Coronary Microvascular Function in Asymptomatic Middle-Aged Individuals With Cardiometabolic Risk Factors

Area of Science:

• Cardiology
• Vascular Biology
• Preventive Medicine

Background:

• Coronary microvascular dysfunction is linked to poor outcomes in ischemic heart disease.
• Data on microvascular function in healthy individuals is limited.
• Understanding microvascular function in asymptomatic individuals is crucial for early risk assessment.

Purpose of the Study:

• To evaluate the impact of cardiovascular risk factors on coronary microvascular function.
• To assess the relationship between subclinical atherosclerosis and microvascular function.
• To investigate these associations in middle-aged, asymptomatic individuals.

Main Methods:

• Cardiac magnetic resonance imaging (MRI) assessed myocardial blood flow (MBF) and myocardial perfusion reserve (MPR).
• Subclinical atherosclerosis was evaluated using vascular ultrasound and coronary artery calcium scoring.
• Data were collected at baseline and a 3-year follow-up.

Main Results:

• Resting MBF correlated with metabolic syndrome components, insulin resistance, and diabetes.
• MPR was reduced in individuals with metabolic syndrome and insulin resistance.
• Stress MBF was inversely associated with coronary artery calcium and plaque burden.
• Higher MBF and MPR predicted less atherosclerosis progression over 3 years.

Conclusions:

• Cardiometabolic risk factors and systemic subclinical atherosclerosis are associated with impaired coronary microvascular function in asymptomatic individuals.
• Good coronary microvascular function is linked to reduced atherosclerosis progression.
• These findings highlight the importance of microvascular health in early cardiovascular disease prevention.