Document Detail


Regional coronary endothelial function is closely related to local early coronary atherosclerosis in patients with mild coronary artery disease: pilot study.
MedLine Citation:
PMID:  22492483     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Coronary endothelial function is abnormal in patients with established coronary artery disease and was recently shown by MRI to relate to the severity of luminal stenosis. Recent advances in MRI now allow the noninvasive assessment of both anatomic and functional (endothelial function) changes that previously required invasive studies. We tested the hypothesis that abnormal coronary endothelial function is related to measures of early atherosclerosis such as increased coronary wall thickness.
METHODS AND RESULTS: Seventeen arteries in 14 healthy adults and 17 arteries in 14 patients with nonobstructive coronary artery disease were studied. To measure endothelial function, coronary MRI was performed before and during isometric handgrip exercise, an endothelial-dependent stressor, and changes in coronary cross-sectional area and flow were measured. Black blood imaging was performed to quantify coronary wall thickness and indices of arterial remodeling. The mean stress-induced change in cross-sectional area was significantly higher in healthy adults (13.5%±12.8%, mean±SD, n=17) than in those with mildly diseased arteries (-2.2%±6.8%, P<0.0001, n=17). Mean coronary wall thickness was lower in healthy subjects (0.9±0.2 mm) than in patients with coronary artery disease (1.4±0.3 mm, P<0.0001). In contrast to healthy subjects, stress-induced changes in cross-sectional area, a measure of coronary endothelial function, correlated inversely with coronary wall thickness in patients with coronary artery disease (r=-0.73, P=0.0008).
CONCLUSIONS: There is an inverse relationship between coronary endothelial function and local coronary wall thickness in patients with coronary artery disease but not in healthy adults. These findings demonstrate that local endothelial-dependent functional changes are related to the extent of early anatomic atherosclerosis in mildly diseased arteries. This combined MRI approach enables the anatomic and functional investigation of early coronary disease.
Authors:
Allison G Hays; Sebastian Kelle; Glenn A Hirsch; Sahar Soleimanifard; Jing Yu; Harsh K Agarwal; Gary Gerstenblith; Michael Schär; Matthias Stuber; Robert G Weiss
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-04-05
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  5     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-17     Completed Date:  2012-07-23     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  341-8     Citation Subset:  IM    
Affiliation:
Department of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Coronary Angiography / methods*
Coronary Artery Disease / complications,  etiology,  physiopathology,  radiography*
Coronary Stenosis / etiology,  physiopathology,  radiography
Endothelium, Vascular / physiopathology*,  radiography*
Female
Humans
Image Processing, Computer-Assisted / methods
Magnetic Resonance Imaging / methods
Male
Middle Aged
Pilot Projects
Severity of Illness Index
Young Adult
Grant Support
ID/Acronym/Agency:
ARRA 3R01-HL084186-04S1/HL/NHLBI NIH HHS; R01 HL061912/HL/NHLBI NIH HHS; R01 HL084186/HL/NHLBI NIH HHS; R01-HL084186/HL/NHLBI NIH HHS; R01-HL61912/HL/NHLBI NIH HHS
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