Key result
Metabolic syndrome was significantly associated with a lesser increase in coronary blood flow in response to acetylcholine infusion (P < 0.0001), indicating impaired microvascular endothelial function.
Why the study?
Does metabolic syndrome impair coronary endothelial function of conduit and resistance vessels in men with chest pain and normal coronary arteries?
Observational (n=78)
Does metabolic syndrome impair coronary endothelial function of conduit and resistance vessels in men with chest pain and normal coronary arteries?
p-value: p=<0.0001
Metabolic syndrome is associated with coronary microvascular endothelial dysfunction (resistance vessels) but not epicardial (conduit) dysfunction in men with chest pain and normal angiograms.
Metabolic syndrome may impair microvascular endothelial function; hypothesis-generating and should not yet change practice.
AIM: To assess coronary endothelial function of conduit and resistance vessels in patients with metabolic syndrome (MS). METHODS: Seventy-eight men (mean age, 57 years) with chest pain and angiographically normal coronary arteries were included in the study. Patients with coronary spastic angina were excluded. Changes in coronary artery diameter and coronary blood flow (CBF) in response to acetylcholine (ACh) were determined using quantitative coronary angiography and Doppler velocity measurements. Coronary flow reserve was calculated as the ratio of coronary blood velocity after adenosine triphosphate infusion relative to baseline values. Patients were divided into two groups based on the presence or absence of MS. RESULTS: There were 24 patients in the MS group (31%). The increase in CBF in response to ACh infusion was impaired in the MS group (P < 0.0001) compared to the non-MS group, whereas changes in coronary artery diameter in response to ACh infusion did not differ between the two groups. Multivariate regression analysis revealed that MS was a significant factor associated with the lesser change in CBF induced by ACh infusion at 30 μg/min (P < 0.0001, r(2) = 0.46). CONCLUSION: Coronary endothelial dysfunction was present at the level of resistance vessels but not conduit vessels in the MS patients included in our study.
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Hiroki Teragawa (2010) conducted an observational in Metabolic syndrome (n=78). Metabolic syndrome vs. Absence of metabolic syndrome was evaluated on Change in coronary blood flow (CBF) in response to acetylcholine (ACh) infusion (p=<0.0001). Metabolic syndrome was significantly associated with a lesser increase in coronary blood flow in response to acetylcholine infusion (P < 0.0001), indicating impaired microvascular endothelial function.
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