Peripheral Endothelial Function and Coronary Flow Velocity Reserve Are Not Associated in Women with Angina and No Obstructive Coronary Artery Disease: The iPOWER Study

Kristoffer Flintholm Raft; Daria Frestad; Marie Mide Michelsen; Hannah Elena Suhrs; Anna Bay Rask; Malin Nilsson; Thomas Steffen Hermann; Eva Prescott

doi:10.1159/000479374

Peripheral Endothelial Function and Coronary Flow Velocity Reserve Are Not Associated in Women with Angina and No Obstructive Coronary Artery Disease: The iPOWER Study

Kristoffer Flintholm Raft, Daria Frestad, Marie Mide Michelsen, Hannah Elena Suhrs, Anna Bay Rask, Malin Nilsson, Thomas Steffen Hermann, Eva Prescott

Department of Clinical Medicine

6 Citations (Scopus)

Abstract

Purpose: We investigated whether impaired flow-mediated dilation (FMD) and plasma biomarkers reflecting endothelial dysfunction are associated with coronary microvascular dysfunction (CMD) in women with angina and no obstructive coronary artery disease (CAD). Methods: Patients (n = 194) were randomly selected women with angina pectoris and no obstructive CAD (<50% stenosis). A reference population of asymptomatic women without CAD (n = 25) was included. We measured FMD in the brachial artery by high-resolution ultrasound. Coronary flow velocity reserve (CFVR) was assessed by transthoracic Doppler flow echocardiography (TTDE) of the left anterior descending artery during rest and high-dose dipyridamole infusion. CMD was defined as CFVR <2. Results: FMD and CFVR were measured in 128 patients and 21 controls. Mean (SD) age was 64.5 (8.9) years, mean CFVR was 2.3 (2.0-2.7), and mean FMD was 8.4% (4.8%) in angina patients. Angina patients had a higher risk factor burden compared with the reference population. Measures of peripheral endothelial dysfunction and endothelial plasma biomarkers did not differ according to angina or CFVR. CFVR and FMD did not correlate (Spearman ρ = -0.07, p = 0.45). Conclusions: FMD and biomarkers of endothelial dysfunction did not identify individuals with CMD assessed as impaired CFVR by TTDE in women with angina and no obstructive CAD.

Original language	English
Journal	Journal of Vascular Research
Volume	54
Issue number	5
Pages (from-to)	309-319
ISSN	1018-1172
DOIs	https://doi.org/10.1159/000479374
Publication status	Published - 1 Oct 2017

Keywords

Aged
Angina Pectoris/diagnosis
Blood Flow Velocity
Brachial Artery/diagnostic imaging
Coronary Stenosis/complications
Coronary Vessels/physiopathology
Dipyridamole/administration & dosage
Echocardiography, Doppler
Endothelium, Vascular/physiopathology
Female
Fractional Flow Reserve, Myocardial
Humans
Microcirculation
Middle Aged
Predictive Value of Tests
Regional Blood Flow
Risk Factors
Severity of Illness Index
Vasodilation
Vasodilator Agents/administration & dosage

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10.1159/000479374

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Flintholm Raft, K., Frestad, D., Michelsen, M. M., Suhrs, H. E., Rask, A. B., Nilsson, M., Hermann, T. S., & Prescott, E. (2017). Peripheral Endothelial Function and Coronary Flow Velocity Reserve Are Not Associated in Women with Angina and No Obstructive Coronary Artery Disease: The iPOWER Study. Journal of Vascular Research, 54(5), 309-319. https://doi.org/10.1159/000479374

Peripheral Endothelial Function and Coronary Flow Velocity Reserve Are Not Associated in Women with Angina and No Obstructive Coronary Artery Disease : The iPOWER Study. / Flintholm Raft, Kristoffer; Frestad, Daria; Michelsen, Marie Mide et al.

In: Journal of Vascular Research, Vol. 54, No. 5, 01.10.2017, p. 309-319.

Research output: Contribution to journal › Journal article › Research › peer-review

Flintholm Raft, K, Frestad, D, Michelsen, MM, Suhrs, HE, Rask, AB, Nilsson, M, Hermann, TS & Prescott, E 2017, 'Peripheral Endothelial Function and Coronary Flow Velocity Reserve Are Not Associated in Women with Angina and No Obstructive Coronary Artery Disease: The iPOWER Study', Journal of Vascular Research, vol. 54, no. 5, pp. 309-319. https://doi.org/10.1159/000479374

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title = "Peripheral Endothelial Function and Coronary Flow Velocity Reserve Are Not Associated in Women with Angina and No Obstructive Coronary Artery Disease: The iPOWER Study",

abstract = "Purpose: We investigated whether impaired flow-mediated dilation (FMD) and plasma biomarkers reflecting endothelial dysfunction are associated with coronary microvascular dysfunction (CMD) in women with angina and no obstructive coronary artery disease (CAD). Methods: Patients (n = 194) were randomly selected women with angina pectoris and no obstructive CAD (<50% stenosis). A reference population of asymptomatic women without CAD (n = 25) was included. We measured FMD in the brachial artery by high-resolution ultrasound. Coronary flow velocity reserve (CFVR) was assessed by transthoracic Doppler flow echocardiography (TTDE) of the left anterior descending artery during rest and high-dose dipyridamole infusion. CMD was defined as CFVR <2. Results: FMD and CFVR were measured in 128 patients and 21 controls. Mean (SD) age was 64.5 (8.9) years, mean CFVR was 2.3 (2.0-2.7), and mean FMD was 8.4% (4.8%) in angina patients. Angina patients had a higher risk factor burden compared with the reference population. Measures of peripheral endothelial dysfunction and endothelial plasma biomarkers did not differ according to angina or CFVR. CFVR and FMD did not correlate (Spearman ρ = -0.07, p = 0.45). Conclusions: FMD and biomarkers of endothelial dysfunction did not identify individuals with CMD assessed as impaired CFVR by TTDE in women with angina and no obstructive CAD.",

keywords = "Aged, Angina Pectoris/diagnosis, Blood Flow Velocity, Brachial Artery/diagnostic imaging, Coronary Stenosis/complications, Coronary Vessels/physiopathology, Dipyridamole/administration & dosage, Echocardiography, Doppler, Endothelium, Vascular/physiopathology, Female, Fractional Flow Reserve, Myocardial, Humans, Microcirculation, Middle Aged, Predictive Value of Tests, Regional Blood Flow, Risk Factors, Severity of Illness Index, Vasodilation, Vasodilator Agents/administration & dosage",

author = "{Flintholm Raft}, Kristoffer and Daria Frestad and Michelsen, {Marie Mide} and Suhrs, {Hannah Elena} and Rask, {Anna Bay} and Malin Nilsson and Hermann, {Thomas Steffen} and Eva Prescott",

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doi = "10.1159/000479374",

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T1 - Peripheral Endothelial Function and Coronary Flow Velocity Reserve Are Not Associated in Women with Angina and No Obstructive Coronary Artery Disease

T2 - The iPOWER Study

AU - Flintholm Raft, Kristoffer

AU - Frestad, Daria

AU - Michelsen, Marie Mide

AU - Suhrs, Hannah Elena

AU - Rask, Anna Bay

AU - Nilsson, Malin

AU - Hermann, Thomas Steffen

AU - Prescott, Eva

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Purpose: We investigated whether impaired flow-mediated dilation (FMD) and plasma biomarkers reflecting endothelial dysfunction are associated with coronary microvascular dysfunction (CMD) in women with angina and no obstructive coronary artery disease (CAD). Methods: Patients (n = 194) were randomly selected women with angina pectoris and no obstructive CAD (<50% stenosis). A reference population of asymptomatic women without CAD (n = 25) was included. We measured FMD in the brachial artery by high-resolution ultrasound. Coronary flow velocity reserve (CFVR) was assessed by transthoracic Doppler flow echocardiography (TTDE) of the left anterior descending artery during rest and high-dose dipyridamole infusion. CMD was defined as CFVR <2. Results: FMD and CFVR were measured in 128 patients and 21 controls. Mean (SD) age was 64.5 (8.9) years, mean CFVR was 2.3 (2.0-2.7), and mean FMD was 8.4% (4.8%) in angina patients. Angina patients had a higher risk factor burden compared with the reference population. Measures of peripheral endothelial dysfunction and endothelial plasma biomarkers did not differ according to angina or CFVR. CFVR and FMD did not correlate (Spearman ρ = -0.07, p = 0.45). Conclusions: FMD and biomarkers of endothelial dysfunction did not identify individuals with CMD assessed as impaired CFVR by TTDE in women with angina and no obstructive CAD.

AB - Purpose: We investigated whether impaired flow-mediated dilation (FMD) and plasma biomarkers reflecting endothelial dysfunction are associated with coronary microvascular dysfunction (CMD) in women with angina and no obstructive coronary artery disease (CAD). Methods: Patients (n = 194) were randomly selected women with angina pectoris and no obstructive CAD (<50% stenosis). A reference population of asymptomatic women without CAD (n = 25) was included. We measured FMD in the brachial artery by high-resolution ultrasound. Coronary flow velocity reserve (CFVR) was assessed by transthoracic Doppler flow echocardiography (TTDE) of the left anterior descending artery during rest and high-dose dipyridamole infusion. CMD was defined as CFVR <2. Results: FMD and CFVR were measured in 128 patients and 21 controls. Mean (SD) age was 64.5 (8.9) years, mean CFVR was 2.3 (2.0-2.7), and mean FMD was 8.4% (4.8%) in angina patients. Angina patients had a higher risk factor burden compared with the reference population. Measures of peripheral endothelial dysfunction and endothelial plasma biomarkers did not differ according to angina or CFVR. CFVR and FMD did not correlate (Spearman ρ = -0.07, p = 0.45). Conclusions: FMD and biomarkers of endothelial dysfunction did not identify individuals with CMD assessed as impaired CFVR by TTDE in women with angina and no obstructive CAD.

KW - Aged

KW - Angina Pectoris/diagnosis

KW - Blood Flow Velocity

KW - Brachial Artery/diagnostic imaging

KW - Coronary Stenosis/complications

KW - Coronary Vessels/physiopathology

KW - Dipyridamole/administration & dosage

KW - Echocardiography, Doppler

KW - Endothelium, Vascular/physiopathology

KW - Female

KW - Fractional Flow Reserve, Myocardial

KW - Humans

KW - Microcirculation

KW - Middle Aged

KW - Predictive Value of Tests

KW - Regional Blood Flow

KW - Risk Factors

KW - Severity of Illness Index

KW - Vasodilation

KW - Vasodilator Agents/administration & dosage

U2 - 10.1159/000479374

DO - 10.1159/000479374

M3 - Journal article

C2 - 28942444

SN - 1018-1172

VL - 54

SP - 309

EP - 319

JO - Journal of Vascular Research

JF - Journal of Vascular Research

IS - 5

ER -

Peripheral Endothelial Function and Coronary Flow Velocity Reserve Are Not Associated in Women with Angina and No Obstructive Coronary Artery Disease: The iPOWER Study

Abstract

Keywords

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