Coronary endothelial function testing may improve long-term quality of life in subjects with microvascular coronary endothelial dysfunction

Martin Reriani, Andreas J. Flammer, Jessica Duhé, Jing Li, Rajiv Gulati, Charanjit Rihal, Ryan Lennon, Jonella M. Tilford, Abhiram Prasad, Lilach O Lerman, Amir Lerman

Research output: Contribution to journalArticle

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Abstract

Aim Angina pectoris in the absence of obstructive coronary artery disease (CAD) is common and is associated with poor quality of life (QOL). Coronary microvascular endothelial dysfunction is associated with myocardial ischaemia and is a common cause of angina. We hypothesise that evaluation of coronary endothelial function, its diagnosis and treatment will favourably impact QOL in patients with angina symptoms and non-obstructive CAD. Methods and results Follow-up was done on 457 patients with chest pain and non-obstructive coronary arteries who had undergone coronary vascular reactivity evaluation by administration of intracoronary acetylcholine at the time of diagnostic study. After a mean follow-up of 8.4±4.7 years, QOL was assessed by administration of the SF-36 QOL survey. Patients diagnosed and treated for microvascular endothelial dysfunction had a higher (better) overall mental composite score (44.8 vs 40.9, p=0.036) and mental health score (44.2 vs 40.7, p=0.047), and a trend towards higher vitality scores (39.1 vs 35.9, p=0.053) and role emotional scores (43.6 vs 40.4, p=0.073), compared with patients with normal endothelial function. Conclusion Among patients with chest pain and normal coronaries, diagnosis and treatment of coronary microvascular endothelial dysfunction in those with angina pectoris and non-obstructive CAD are associated with better QOL compared with patients with normal endothelial function.

Original languageEnglish (US)
Article numbere000870
JournalOpen Heart
Volume6
Issue number1
DOIs
StatePublished - Feb 1 2019

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Quality of Life
Coronary Artery Disease
Angina Pectoris
Chest Pain
Acetylcholine
Myocardial Ischemia
Blood Vessels
Coronary Vessels
Mental Health
Therapeutics

Keywords

  • angina
  • microvascular endothelial function
  • quality of life

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Coronary endothelial function testing may improve long-term quality of life in subjects with microvascular coronary endothelial dysfunction. / Reriani, Martin; Flammer, Andreas J.; Duhé, Jessica; Li, Jing; Gulati, Rajiv; Rihal, Charanjit; Lennon, Ryan; Tilford, Jonella M.; Prasad, Abhiram; Lerman, Lilach O; Lerman, Amir.

In: Open Heart, Vol. 6, No. 1, e000870, 01.02.2019.

Research output: Contribution to journalArticle

Reriani, Martin ; Flammer, Andreas J. ; Duhé, Jessica ; Li, Jing ; Gulati, Rajiv ; Rihal, Charanjit ; Lennon, Ryan ; Tilford, Jonella M. ; Prasad, Abhiram ; Lerman, Lilach O ; Lerman, Amir. / Coronary endothelial function testing may improve long-term quality of life in subjects with microvascular coronary endothelial dysfunction. In: Open Heart. 2019 ; Vol. 6, No. 1.
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AU - Gulati, Rajiv

AU - Rihal, Charanjit

AU - Lennon, Ryan

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N2 - Aim Angina pectoris in the absence of obstructive coronary artery disease (CAD) is common and is associated with poor quality of life (QOL). Coronary microvascular endothelial dysfunction is associated with myocardial ischaemia and is a common cause of angina. We hypothesise that evaluation of coronary endothelial function, its diagnosis and treatment will favourably impact QOL in patients with angina symptoms and non-obstructive CAD. Methods and results Follow-up was done on 457 patients with chest pain and non-obstructive coronary arteries who had undergone coronary vascular reactivity evaluation by administration of intracoronary acetylcholine at the time of diagnostic study. After a mean follow-up of 8.4±4.7 years, QOL was assessed by administration of the SF-36 QOL survey. Patients diagnosed and treated for microvascular endothelial dysfunction had a higher (better) overall mental composite score (44.8 vs 40.9, p=0.036) and mental health score (44.2 vs 40.7, p=0.047), and a trend towards higher vitality scores (39.1 vs 35.9, p=0.053) and role emotional scores (43.6 vs 40.4, p=0.073), compared with patients with normal endothelial function. Conclusion Among patients with chest pain and normal coronaries, diagnosis and treatment of coronary microvascular endothelial dysfunction in those with angina pectoris and non-obstructive CAD are associated with better QOL compared with patients with normal endothelial function.

AB - Aim Angina pectoris in the absence of obstructive coronary artery disease (CAD) is common and is associated with poor quality of life (QOL). Coronary microvascular endothelial dysfunction is associated with myocardial ischaemia and is a common cause of angina. We hypothesise that evaluation of coronary endothelial function, its diagnosis and treatment will favourably impact QOL in patients with angina symptoms and non-obstructive CAD. Methods and results Follow-up was done on 457 patients with chest pain and non-obstructive coronary arteries who had undergone coronary vascular reactivity evaluation by administration of intracoronary acetylcholine at the time of diagnostic study. After a mean follow-up of 8.4±4.7 years, QOL was assessed by administration of the SF-36 QOL survey. Patients diagnosed and treated for microvascular endothelial dysfunction had a higher (better) overall mental composite score (44.8 vs 40.9, p=0.036) and mental health score (44.2 vs 40.7, p=0.047), and a trend towards higher vitality scores (39.1 vs 35.9, p=0.053) and role emotional scores (43.6 vs 40.4, p=0.073), compared with patients with normal endothelial function. Conclusion Among patients with chest pain and normal coronaries, diagnosis and treatment of coronary microvascular endothelial dysfunction in those with angina pectoris and non-obstructive CAD are associated with better QOL compared with patients with normal endothelial function.

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