Comorbidities associated with reduced myocardial flow reserve in non-obstructive disease

Autor: J L Bermudez-Gonzalez, J K Cuellar-Vargas, I Carvajal-Juarez, R E Romero-Montiel, C R Arce-Sandoval, E Alexanderson Rosas, H Gurrola-Luna, M E Soto-Lopez, L Zavala-Romero, J K Rojas-Sernaque, A J Garcia-Arroyo, M Gomez-Salgado, B Rivera-Bravo, A J Barajas Paulin
Rok vydání: 2021
Předmět:
Zdroj: European Heart Journal. 42
ISSN: 1522-9645
0195-668X
DOI: 10.1093/eurheartj/ehab724.0258
Popis: Introduction Microvascular Dysfunction defined as a Myocardial Flow Reserve (MFR) Methods Retrospective cross-sectional study of patients with suspected CAD in which both PET/CT and CCTA were performed. Inclusion:CCTA with obstruction Results 335 patients included. MFR difference for each variable: female sex, hypertension (HT), Type 2 diabetes (T2D) and smoking – Appendix 1. Significant MFR difference for HT (p=0.024) and T2D (p=0.046). Severe ischemia had significant MFR reduction (p=0.006); patients with both HT and mild ischemia (p=0.018) – Appendix 2. Discussion Individuals with HT and T2D had a significantly lower MFR, consistent with previous studies (8,9). Absence of correlation with other risk factors, such as smoking (10) and female sex (11); latter may be caused by a significant lower number of women (108 vs 227). Further analysis in this subgroup ought to be done. When comparing MFR between level-of-ischemia groups, microvascular function was not reduced until severe ischemia. Remarkably, if we analyze the coexistence of HT with ischemia, MFR is reduced even in patients with mild ischemia. This finding highlights the importance of HT which alters function in early stages even in the absence of significant obstruction. This is one of the first studies correlating MFR with comorbidities in our population. Limitations the retrospective nature of the study. Conclusions MFR non-invasive assessment by PET/CT allows identifying very early stages of MVD, even in asymptomatic patients and when there's no evidence of ischemia or CAD. Therefore, timely recognition of this problem is mandatory to implement action strategies to stop the triggered events' cascade. Funding Acknowledgement Type of funding sources: None.
Databáze: OpenAIRE
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