Key result
In patients with coronary slow flow, higher uric acid levels were significantly associated with worsening diastolic function during stress, specifically demonstrating an inverse association with the change in peak filling rate normalized to end-diastolic volume (β = -0.560, p=0.015).
Why the study?
The use of G-SPECT to estimate left ventricular diastolic function during stress in coronary slow flow patients was not well determined.
Does stress testing alter left ventricular diastolic function in patients with coronary slow flow compared to rest, and what clinical variables are associated with these changes?
Observational (n=18)
No
Does stress testing alter left ventricular diastolic function in patients with coronary slow flow compared to rest, and what clinical variables are associated with these changes?
Effect estimate: β = -0.560
p-value: p=0.015
In patients with coronary slow flow, uric acid levels are significantly associated with stress-induced worsening of diastolic function as measured by G-SPECT.
Background Gated 99m Tc-sestamibi myocardial perfusion single-photon emission computed tomography (G-SPECT) is a non-invasive imaging technique that offers accurate evaluation of myocardial perfusion and resting left ventricular diastolic function in patients with coronary slow flow (CSF). However, it’s uses to estimate the diastolic function during stress is still not well determined.Objective To evaluate the left ventricular diastolic function at rest and during stress in CSF patients using G-SPECT and to determine the association between the clinical variables and the rest-stress changes in diastolic function.Methods We identified 18 angiographically proven CSF patients (56 ± 8.9 years, 12 male), from January 2017 through October 2018, who underwent a 2-day 99mTc-t sestamibi adenosine/exercise stress test along with rest protocols. The cardiac diastolic function parameters, including peak filling rate (PFR), time to peak filling (TTPF), and peak filling rate normalized to EDV (end diastolic volume) (PFR/EDV) were obtained using G‑SPECT. Then, the association between the diastolic function parameter changes (Δ stress-rest) and cardiovascular risk factors were analyzed.Results Compared with rest, summed stress scores were significantly higher (P = 0.01). TTPF, PFR, and PFR adjusted by EDV(PFR/EDV) alone showed no significant difference between rest and stress as diastolic dysfunction was present in both states. There was progressive decrease in TTPF, PFR and PFR/EDV with stress. In stepwise regression model, total cholesterol was significantly associated with the difference of summed scores (ΔStress-Rest) (β = 0.518, P = 0.028). In the same model, uric acid was found inversely associated with the difference in TTPF (ΔStress-Rest) and PFR/EDV (ΔStress-Rest) (β= -0.516, P = 0.028 and β= -0.560, P = 0.015, respectively).Conclusion Uric acid is significantly associated with the diastolic function worsening during stress in CSF patients. It may be a potential predictor and possible therapeutic target to attenuate the early diastolic function deterioration in these patients.
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Wang et al. (2023) conducted an observational in Coronary slow flow (n=18). Uric acid level was evaluated on Change in peak filling rate normalized to end-diastolic volume (Δ PFR/EDV) between stress and rest (β = -0.560, p=0.015). In patients with coronary slow flow, higher uric acid levels were significantly associated with worsening diastolic function during stress, specifically demonstrating an inverse association with the change in peak filling rate normalized to end-diastolic volume (β = -0.560, p=0.015).
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