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
Year: 2021
Type: article
Abstract: 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.
Source: PLoS ONE
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,749
Funders: U.S. Department of Health and Human Services, Gustavus and Louise Pfeiffer Research Foundation, Deutsches Krebsforschungszentrum, Society for Women’s Health Research, Ladies Hospital Aid Society, Cedars-Sinai Medical Center, Adelson Family Foundation, National Institutes of Health, National Institute on Aging, National Heart, Lung, and Blood Institute, National Center for Research Resources, National Center for Advancing Translational Sciences, Congressionally Directed Medical Research Programs
Awards: G1120375403, G1134269671, G1313999278, G1369121676, G1438650436, G1629590552, G1710551794, G1764559527, Behavioral Medicine and Cardiovascular Research Training, EVAL OF ISCHEMIC HEART DISEASE IN WOMEN-CLINICAL CTR, G2540502964, G2620772713, G276921238, G2933049717, EVAL OF ISCHEMIC HEART DISEASE IN WOMEN-CLINICAL CTR, G310026855, ISCHEMIC HEART DISEASE IN WOMEN-CLINICAL CENTER, G327285978, UCLA Clinical and Translational Science Institute, G3477403096, G3751788867, ISCHEMIC HEART DISEASE IN WOMEN--CLINICAL CENTER, G3821788555, Hypertensive Disorders of Pregnancy: Pathways to Future Cardiovascular Disease, Women's Ischemia Syndrome Evaluation (WISE) - Mechanisms of Coronary Microvascular Dysfunction Leading to Pre-Heart Failure with Preserved Ejection Fraction (HFpEF), G4144345384, G430456586, G453528718, G4690476334, Cardiovascular Events in Women's Ischemia Syndrome Evaluation, G5365819722, G5394483415, G545546532, Whole-Heart Myocardial Blood Flow Quantification Using MRI, Magnetic Resonance Imaging for Global Atherosclerosis Risk Assessment, G6621596241, Women's Ischemia Syndrome Evaluation (WISE) Coronary Vascular Dysfunction, Immunologic Basis of Coronary Disease in Women, G7078459433, G7086251139, Renin Angiotensin for Coronary Microvascular Dysfunction, G754274488, General Clinical Research Center, G7636702871, G7781681247, G7884066925, G7932595472, G8235554331, The Microvascular Aging and Eicosanoids - Women's Evaluation of Systemic Aging Tenacity (MAE-WEST) ("You are never too old to become younger!") Specialized Center for Research Excellence (SCORE), G8664061136, Cardiac Autonomic Function in Women, Atherosclerosis, Immune Mediated Inflammation and Hypoestrogenemia in Young Women, G9000019314, G9000048965, G9000059892, G9000112759, G9000118442, G9000119693, G950221744
OpenAlex ID: W3204420189