Patients With Coronary Microvascular Dysfunction Have Less Circulating α-Klotho.

Area of Science:

• Cardiology
• Gerontology
• Vascular Biology

Background:

• Coronary microvascular dysfunction (CMD) is an early indicator of coronary vascular aging.
• Klotho (α-klotho) is a circulating protein associated with physiological aging.
• The study investigates low Klotho as a marker for vascular aging in patients with CMD but no coronary artery disease.

Purpose of the Study:

• To determine if low Klotho levels are associated with coronary microvascular dysfunction (CMD).
• To explore Klotho's potential as a biomarker for vascular aging in patients without significant coronary artery disease.
• To assess the relationship between Klotho levels, endothelial progenitor cells, and CMD.

Main Methods:

• Invasive coronary microvascular and endothelial function testing were performed on patients undergoing angiogram for chest pain.
• CMD was defined by coronary blood flow response to acetylcholine or coronary flow reserve.
• Circulating endothelial progenitor cells and plasma Klotho levels were analyzed using flow cytometry and ELISA, respectively.

Main Results:

• Patients with CMD had significantly lower Klotho levels compared to those without CMD (P=0.03).
• Low Klotho was a significant predictor of CMD, even after adjusting for traditional cardiovascular risk factors (OR, 0.80; P=0.05).
• Higher Klotho levels correlated with increased numbers of endothelial progenitor cells, suggesting enhanced vascular regenerative potential.

Conclusions:

• Klotho may serve as a valuable biomarker for identifying coronary microvascular dysfunction (CMD).
• Klotho presents a potential therapeutic target for managing vascular aging and CMD, particularly in patients lacking traditional cardiovascular risk factors.