Coronary microvascular dysfunction and atrial reservoir function.

IF 1.9 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Ultrasound Pub Date : 2024-05-14 DOI:10.1186/s12947-024-00324-0

Julien La Mela, Laurent Riou, Gilles Barone-Rochette

{"title":"Coronary microvascular dysfunction and atrial reservoir function.","authors":"Julien La Mela, Laurent Riou, Gilles Barone-Rochette","doi":"10.1186/s12947-024-00324-0","DOIUrl":null,"url":null,"abstract":"Background: Coronary microvascular dysfunction (CMD) refers to structural and functional abnormalities of the coronary microcirculation, which may be diagnosed using invasive coronary physiology. CMD is responsible for impaired diastolic cardiac function. It has recently been suggested that left atrial strain (LASr) represents a highly sensitive tool for detecting cardiac diastolic function abnormalities. Accordingly, the aim of this study was to investigate the relationship between CMD and LASr.Methods: Consecutively enrolled patients with non-obstructed coronary arteries (NOCA) underwent CMD and LASr evaluation by invasive thermodilution and noninvasive echocardiography, respectively.Results: Forty-two (42) patients were included, out of which 26 presented with CMD. There were no significant differences between CMD-positive and negative patients in terms of clinical and echocardiographic characteristics. LASr was significantly reduced in patients with CMD (24.6% ± 6.1 vs. 30.3 ± 7.8%, p = 0.01). A moderate correlation was observed between coronary flow reserve and LAsr (r = 0.47, p = 0.002). A multivariate logistic regression analysis demonstrated that CMD was independently associated with LASr (OR = 0.88, 95%CI 0.78-0.99.135, p = 0.04). A LASr cut-off of 25.5% enabled an optimal classification of patients with or without CMD.Conclusion: Patients with NOCA and CMD had a significantly reduced LASr compared with patients without CMD, suggesting the early impairment of diastolic function in these patients.","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"22 1","pages":"5"},"PeriodicalIF":1.9000,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11092318/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular Ultrasound","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12947-024-00324-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Coronary microvascular dysfunction (CMD) refers to structural and functional abnormalities of the coronary microcirculation, which may be diagnosed using invasive coronary physiology. CMD is responsible for impaired diastolic cardiac function. It has recently been suggested that left atrial strain (LASr) represents a highly sensitive tool for detecting cardiac diastolic function abnormalities. Accordingly, the aim of this study was to investigate the relationship between CMD and LASr.

Methods: Consecutively enrolled patients with non-obstructed coronary arteries (NOCA) underwent CMD and LASr evaluation by invasive thermodilution and noninvasive echocardiography, respectively.

Results: Forty-two (42) patients were included, out of which 26 presented with CMD. There were no significant differences between CMD-positive and negative patients in terms of clinical and echocardiographic characteristics. LASr was significantly reduced in patients with CMD (24.6% ± 6.1 vs. 30.3 ± 7.8%, p = 0.01). A moderate correlation was observed between coronary flow reserve and LAsr (r = 0.47, p = 0.002). A multivariate logistic regression analysis demonstrated that CMD was independently associated with LASr (OR = 0.88, 95%CI 0.78-0.99.135, p = 0.04). A LASr cut-off of 25.5% enabled an optimal classification of patients with or without CMD.

Conclusion: Patients with NOCA and CMD had a significantly reduced LASr compared with patients without CMD, suggesting the early impairment of diastolic function in these patients.

查看原文本刊更多论文

冠状动脉微血管功能障碍与心房储库功能

背景：冠状动脉微血管功能障碍（CMD）是指冠状动脉微循环的结构和功能异常，可通过有创冠状动脉生理学诊断。冠状动脉微血管功能障碍是心脏舒张功能受损的原因。最近有研究表明，左心房应变（LASr）是检测心脏舒张功能异常的一种高度敏感的工具。因此，本研究旨在探讨 CMD 与 LASr 之间的关系：连续入组的冠状动脉未阻塞（NOCA）患者分别通过有创热稀释和无创超声心动图对 CMD 和 LASr 进行评估：共纳入 42 名患者，其中 26 人患有 CMD。在临床和超声心动图特征方面，CMD 阳性和阴性患者之间没有明显差异。CMD患者的LASr明显降低（24.6% ± 6.1 vs. 30.3 ± 7.8%，P = 0.01）。冠状动脉血流储备与 LAsr 之间存在中度相关性（r = 0.47，p = 0.002）。多变量逻辑回归分析表明，CMD与LASr独立相关（OR = 0.88，95%CI 0.78-0.99.135，p = 0.04）。将 LASr 临界值定为 25.5%，可以对有或没有 CMD 的患者进行最佳分类：结论：与无 CMD 的患者相比，NOCA 和 CMD 患者的 LASr 明显降低，表明这些患者的舒张功能早期受损。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Cardiovascular Ultrasound CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.10

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Cardiovascular Ultrasound is an online journal, publishing peer-reviewed: original research; authoritative reviews; case reports on challenging and/or unusual diagnostic aspects; and expert opinions on new techniques and technologies. We are particularly interested in articles that include relevant images or video files, which provide an additional dimension to published articles and enhance understanding. As an open access journal, Cardiovascular Ultrasound ensures high visibility for authors in addition to providing an up-to-date and freely available resource for the community. The journal welcomes discussion, and provides a forum for publishing opinion and debate ranging from biology to engineering to clinical echocardiography, with both speed and versatility.