Women with coronary microvascular dysfunction and no obstructive coronary artery disease have reduced exercise capacity
| Autor: | Jens D. Hove, Persia Shahriari, Eva Prescott, Hannah Elena Suhrs, Daria Frestad Bechsgaard, Ida Gustafsson, Kira Bang Bové |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Denmark Coronary Artery Disease 030204 cardiovascular system & hematology Doppler echocardiography Asymptomatic Angina Coronary artery disease 03 medical and health sciences Oxygen Consumption 0302 clinical medicine Heart Rate Coronary Circulation Internal medicine Heart rate medicine Humans Prospective Studies 030212 general & internal medicine Exercise physiology Prospective cohort study Exercise Aged Exercise Tolerance medicine.diagnostic_test business.industry Microcirculation Middle Aged medicine.disease medicine.anatomical_structure Exercise Test Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | International Journal of Cardiology. 293:1-9 |
| ISSN: | 0167-5273 |
| Popis: | Background Both coronary microvascular dysfunction (CMD) and reduced exercise capacity are associated with adverse cardiovascular prognosis. The association between CMD and cardiopulmonary exercise testing (CPET) derived exercise capacity in symptomatic individuals without obstructive coronary artery disease (CAD) is not clear. We investigated whether exercise capacity was reduced in women with angina, CMD and no obstructive CAD compared with sex-matched controls. Furthermore, we assessed the association between CMD and other CPET-derived variables. Methods All participants underwent transthoracic Doppler echocardiography of the left anterior descending artery with dipyridamole-induced vasodilation and CPET using ergometer cycle with an incremental test protocol. Results We included 99 women with angina and no obstructive CAD (patients) and 27 asymptomatic women (controls), age (mean ± standard deviation) 61 ± 10 and 58 ± 10 years, respectively. Patients had a higher burden of risk factors compared with controls, while the weekly physical activity level was comparable between the groups (p = 0.72). CMD was present in 27 (27%) patients and 5 (19%) controls. Peak VO2 was significantly reduced in patients with CMD compared with controls with normal coronary microvascular function ((median (IQR) 17.3 (15.5–21.3) vs. 27.3 (21.6–30.8) ml/kg/min; age-adjusted p = 0.001), independent of cardiovascular risk factors (p = 0.041). Presence of CMD in symptomatic women was also associated with diminished heart rate reserve (p Conclusions Women with angina, CMD and no obstructive CAD have markedly reduced exercise capacity compared with sex-matched controls. Moreover, combination of angina and CMD is associated with impaired heart rate response and heart rate recovery. |
| Databáze: | OpenAIRE |
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