Logo image
Back
Myocardial blood flow reserve is impaired in patients with aortic valve calcification and unobstructed epicardial coronary arteries
Journal article   Open access   Peer reviewed

Myocardial blood flow reserve is impaired in patients with aortic valve calcification and unobstructed epicardial coronary arteries

Karen Nel, Michael C Y Nam, Chris Anstey, Christopher J Boos, Edward Carlton, Roxy Senior, Juan Carlos Kaski, Ahmed Khattab, Delva Shamley, Christopher Byrne, …
International Journal of Cardiology, Vol.248, pp.427-432
2017
DOI: https://doi.org/10.1016/j.ijcard.2017.06.023
pdf
PDF - Author's Accepted Version (Open Access)678.14 kBDownloadView
Accepted VersionPDF - Author Accepted Version (Open Access)CC BY-NC-ND V4.0,  Open Access
url
https://doi.org/10.1016/j.ijcard.2017.06.023View
Published Version

Abstract

aortic valve calcification score coronary microvascular dysfunction calcific aortic valve disease
Background: Although calcific aortic valve disease (CAVD) is associated with coronary atherosclerosis, it is not known whether early CAVD is associated with coronary microcirculatory dysfunction (CMD). We sought to investigate the relationship between myocardial blood flow reserve (MBFR) - a measure of CMD, and early CAVD in the absence of obstructive epicardial coronary artery disease. We also determined whether this relationship was independent of coronary artery disease (CAD) and hs-CRP, a marker of systemic inflammation. Methods: 183 patients with chest pain and unobstructed coronary arteries were studied. Aortic valve calcification score (AVCS), coronary total plaque length (TPL), and coronary calcium score were quantified from multislice CT. MBFR was assessed using vasodilator myocardial contrast echocardiography. Hs-CRP was measured from venous blood using a particle-enhanced immunoassay. Results: Mean (± SD) participant age was 59.8 (9.6) years. Mean AVCS was 68 (258) AU, TPL was 15.6 (22.2) mm, and median coronary calcification score was 43.5 AU. Mean MBFR was 2.20 (0.52). Mean hs-CRP was 2.52 (3.86) mg/l. Multivariable linear regression modelling incorporating demographics, coronary plaque characteristics, MBFR, and inflammatory markers, demonstrated that age (β = 0.05, 95% CI: 0.02, 0.08, P = 0.007), hs-CRP (β = 0.09, CI: 0.02, 0.16, P = 0.010) and diabetes (β = 1.03, CI: 0.08, 1.98, P = 0.033), were positively associated with AVCS. MBFR (β = - 0.87, CI: - 1.44, - 0.30, P = 0.003), BMI (β = - 0.11, CI: - 0.21, - 0.01, P = 0.033), and LDL (β = - 0.32, CI: - 0.61, - 0.03, P = 0.029) were negatively associated with AVCS. TPL and coronary calcium score were not independently associated with AVCS when included in the regression model. Conclusion: Coronary microvascular function as determined by measurement of myocardial blood flow reserve is independently associated with early CAVD. This effect is independent of the presence of coronary artery disease and also systemic inflammation.

Details

Metrics

25 File views/ downloads
465 Record Views
4 Times Cited - Web of Science

InCites Highlights

These are selected metrics from InCites Benchmarking & Analytics tool, related to this output

Collaboration types
Domestic collaboration
International collaboration
Web Of Science research areas
Cardiac & Cardiovascular Systems

UN Sustainable Development Goals (SDGs)

This output has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

Source: InCites

Logo image