameters from clinical data.

Main Results:

• Coronary microvascular resistance (CMVR) was found to be significantly higher in women compared to men (860 vs. 680 WU, p=0.025).
• No significant differences in CMVR were observed in other major subgroup comparisons.
• The study identified a statistically significant sex-specific difference in CMVR.

Conclusions:

• Women exhibit significantly higher coronary microvascular resistance (CMVR) than men.
• These sex-specific differences in CMVR may elucidate the increased prevalence of coronary microvascular dysfunction (CMD) observed in women.
• The findings highlight the importance of considering sex-specific factors in cardiovascular health.