In:
Echocardiography, Wiley, Vol. 36, No. 6 ( 2019-06), p. 1110-1117
Abstract:
Coronary microvascular dysfunction ( CMD ) may cause angina in the absence of obstructive coronary artery disease ( CAD ) and increases the risk of future adverse cardiovascular events. Transthoracic Doppler echocardiography ( TTDE ) with pharmacological stress can assess coronary flow velocity reserve ( CFVR ), a measure of coronary microvascular function. However, simpler methods would be preferable for diagnosing CMD . Therefore, we examined the relationship between CFVR and cardiac time intervals measured by TTDE in a cohort of women with angina and no obstructive CAD . Methods In a prospective cohort study, we included 389 women with angina, left ventricular ejection fraction 〉 45%, and no obstructive CAD . CMD was defined as CFVR 〈 2.0. The study population was divided into three groups according to cutoff values of CFVR 〈 2, 2 ≤ CFVR ≤ 2.5, and CFVR 〉 2.5. Isovolumic contraction time ( IVCT ), ejection time ( ET ), and isovolumic relaxation time ( IVRT ) were measured by tissue Doppler M‐mode, and the myocardial performance index ( MPI = ( IVCT + IVRT )/ ET ) was calculated. Results Coronary microvascular dysfunction was associated with increasing age, hypertension, higher resting heart rate, and lower diastolic blood pressure. Moreover, CMD was associated with higher E/e′ ratio ( P = 0.002) and longer IVCT ( P 〈 0.001), higher MPI ( P 〈 0.001) and shorter ET ( P = 0.002), but not with IVRT or conventional measures of left ventricular geometry, mass, and function. In multivariable analysis, longer IVCT ( P 〈 0.001) and higher MPI ( P = 0.002) remained associated with CMD . Conclusion In women with angina and no obstructive CAD , CMD is associated with longer IVCT and higher MPI indicating a link between CMD and subtle alternations of systolic and combined measures of cardiac time intervals.
Type of Medium:
Online Resource
ISSN:
0742-2822
,
1540-8175
DOI:
10.1111/echo.2019.36.issue-6
Language:
English
Publisher:
Wiley
Publication Date:
2019
detail.hit.zdb_id:
2041033-5
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