Coronary Microvascular Dysfunction is Associated with cBIN1 Score (CS) – Insights from the Women’s Ischemia Syndrome Evaluation – Coronary Vascular Dysfunction (WISE-CVD) Continuation Study

2018 ◽  
Vol 34 (4) ◽  
pp. e1
Author(s):  
C. Pacheco ◽  
J. Wei ◽  
T.C. Hitzeman ◽  
G. Cook-Wiens ◽  
C.J. Pepine ◽  
...  
Keyword(s):  
Vascular Dysfunction ◽  
Microvascular Dysfunction ◽  
Coronary Microvascular Dysfunction

scholarly journals Obesity Related Coronary Microvascular Dysfunction: From Basic to Clinical Practice

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
K. Selthofer-Relatić ◽  
I. Bošnjak ◽  
A. Kibel
Keyword(s):  
Vascular Dysfunction ◽  
Real Life ◽  
Microvascular Disease ◽  
Microvascular Dysfunction ◽  
Point Of View ◽  
Coronary Microvascular Dysfunction ◽  
Diabetes Mellitus Type Ii ◽  
Practice Problem ◽  
Medical Entity ◽  
Underlying Mechanisms

Obesity related coronary microvascular disease is a medical entity which is not yet fully elucidated. The pathophysiological basis of coronary microcirculatory dysfunction consists of a heterogeneous group of disorders with individual morphologic/functional/clinical presentation and prognosis. Coronary microcirculatory changes include mechanisms connected with vascular dysfunction, as well as extravascular and vasostructural changes in responses to neural, mechanical, and metabolic factors. Cardiometabolic changes that include obesity, dyslipidemia, diabetes mellitus type II, and hypertension are associated with atherosclerosis of epicardial coronary arteries and/or microvascular coronary dysfunction, with incompletely understood underlying mechanisms. In obesity, microvascular disease is mediated via adipokines/cytokines causing chronic, subclinical inflammation with (a) reduced NO-mediated dilatation, (b) changed endothelial- and smooth muscle-dependent vasoregulating mechanisms, (c) altered vasomotor control with increased sympathetic activity, and (d) obesity related hypertension with cardiomyocytes hypertrophy and impaired cardiac vascular adaptation to metabolic needs. From a clinical point of view it can present itself in acute or chronic form with different prognosis, as a practice problem for real-life diagnosis and treatment.

scholarly journals Prevalence of Coronary Endothelial and Microvascular Dysfunction in Women with Symptoms of Ischemia and No Obstructive Coronary Artery Disease Is Confirmed by a New Cohort: The NHLBI-Sponsored Women’s Ischemia Syndrome Evaluation–Coronary Vascular Dysfunction (WISE-CVD)

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
R. David Anderson ◽  
John W. Petersen ◽  
Puja K. Mehta ◽  
Janet Wei ◽  
B. Delia Johnson ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Vascular Dysfunction ◽  
Hormone Replacement ◽  
Obstructive Coronary Artery Disease ◽  
Signs And Symptoms ◽  
Microvascular Dysfunction ◽  
Coronary Microvascular Dysfunction ◽  
Cardiac Events ◽  
Flow Reserve ◽  
Artery Disease

Objective. In a separate, contemporary cohort, we sought to confirm findings of the original Women’s Ischemia Syndrome Evaluation (WISE). Background. The original WISE observed a high prevalence of both invasively determined coronary endothelial and coronary microvascular dysfunction (CMD) that predicted adverse events in follow-up. Methods. We comparatively studied the WISE-Coronary Vascular Dysfunction (CVD) cohort (2009-2011), with signs and symptoms of ischemia but without significant CAD, to the original WISE (1997-2001) cohort. CMD was defined as coronary flow reserve (CFR) ≤2.5, or endothelial dysfunction as epicardial coronary artery constriction to acetylcholine (ACH), or <20% epicardial coronary dilation to nitroglycerin (NTG). Results. In WISE (n=181) and WISE-CVD (n=235) women, mean age in both was 54 years, and 83% were white (WISE) vs 74% (WISE-CVD, p=0.04). Use of hormone replacement therapy was less frequent in WISE-CVD vs WISE (46% vs 57%, p=0.026) as was presence of hypertension (40% vs 52%, p=0.013), hyperlipidemia (20% vs 46%, p<0.0001), and smoking (46% vs 56%, p=0.036). Similar rates were observed in WISE-CVD and WISE cohorts for CMD (mean CFR 2.7±0.6 vs 2.6±0.8, p=0.35), mean change in diameter with intracoronary ACH (0.2±10.0 vs 1.6±12.8 mm, p=0.34), and mean change in diameter with intracoronary NTG (9.7±13.0 vs 9.8±13.5 mm, p=0.94), respectively. Conclusions. This study confirms prevalence of CMD in the contemporary WISE-CVD cohort similar to that of the original WISE cohort, despite a lower risk factor burden in WISE-CVD. Because these coronary functional abnormalities predict major adverse cardiac events, clinical trials of therapies targeting these abnormalities are indicated.

scholarly journals Coronary endothelial dysfunction appears to be a manifestation of a systemic process: A report from the Women’s Ischemia Syndrome Evaluation – Coronary Vascular Dysfunction (WISE-CVD) study

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257184
Author(s):  
Sawan Jalnapurkar ◽  
Sofy Landes ◽  
Janet Wei ◽  
Puja K. Mehta ◽  
Chrisandra Shufelt ◽  
...  
Keyword(s):  
Risk Factor ◽  
Endothelial Dysfunction ◽  
Vascular Dysfunction ◽  
Obstructive Coronary Artery Disease ◽  
Microvascular Dysfunction ◽  
Cardiac Risk Factor ◽  
Coronary Microvascular Dysfunction ◽  
Urine Albumin ◽  
Dependent Function ◽  
Systemic Process

Background Coronary microvascular dysfunction (CMD) is prevalent in symptomatic women with ischemia but no obstructive coronary artery disease (INOCA). Urine albumin-creatinine ratio (UACR) is a measure of renal microvascular endothelial dysfunction. Both are predictors of adverse cardiovascular events. It is unknown if CMD could be a manifestation of a systemic process. We evaluated the relationship between renal microvascular dysfunction and CMD as measured by invasive coronary function testing (CFT). Methods and results We measured urine albumin and creatinine to provide UACR in 152 women enrolled in the Women’s Ischemia Syndrome Evaluation–Coronary Vascular Dysfunction (WISE-CVD) study (2008–2015) with suspected INOCA who underwent CFT. Invasive CFT measures of endothelial and non-endothelial dependent coronary microvascular function were obtained. Subjects were divided into those with detectable (≥20 mg/g) and undetectable urine albumin (<20 mg/g). The group mean age was 54 ± 11 years, with a moderate cardiac risk factor burden including low diabetes prevalence, and a mean UACR of 12 ± 55 mg/g (range 9.5–322.7 mg/g). Overall, coronary endothelial-dependent variables (change in coronary blood flow and coronary diameter in response to cold pressor testing) had significant inverse correlations with log UACR (r = -0.17, p = 0.05; r = -0.18, p = 0.03, respectively). Conclusions Among women with INOCA and relatively low risk factor including diabetes burden, renal microvascular dysfunction, measured by UACR, is related to coronary endothelial-dependent CMD. These results suggest that coronary endothelial-dependent function may be a manifestation of a systemic process. Enhancing efferent arteriolar vasodilatation in both coronary endothelial-dependent function and renal microvascular dysfunction pose potential targets for investigation and treatment. Clinical trial registration https://clinicaltrials.gov/ct2/show/NCT00832702.

Coronary microvascular dysfunction

2020 ◽  
Vol 68 (2) ◽  
Author(s):  
Vincenzo Sucato ◽  
Giuseppina Novo ◽  
Antonino Saladino ◽  
Salvatore Evola ◽  
Alfredo R. Galassi
Keyword(s):  
Microvascular Dysfunction ◽  
Coronary Microvascular Dysfunction
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