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Park, Youn, Ihm, Cho, Jung, Jeon, Lee, Oh, Chung, Kim, Choi, and Hong: Relation between Peripheral Vascular Endothelial Function and Coronary Flow Reserve in Patients with Chest Pain and Normal Coronary Angiogram
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Korean Circulation Journal

Korean Circulation Journal 2004; 34(5): 485-491.

Published online: 31 May 2004

DOI: https://doi.org/10.4070/kcj.2004.34.5.485

Relation between Peripheral Vascular Endothelial Function and Coronary Flow Reserve in Patients with Chest Pain and Normal Coronary Angiogram

Chul Soo Park, Ho Joong Youn, Sang Hyun Ihm, Eun Joo Cho, Hae Ok Jung, Hui Kyung Jeon, Jong Min Lee, Yong Seok Oh, Wook Sung Chung, Jae Hyung Kim, Kyu Bo Choi, Soon Jo Hong

Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Copyright © 2004 The Korean Society of Circulation

Abstract

BACKGROUND AND OBJECTIVES: Previous studies suggest the endothelium dependent coronary vasodilation is impaired in many patients with microvascular angina. However, the relationship between the peripheral vascular endothelial function and coronary flow reserve (CFR) in these patients remains elusive. The relationship between the peripheral vascular endothelial function and CFR was sought in patients with chest pain and a normal coronary angiogram.
SUBJECTS AND METHODS: In 32 subjects (mean age 58±9 yrs, M:F=9:23) with chest pain and a normal coronary angiogram, the flow mediated dilation (FMD) was assessed in the brachial artery by measuring the change in brachial artery diameter in response to hyperemic flow. In all subjects, the intimamedia thickness (IMT) of the carotid artery was also measured using a 15 MHz linear array transducer. Subjects were divided into 2 groups according to their CFR:> or =2.1 or<2.1, as measured with transthoracic echocardiography in the distal left anterior descending coronary artery.
RESULTS: The percentage FMD was 6.04±5.78% in those with a CFR<2.1 and 11.77±6.82% in those with a CFR> or =2.1 (p<0.05). The CFR was closely related to the peripheral FMD (r=0.361, p<0.05). The average IMT were 0.71±0.26 and 0.68±0.14 mm in those with CFR<2.1 and > or =2.1 (p=NS), respectively. The percentage FMD was not related to the IMT (p=NS).
CONCLUSION: Microvascular dysfunction is primarily related to endothelial dysfunction, rather than advanced atherosclerosis, and this endothelial dysfunction is a generalized process that involves whole arteries in patients with chest pain and a normal coronary angiogram.

Keywords: Angina, microvascular, Endothelium, vascular

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