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A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
Published on: February 7, 2015
Association between cardiovascular risk profile and impaired microvascular function in a Swedish middle-aged cohort
Sara Bergstrand1, Hanna Jonasson2, Ingemar Fredriksson2,3
1Department of Health, Medicine and Caring Sciences, Linköping University, Building 511, Entrance 75, Room 13.1309 Campus US, 581 83 Linköping, Sweden.
Insights
Impaired microvascular function, measured by peak blood oxygen saturation (OxyP), is linked to higher cardiovascular risk and subclinical atherosclerosis in adults without prior CVD. OxyP may indicate early signs of disease not seen in structural scans.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Public Health
Background:
- Cardiovascular disease (CVD) risk is influenced by various factors, including microvascular function and subclinical atherosclerosis.
- Early detection of cardiovascular risk is crucial for preventative strategies.
Purpose of the Study:
- To investigate the association between microvascular function, cardiovascular risk profiles, and subclinical atherosclerotic burden.
- To determine if microvascular function assessed by peak blood oxygen saturation (OxyP) can serve as a marker for early CVD risk.
Main Methods:
- The study analyzed 3809 individuals aged 50-65 from the Swedish CArdioPulmonary bioImage Study.
- Microvascular function was assessed using forearm skin arterial occlusion and release to determine OxyP.
- Cardiovascular risk was evaluated using the Systematic Coronary Risk Evaluation (SCORE2), and subclinical atherosclerosis was assessed via coronary artery calcification score (CACS) and carotid plaques.
Main Results:
- Individuals with impaired microvascular function (lowest OxyP quartile) had a 53% higher mean SCORE2 risk compared to those with optimal function.
- The risk of having a SCORE2 > 10% was five times higher in the lowest OxyP quartile, even after adjustments.
- Lower OxyP values were observed in individuals with detectable coronary artery calcification and/or carotid plaques.
Conclusions:
- Impaired microvascular function is significantly associated with elevated cardiovascular risk and subclinical atherosclerosis in an adult population without diagnosed CVD or diabetes.
- Peak blood oxygen saturation (OxyP) shows potential as a functional marker for subclinical atherosclerosis and CVD risk.
- OxyP may detect circulatory issues not apparent through traditional structural assessments of atherosclerosis.
Aims:
The aim was to investigate the relationship between microvascular function, cardiovascular risk profile, and subclinical atherosclerotic burden.
Methods And Results:
The study enrolled 3809 individuals, 50-65 years old, participating in the population-based observational cross-sectional Swedish CArdioPulmonary bioImage Study. Microvascular function was assessed in forearm skin using an arterial occlusion and release protocol determining peak blood oxygen saturation (OxyP). Cardiovascular risk was calculated using the updated Systematic Coronary Risk Evaluation [SCORE2; 10-year risk of fatal and non-fatal cardiovascular disease (CVD) events]. The OxyP was compared with coronary artery calcification score (CACS) and to plaques in the carotid arteries. Individuals with OxyP values in the lowest quartile (Q1; impaired microvascular function) had a mean SCORE2 of 5.8% compared with 3.8% in those with the highest values of OxyP (Q4), a relative risk increase of 53%. The risk of having a SCORE2 > 10% was five times higher for those in Q1 (odds ratio: 4.96, 95% confidence interval: 2.76-8.93) vs. Q4 when adjusting for body mass index and high-sensitivity C-reactive protein. The OxyP was lower in individuals with CACS > 0 and in those with both carotid plaques and CACS > 0, compared with individuals without subclinical atherosclerotic burdens (87.5 ± 5.6% and 86.9 ± 6.0%, vs. 88.6 ± 5.8%, P < 0.01).
Conclusion:
In a population without CVD or diabetes mellitus, impaired microvascular function is associated with cardiovascular risk profiles such as higher SCORE2 risk and CACS. We suggest that OxyP may serve as a microcirculatory functional marker of subclinical atherosclerosis and CVD risk that is not detected by structural assessments.
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