Evaluation of endothelial dysfunction with coronary flow reserve measurement in patients with fibromyalgia

Objectives: This study aims to investigate the role of increased inflammation and oxidative stress over endothelial functions with echocardiographic evaluation of coronary flow reserve in patients with fibromyalgia (FM). Patients and methods: Between December 2021 and September 2022, a total of 38 female patients (mean age: 43.4±7.0 years; range, 34 to 51 years) with the diagnosis of FM and 35 healthy controls (15 males, 20 females; mean age: 41.1±6.3 years; range, 34 to 49 years) were included. The endothelial functions were evaluated by measuring coronary flow reserve. Coronary flow reserve of the left anterior descending coronary artery was measured from distal and middle portions with pulse wave Doppler at both baseline and hyperemic peak diastolic flow rate by transthoracic echocardiography. Results: There were no significant differences in clinical, demographical and laboratory findings between the FM and control group, except for conventional C-reactive protein (CRP) levels. The mean hyperemic peak diastolic flow rate and coronary flow reserve values were significantly lower in FM patients (p<0.001). Conclusion: Chronic stress and pain augment the sympathetic activity, resulting in endothelial dysfunction and increasing the cardiovascular risk. Endothelial dysfunction should be evaluated by measuring coronary flow reserve in FM patients.