Coronary endothelial function testing may improve long-term quality of life in subjects with microvascular coronary endothelial dysfunction

Aim Angina pectoris in the absence of obstructive coronary artery disease (CAD) is common and is associated with poor quality of life (QOL). Coronary microvascular endothelial dysfunction is associated with myocardial ischaemia and is a common cause of angina. We hypothesise that evaluation of coron...

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Main Authors: Ryan Lennon, Andreas J Flammer, Jing Li, Charanjit S Rihal, Martin Reriani, Jessica Duhé, Rajiv Gulati, Jonella M Tilford, Abhiram Prasad, Lilach O Lerman, Amir Lerman
Format: Article
Language:English
Published: BMJ Publishing Group 2019-05-01
Series:Open Heart
Online Access:https://openheart.bmj.com/content/6/1/e000870.full
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author Ryan Lennon
Andreas J Flammer
Jing Li
Charanjit S Rihal
Martin Reriani
Jessica Duhé
Rajiv Gulati
Jonella M Tilford
Abhiram Prasad
Lilach O Lerman
Amir Lerman
author_facet Ryan Lennon
Andreas J Flammer
Jing Li
Charanjit S Rihal
Martin Reriani
Jessica Duhé
Rajiv Gulati
Jonella M Tilford
Abhiram Prasad
Lilach O Lerman
Amir Lerman
author_sort Ryan Lennon
collection DOAJ
description Aim Angina pectoris in the absence of obstructive coronary artery disease (CAD) is common and is associated with poor quality of life (QOL). Coronary microvascular endothelial dysfunction is associated with myocardial ischaemia and is a common cause of angina. We hypothesise that evaluation of coronary endothelial function, its diagnosis and treatment will favourably impact QOL in patients with angina symptoms and non-obstructive CAD.Methods and results Follow-up was done on 457 patients with chest pain and non-obstructive coronary arteries who had undergone coronary vascular reactivity evaluation by administration of intracoronary acetylcholine at the time of diagnostic study. After a mean follow-up of 8.4±4.7 years, QOL was assessed by administration of the SF-36 QOL survey. Patients diagnosed and treated for microvascular endothelial dysfunction had a higher (better) overall mental composite score (44.8 vs 40.9, p=0.036) and mental health score (44.2 vs 40.7, p=0.047), and a trend towards higher vitality scores (39.1 vs 35.9, p=0.053) and role emotional scores (43.6 vs 40.4, p=0.073), compared with patients with normal endothelial function.Conclusion Among patients with chest pain and normal coronaries, diagnosis and treatment of coronary microvascular endothelial dysfunction in those with angina pectoris and non-obstructive CAD are associated with better QOL compared with patients with normal endothelial function.
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spelling doaj-art-a1c1e86230e44b12b3650296c3ed37cf2024-11-12T13:50:07ZengBMJ Publishing GroupOpen Heart2053-36242019-05-016110.1136/openhrt-2018-000870Coronary endothelial function testing may improve long-term quality of life in subjects with microvascular coronary endothelial dysfunctionRyan Lennon0Andreas J Flammer1Jing Li2Charanjit S Rihal3Martin Reriani4Jessica Duhé5Rajiv Gulati6Jonella M Tilford7Abhiram Prasad8Lilach O Lerman9Amir Lerman103 Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, Minnesota, USA1 Division of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USAophthalmologist1 Division of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA1 Division of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA1 Division of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USADepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA1 Division of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USACardiovascular Diseases, Mayo Clinic Minnesota, Rochester, Minnesota, USA4 Division of Nephrology, Mayo Clinic College of Medicine, Rochester, Minnesota, USADepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USAAim Angina pectoris in the absence of obstructive coronary artery disease (CAD) is common and is associated with poor quality of life (QOL). Coronary microvascular endothelial dysfunction is associated with myocardial ischaemia and is a common cause of angina. We hypothesise that evaluation of coronary endothelial function, its diagnosis and treatment will favourably impact QOL in patients with angina symptoms and non-obstructive CAD.Methods and results Follow-up was done on 457 patients with chest pain and non-obstructive coronary arteries who had undergone coronary vascular reactivity evaluation by administration of intracoronary acetylcholine at the time of diagnostic study. After a mean follow-up of 8.4±4.7 years, QOL was assessed by administration of the SF-36 QOL survey. Patients diagnosed and treated for microvascular endothelial dysfunction had a higher (better) overall mental composite score (44.8 vs 40.9, p=0.036) and mental health score (44.2 vs 40.7, p=0.047), and a trend towards higher vitality scores (39.1 vs 35.9, p=0.053) and role emotional scores (43.6 vs 40.4, p=0.073), compared with patients with normal endothelial function.Conclusion Among patients with chest pain and normal coronaries, diagnosis and treatment of coronary microvascular endothelial dysfunction in those with angina pectoris and non-obstructive CAD are associated with better QOL compared with patients with normal endothelial function.https://openheart.bmj.com/content/6/1/e000870.full
spellingShingle Ryan Lennon
Andreas J Flammer
Jing Li
Charanjit S Rihal
Martin Reriani
Jessica Duhé
Rajiv Gulati
Jonella M Tilford
Abhiram Prasad
Lilach O Lerman
Amir Lerman
Coronary endothelial function testing may improve long-term quality of life in subjects with microvascular coronary endothelial dysfunction
Open Heart
title Coronary endothelial function testing may improve long-term quality of life in subjects with microvascular coronary endothelial dysfunction
title_full Coronary endothelial function testing may improve long-term quality of life in subjects with microvascular coronary endothelial dysfunction
title_fullStr Coronary endothelial function testing may improve long-term quality of life in subjects with microvascular coronary endothelial dysfunction
title_full_unstemmed Coronary endothelial function testing may improve long-term quality of life in subjects with microvascular coronary endothelial dysfunction
title_short Coronary endothelial function testing may improve long-term quality of life in subjects with microvascular coronary endothelial dysfunction
title_sort coronary endothelial function testing may improve long term quality of life in subjects with microvascular coronary endothelial dysfunction
url https://openheart.bmj.com/content/6/1/e000870.full
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