RT Journal Article
SR Electronic
T1 Coronary endothelial function testing may improve long-term quality of life in subjects with microvascular coronary endothelial dysfunction
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e000870
DO 10.1136/openhrt-2018-000870
VO 6
IS 1
A1 Martin Reriani
A1 Andreas J Flammer
A1 Jessica Duhé
A1 Jing Li
A1 Rajiv Gulati
A1 Charanjit S Rihal
A1 Ryan Lennon
A1 Jonella M Tilford
A1 Abhiram Prasad
A1 Lilach O Lerman
A1 Amir Lerman
YR 2019
UL http://openheart.bmj.com/content/6/1/e000870.abstract
AB 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.