Author + information
- Louise Jessen1,
- Karsten Veien2,
- Julia Ellert3,
- Ahmed Aziz4,
- Anders Junker2 and
- Lisette Okkels Jensen2
Women generally have a lesser extent of both overt and subclinical coronary atherosclerosis compared to men, and microvascular function may differ within gender. Abnormalities in the microcirculation can contribute to myocardial ischemia that partly affect fractional flow reserve (FFR) measurements.
To evaluate the effect of gender differences in FFR, index of microvascular resistance (IMR) and coronary flow reserve (CFR) measurements in patients with stable angina.
FFR, IMR and CFR were measured after 2 minutes infusion of an adenosine dose at 140μg/kg/min. IMR ≥ 24 was defined as microcirculatory dysfunction, whereas IMR < 24 equaled a normal microcirculation. Adenosine dose was then increased to 200μg/kg/min in 2 minutes and FFR was measured again.
A total of 50 patients were consecutively enrolled. Mean FFR was 0.81 ± 0.11, mean IMR 29.0 ± 17.3 and mean CFR 2.4 ± 0.95. Male patients counted for 37 (74.0%) and female patients 13 (26%). IMR tended to be higher for male patients (IMR = 34.6 ± 24.8) compared to female patients (IMR = 21.5 ± 12.1), p=0.074; and a higher proportion of male patients had an increased IMR ≥ 24 compared to female patients (24 [88.9%] vs 3 [11.1%], p=0.009). Neither FFR (0.82 ± 0.11 vs. 0.81 ± 0.09, p=0.74) nor CFR (2.3 ± 0.9 vs. 2.7 ± 1.7, p=0.25) differed significantly between male and female patients. Overall, mean FFR decreased significantly from 0.81 ± 0.10 at standard dose of adenosine to 0.79 ± 0.10 at increased dose of adenosine (p≤0.001). For male patients, the mean FFR decreased from 0.82 ± 0.11 to 0.79 ± 0.10 (p≤0.001) vs. 0.81 ± 0.09 to 0.79 ± 0.09 (p=0.044) in female patients.
Microvascular function was less affected in female compared to male patients; whereas CFR and FFR did not differ significantly among gender. Increased hyperemic stimulus induced further FFR reduction in both male and female patients.
OTHER: Womens Health Issues