Vascular Remodeling in Coronary Microvascular Dysfunction.

Details

Serval ID
serval:BIB_795C1F1E414E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Vascular Remodeling in Coronary Microvascular Dysfunction.
Journal
JACC. Cardiovascular imaging
Author(s)
Collet C., Sakai K., Mizukami T., Ohashi H., Bouisset F., Caglioni S., van Hoe L., Gallinoro E., Bertolone D.T., Pardaens S., Brouwers S., Storozhenko T., Seki R., Munhoz D., Tajima A., Buytaert D., Vanderheyden M., Wyffels E., Bartunek J., Sonck J., De Bruyne B.
ISSN
1876-7591 (Electronic)
ISSN-L
1876-7591
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Approximately half of the patients with angina and nonobstructive coronary artery disease (ANOCA) have evidence of coronary microvascular dysfunction (CMD).
This study aims to characterize patients with ANOCA by measuring their minimal microvascular resistance and to examine the pattern of vascular remodeling associated with these measurements.
The authors prospectively included patients with ANOCA undergoing continuous thermodilution assessment. Lumen volume and vessel-specific myocardial mass were quantified using coronary computed tomography angiography (CTA). CMD was defined as coronary flow reserve <2.5 and high minimal microvascular resistance as >470 WU.
A total of 153 patients were evaluated; 68 had CMD, and 22 of them showed high microvascular resistance. In patients with CMD, coronary flow reserve was 1.9 ± 0.38 vs 3.2 ± 0.81 in controls (P < 0.001). Lumen volume was significantly correlated with minimal microvascular resistance (r = -0.59 [95% CI: -0.45 to -0.71]; P < 0.001). In patients with CMD and high microvascular resistance, lumen volume was 40% smaller than in controls (512.8 ± 130.3 mm <sup>3</sup> vs 853.2 ± 341.2 mm <sup>3</sup> ; P < 0.001). Epicardial lumen volume assessed by coronary CTA was independently associated with minimal microvascular resistance (P < 0.001). The predictive capacity of lumen volume from coronary CTA for detecting high microvascular resistance showed an area under the curve of 0.79 (95% CI: 0.69-0.88).
Patients with CMD and high minimal microvascular resistance have smaller epicardial vessels than those without CMD. Coronary CTA detected high minimal microvascular resistance with very good diagnostic capacity. Coronary CTA could potentially aid in the diagnostic pathway for patients with ANOCA.
Keywords
absolute coronary flow, coronary microvascular dysfunction, microvascular resistance, vessel lumen volume, vessel-to-mass ratio
Pubmed
Create date
20/09/2024 16:14
Last modification date
03/10/2024 6:06
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