Effects of age on microvascular function in patients with normal coronary arteries.

Autor: Jansen TPJ; Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands., Crooijmans C; Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands., Pijls N; Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands., Paradies V; Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands., de Vos A; Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands., Dimitriu-Leen AC; Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands., Elias-Smale S; Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands., Rodwell L; Department of Health Evidence, Section Biostatistics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands., van Royen N; Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands., Smits P; Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands., Damman P; Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands.
Jazyk: angličtina
Zdroj: EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology [EuroIntervention] 2024 Jun 03; Vol. 20 (11), pp. e690-e698. Date of Electronic Publication: 2024 Jun 03.
DOI: 10.4244/EIJ-D-23-00778
Abstrakt: Background: It has been suggested that coronary microvascular function decreases with age, irrespective of the presence of epicardial atherosclerosis.
Aims: Our aim is to quantitatively investigate the effects of age on microvascular function in patients with normal coronary arteries.
Methods: In 314 patients with angina with no obstructive coronary artery disease (ANOCA), microcirculatory function was tested using the continuous thermodilution method. In 305 patients, the association between age and both resting and hyperaemic myocardial blood flow (Q), microvascular resistance (R μ ), absolute coronary flow reserve (CFR) and microvascular resistance reserve (MRR) was assessed. In addition, patients were divided into 3 groups to test for differences based on age quartiles (≤52 years [24.9%], 53-64 years [49.2%], ≥65 years [25.9%]).
Results: The mean age was 59±9 years with a range from 22 to 79 years. The mean resting Q (Q rest ) was not different in the 3 age groups (88±34 mL/min, 82±29 mL/min, and 86±38 mL/min, R 2 =0.001; p=0.62). A trend towards a decreasing mean hyperaemic Q (Q max ) was observed with increasing age (223±79 mL/min, 209±84 mL/min, 200±80 mL/min, R 2 =0.010; p=0.083). The mean resting R μ (R μ,rest ) were 1,204±460 Wood units (WU), 1,260±411 WU, and 1,289±455 WU (p=0.23). The mean hyperaemic R μ (R μ,hyp ) increased significantly with advancing age (429±149 WU, 464±164 WU, 503±162 WU, R 2 =0.026; p=0.005). Consequently, MRR decreased with age (3.2±1.2, 3.1±1.0, 2.9±0.9; p=0.038). This trend was present in both the patients with (n=121) and without (n=184) coronary microvascular dysfunction (CMD).
Conclusions: There is an age-dependent physiological increase in minimal microvascular resistance and decrease in microvascular function, which is represented by a decreased MRR and is independent of atherosclerosis. The age-dependent decrease in MRR was present in both patients with and without CMD and was most evident in patients with smooth coronary arteries.
Databáze: MEDLINE
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