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

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, MF=923) 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 or =2.1 (p 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.