Resting coronary velocity and myocardial performance in women with impaired coronary flow reserve: Results from the Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) study

Research output: Contribution to journalArticle

Authors

  • Nissi Suppogu
  • Janet Wei
  • Michael D. Nelson
  • Galen Cook-Wiens
  • Susan Cheng
  • Chrisandra L. Shufelt
  • Louise E.J. Thomson
  • Balaji Tamarappoo
  • Daniel S. Berman
  • Bruce Samuels
  • Babak Azarbal
  • R. David Anderson
  • John W. Petersen
  • Eileen M. Handberg
  • Carl J. Pepine
  • C. Noel Bairey Merz

External Institution(s)

  • Cedars-Sinai Medical Center
  • University of Florida

Details

Original languageEnglish (US)
Pages (from-to)19-22
Number of pages4
JournalInternational journal of cardiology
Volume309
StatusPublished - Jun 15 2020
Peer-reviewedYes

Abstract

Background: Women with evidence of ischemia and no obstructive coronary arteries (INOCA) often have coronary microvascular dysfunction (CMD) indicated by impaired coronary flow reserve (CFR) to adenosine. Low CFR is associated with an adverse prognosis, including incident heart failure. Because the CFR calculation relies on the baseline intrinsic coronary vasomotor flow velocity, a major determinate of CFR and the degree of variation in baseline flow alone may be an important contributor to risk of adverse outcomes in women with CMD. A better understanding of baseline blood flow in the setting of low CFR and its association with myocardial performance would be helpful. Methods: We evaluated 74 women who underwent invasive coronary reactivity testing in the Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) study and had impaired CFR (<2.32). We assessed the relationship between coronary artery baseline average peak velocity (bAPV) at rest and cardiac magnetic resonance imaging measures of left ventricular (LV) structure and function. Results: When stratified as low (<22 cm/s) versus high (≥22 cm/s) bAPV, there were no differences in cardiovascular risk factors, coronary plaque burden, or LV structure. However, low bAPV was associated with higher LV end-diastolic filling pressure (P = 0.04), lower LV ejection fraction (P = 0.001), and differences in late systolic and diastolic strain rates (P = 0.01 to 0.05). Conclusions: In women with impaired CFR, low resting coronary flow velocity is associated with more adverse myocardial performance, which may contribute to risk for adverse outcomes and particularly heart failure in women with CMD.

    Research areas

  • Baseline average peak velocity, Coronary flow reserve, Heart failure with preserved ejection fraction

Citation formats

APA

Harvard

Suppogu, N, Wei, J, Nelson, MD, Cook-Wiens, G, Cheng, S, Shufelt, CL, Thomson, LEJ, Tamarappoo, B, Berman, DS, Samuels, B, Azarbal, B, Anderson, RD, Petersen, JW, Handberg, EM, Pepine, CJ & Merz, CNB 2020, 'Resting coronary velocity and myocardial performance in women with impaired coronary flow reserve: Results from the Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) study', International journal of cardiology, vol. 309, pp. 19-22. https://doi.org/10.1016/j.ijcard.2020.01.053