Significant Association of Serum Albumin With the Severity of Coronary Microvascular Dysfunction Using Dynamic...

Area of Science:

• Cardiology
• Biochemistry
• Medical Imaging

Background:

• Low serum albumin (SA) concentration is a known risk factor for heart failure (HF).
• Coronary microvascular dysfunction (CMD) is also a significant risk factor for HF development.
• The relationship between SA levels and CMD, specifically myocardial flow reserve (MFR), requires further investigation.

Purpose of the Study:

• To investigate the association between serum albumin (SA) concentration and myocardial flow reserve (MFR).
• To explore the role of SA in the pathophysiological mechanisms of heart failure (HF).
• To assess the predictive value of SA for coronary microvascular dysfunction (CMD).

Main Methods:

• Retrospective analysis of 454 patients undergoing dynamic cardiac cadmium-zinc-telluride myocardial perfusion imaging.
• Patients were categorized into three groups based on serum albumin (SA) levels (g/dL): >4, 3.5-4, and <3.5.
• Comparison of myocardial blood flow (MBF) and myocardial flow reserve (MFR) across different SA groups.

Main Results:

• Decreasing SA levels correlated with reduced stress MBF and MFR, and increased rest MBF.
• Low SA concentration was significantly associated with impaired MFR (MFR < 2.5), with odds ratios of 3.57 for SA 3.5-4 g/dL and 34.9 for SA < 3.5 g/dL, compared to SA > 4 g/dL.
• Serum albumin demonstrated acceptable predictive performance for CMD with an AUC of 0.76.

Conclusions:

• Low serum albumin concentration is significantly associated with the severity of coronary microvascular dysfunction (CMD).
• SA levels are linked to impaired global and regional myocardial flow reserve (MFR) and myocardial blood flow (MBF).
• Serum albumin may serve as a valuable indicator for assessing CMD and predicting heart failure risk.