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KMID : 0368120040340050485
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Korean Circulation Journal
2004 Volume.34 No. 5 p.485 ~ p.491
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Relation between Peripheral Vascular Endothelial Function and Coronary Flow Reserve in Patients with Chest Pain and Normal Coronary Angiogram
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박철수/Park CS
윤호중/임상헌/조은주/정해억/전희경/이종민/오용석/정욱성/김재형/최규보/홍순조/Youn HJ/Ihm SH/Cho EJ/Jung HO/Jeon HK/Lee JM/Oh YS/Chung WS/Kim JH/Choi KB/Hong SJ
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Abstract
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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, M：F=9：23) 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 intima-media 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：≥2.1 or <2.1, as measured with transthoracic echocardiography in the distal left anterior descending coronary artery.
Results：The percentage FMD was 6.04±5.78% in those with a CFR<2.1 and 11.77±6.82% in those with a CFR≥2.1 (p<0.05). The CFR was closely related to the peripheral FMD (r=0.361, p<0.05). The average IMT were 0.71±0.26 and 0.68±0.14 mm in those with CFR<2.1 and ≥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.
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