Author + information
- Marie Mide Michelsen,
- Adam Pena,
- Naja Mygind,
- Ida Gustafsson,
- Nis Host,
- Jan Bech,
- Henrik Steen Hansen,
- Jens Kastrup,
- Peter Riis Hansen and
- Eva Prescott
Background: Coronary microvascular dysfunction (CMD) is a potential cause of ischemia and may affect myocardial systolic function at rest and during stress. We investigated whether CMD was associated with left ventricular systolic function during rest and pharmacological induced hyperemic stress.
Method: We included 360 women with angina, left ventricular ejection fraction (LVEF) >45% and an invasive coronary angiogram without significant coronary artery stenosis (<50%). LVEF, speckle tracking-derived global longitudinal strain (GLS) and CMD were assessed by echocardiography during rest and dipyridamole infusion. Patients were divided by coronary flow velocity reserve (CFVR) in three risk groups and CMD was defined as CFVR<2. The GLS and LVEF reserves were defined as the absolute increases in GLS and LVEF during stress.
Results: CMD was present in 31% women who were older and had a higher resting heart rate. Low CFVR was associated with a reduced GLS reserve (p=0.005) (Table) while we found no association between CFVR and baseline LVEF, baseline GLS or LVEF reserve. GLS reserve remained associated with CFVR (p<0.001) in a multivariable regression analysis adjusting for cardiovascular risk factors, hemodynamic variables and baseline GLS.
Conclusions: The GLS reserve was significantly lower in women with CMD. This suggests that CMD contributes to ischemia and subtle reductions in the ability to increase left ventricular systolic function during hyperemic stress in women with angina and no obstructive CAD.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Novel Echocardiographic Methods for Assessing Cardiac Function
Abstract Category: 28. Non Invasive Imaging: Echo
Presentation Number: 1120-233
- 2017 American College of Cardiology Foundation