Coronary endothelial dysfunction and hyperlipidemia are independently associated with diastolic dysfunction in humans

Ahmad A. Elesber, Margaret May Redfield, Charanjit S. Rihal, Abhiram Prasad, Shahar Lavi, Ryan Lennon, Verghese Mathew, Lilach O Lerman, Amir Lerman

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: Coronary endothelial dysfunction (CED) and DHF are both associated with myocardial ischemia and CAD risk factors. The objective of the this study was to determine if CED and CAD factors are associated with diastolic dysfunction before the development of occlusive CAD or clinical heart failure. Methods: Patients with normal ejection fraction and nonocclusive CAD who underwent coronary endothelial function studies were identified. Left ventricular relaxation was assessed by tissue Doppler assessment of early diastolic ascent of the septal mitral annulus (Ea). Multiple linear regression was used to investigate whether coronary risk factors influenced diastolic function after adjusting for the presence of CED. Results: A total of 160 patients had adequate assessment of diastolic relaxation. With multiple linear regression models, %ΔCBF (P = .018) was associated with a higher Ea; in contrast, older age (P < .001), female sex (P = .028), higher left ventricular mass index (P = .016), and higher nonhigh-density lipoprotein cholesterol (P = .022) were associated with a lower Ea. Conclusion: Coronary endothelial dysfunction and hyperlipidemia are independently associated with impaired relaxation in patients with normal ejection fraction in the absence of occlusive CAD and heart failure. The current study suggests a new potential mechanism for the development of endothelial and diastolic dysfunction in humans.

Original languageEnglish (US)
Pages (from-to)1081-1087
Number of pages7
JournalAmerican Heart Journal
Volume153
Issue number6
DOIs
StatePublished - Jun 2007

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Hyperlipidemias
Linear Models
Heart Failure
HDL Cholesterol
Myocardial Ischemia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Coronary endothelial dysfunction and hyperlipidemia are independently associated with diastolic dysfunction in humans. / Elesber, Ahmad A.; Redfield, Margaret May; Rihal, Charanjit S.; Prasad, Abhiram; Lavi, Shahar; Lennon, Ryan; Mathew, Verghese; Lerman, Lilach O; Lerman, Amir.

In: American Heart Journal, Vol. 153, No. 6, 06.2007, p. 1081-1087.

Research output: Contribution to journalArticle

Elesber, Ahmad A. ; Redfield, Margaret May ; Rihal, Charanjit S. ; Prasad, Abhiram ; Lavi, Shahar ; Lennon, Ryan ; Mathew, Verghese ; Lerman, Lilach O ; Lerman, Amir. / Coronary endothelial dysfunction and hyperlipidemia are independently associated with diastolic dysfunction in humans. In: American Heart Journal. 2007 ; Vol. 153, No. 6. pp. 1081-1087.
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AU - Elesber, Ahmad A.

AU - Redfield, Margaret May

AU - Rihal, Charanjit S.

AU - Prasad, Abhiram

AU - Lavi, Shahar

AU - Lennon, Ryan

AU - Mathew, Verghese

AU - Lerman, Lilach O

AU - Lerman, Amir

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N2 - Background: Coronary endothelial dysfunction (CED) and DHF are both associated with myocardial ischemia and CAD risk factors. The objective of the this study was to determine if CED and CAD factors are associated with diastolic dysfunction before the development of occlusive CAD or clinical heart failure. Methods: Patients with normal ejection fraction and nonocclusive CAD who underwent coronary endothelial function studies were identified. Left ventricular relaxation was assessed by tissue Doppler assessment of early diastolic ascent of the septal mitral annulus (Ea). Multiple linear regression was used to investigate whether coronary risk factors influenced diastolic function after adjusting for the presence of CED. Results: A total of 160 patients had adequate assessment of diastolic relaxation. With multiple linear regression models, %ΔCBF (P = .018) was associated with a higher Ea; in contrast, older age (P < .001), female sex (P = .028), higher left ventricular mass index (P = .016), and higher nonhigh-density lipoprotein cholesterol (P = .022) were associated with a lower Ea. Conclusion: Coronary endothelial dysfunction and hyperlipidemia are independently associated with impaired relaxation in patients with normal ejection fraction in the absence of occlusive CAD and heart failure. The current study suggests a new potential mechanism for the development of endothelial and diastolic dysfunction in humans.

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