Left ventricular concentric remodelling and functional impairment in women with ischaemia with no obstructive coronary artery disease and intermediate coronary flow reserve: A report from the WISE-CVD study

Seong Mi Park; Janet Wei; Galen Cook-Wiens; Michael D. Nelson; Louise Thomson; Daniel Berman; Eileen Handberg; John Petersen; David Anderson; Carl J. Pepine; C. Noel Bairey Merz

doi:10.1093/ehjci/jez044

Left ventricular concentric remodelling and functional impairment in women with ischaemia with no obstructive coronary artery disease and intermediate coronary flow reserve: A report from the WISE-CVD study

Seong Mi Park, Janet Wei, Galen Cook-Wiens, Michael D. Nelson, Louise Thomson, Daniel Berman, Eileen Handberg, John Petersen, David Anderson, Carl J. Pepine, C. Noel Bairey Merz

Research output: Contribution to journal › Article › peer-review

16 Citations (Scopus)

Abstract

Women with evidence of ischaemia but no obstructive coronary artery disease (INOCA) often have coronary microvascular dysfunction (CMD). Although invasively measured coronary flow reserve (CFR) is useful for the diagnosis of CMD, intermediate CFR values are often found of uncertain significance. We investigated myocardial flow reserve and left ventricular (LV) structural and functional remodelling in women with suspected INOCA and intermediate CFR. Methods and results: Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) study participants who had invasively measured intermediate CFR of 2.0≤ CFR ≤3.0 (n = 125) were included for this analysis. LV strain, peak filling rate (PFR) and myocardial perfusion reserve index (MPRI) were obtained by cardiac magnetic resonance imaging. Participants were divided: (i) Group 1 (n = 66) high MPRI ≥ 1.8, and (ii) Group 2 (n = 59) low MPRI < 1.8. The mean age was 54 ± 12 years and CFR was 2.46 ± 0.27. MPRI was significantly different but CFR did not differ between groups. LV relative wall thickness (RWT) trended higher in Group 2 and circumferential peak systolic strain and early diastolic strain rate were lower (P = 0.039 and P = 0.035, respectively), despite a similar LV ejection fraction and LV mass. PFR was higher in Group 1 and LV RWT was negatively related to PFR (r = -0.296, P = 0.001). Conclusions: In women with suspected INOCA and intermediate CFR, those with lower MPRI had a trend towards more adverse remodelling and impaired diastolic LV function compared with those with higher MPRI. CFR was similar between the two groups. These findings provide evidence that both coronary microvessel vasomotion and structural and functional myocardial remodelling contribute to CMD.

Original language	English
Article number	jez044
Pages (from-to)	875-882
Number of pages	8
Journal	European heart journal cardiovascular Imaging
Volume	20
Issue number	8
DOIs	https://doi.org/10.1093/ehjci/jez044
Publication status	Published - 2019 Aug 1

Bibliographical note

Funding Information:
Research reported in this publication was supported by the National Heart, Lung and Blood Institute (NHLBI) under grant numbers N01HV68161, N01HV68162, N01HV68163, N01HV68164, U01HL64829, U01HL64914, U01HL64924, K23HL105787, T32HL69751, R01HL090957, R01HL33610, R01HL56921, and UM1HL087366; the National Institute on Aging (NIA) under grant number R03AG032631; the National Center for Research Resources (NCRR) under grant number M01RR000425; the National Center for Advancing Translational Sciences (NCATS) under grant numbers UL1TR000124, UL1TR000064, and UL1TR001427. This work was also supported by grants from the Gustavus and Louis Pfeiffer Research Foundation, Danville, NJ; The Ladies Hospital Aid Society of Western Pennsylvania, Pittsburgh, PA; The Society for Women’s Health Research (SWHR), Washington, DC; QMED, Inc., Laurence Harbor, NJ; The Women’s Guild of Cedars-Sinai, the Edythe L. Broad, the Constance Austin Women’s Heart Research Fellowships, the Barbra Streisand

Publisher Copyright:
© 2019 Published on behalf of the European Society of Cardiology. All rights reserved.

Keywords

cardiac magnetic resonance
coronary flow reserve
coronary microvascular dysfunction
remodelling
women

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

Access to Document

10.1093/ehjci/jez044

Fingerprint

Dive into the research topics of 'Left ventricular concentric remodelling and functional impairment in women with ischaemia with no obstructive coronary artery disease and intermediate coronary flow reserve: A report from the WISE-CVD study'. Together they form a unique fingerprint.

Cite this

Park, S. M., Wei, J., Cook-Wiens, G., Nelson, M. D., Thomson, L., Berman, D., Handberg, E., Petersen, J., Anderson, D., Pepine, C. J., & Merz, C. N. B. (2019). Left ventricular concentric remodelling and functional impairment in women with ischaemia with no obstructive coronary artery disease and intermediate coronary flow reserve: A report from the WISE-CVD study. European heart journal cardiovascular Imaging, 20(8), 875-882. Article jez044. https://doi.org/10.1093/ehjci/jez044

Left ventricular concentric remodelling and functional impairment in women with ischaemia with no obstructive coronary artery disease and intermediate coronary flow reserve: A report from the WISE-CVD study. / Park, Seong Mi; Wei, Janet; Cook-Wiens, Galen et al.
In: European heart journal cardiovascular Imaging, Vol. 20, No. 8, jez044, 01.08.2019, p. 875-882.

Research output: Contribution to journal › Article › peer-review

Park, SM, Wei, J, Cook-Wiens, G, Nelson, MD, Thomson, L, Berman, D, Handberg, E, Petersen, J, Anderson, D, Pepine, CJ & Merz, CNB 2019, 'Left ventricular concentric remodelling and functional impairment in women with ischaemia with no obstructive coronary artery disease and intermediate coronary flow reserve: A report from the WISE-CVD study', European heart journal cardiovascular Imaging, vol. 20, no. 8, jez044, pp. 875-882. https://doi.org/10.1093/ehjci/jez044

Park SM, Wei J, Cook-Wiens G, Nelson MD, Thomson L, Berman D et al. Left ventricular concentric remodelling and functional impairment in women with ischaemia with no obstructive coronary artery disease and intermediate coronary flow reserve: A report from the WISE-CVD study. European heart journal cardiovascular Imaging. 2019 Aug 1;20(8):875-882. jez044. doi: 10.1093/ehjci/jez044

@article{fc15f61138bc4b06b9cb83ec3624b8b7,

title = "Left ventricular concentric remodelling and functional impairment in women with ischaemia with no obstructive coronary artery disease and intermediate coronary flow reserve: A report from the WISE-CVD study",

abstract = "Women with evidence of ischaemia but no obstructive coronary artery disease (INOCA) often have coronary microvascular dysfunction (CMD). Although invasively measured coronary flow reserve (CFR) is useful for the diagnosis of CMD, intermediate CFR values are often found of uncertain significance. We investigated myocardial flow reserve and left ventricular (LV) structural and functional remodelling in women with suspected INOCA and intermediate CFR. Methods and results: Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) study participants who had invasively measured intermediate CFR of 2.0≤ CFR ≤3.0 (n = 125) were included for this analysis. LV strain, peak filling rate (PFR) and myocardial perfusion reserve index (MPRI) were obtained by cardiac magnetic resonance imaging. Participants were divided: (i) Group 1 (n = 66) high MPRI ≥ 1.8, and (ii) Group 2 (n = 59) low MPRI < 1.8. The mean age was 54 ± 12 years and CFR was 2.46 ± 0.27. MPRI was significantly different but CFR did not differ between groups. LV relative wall thickness (RWT) trended higher in Group 2 and circumferential peak systolic strain and early diastolic strain rate were lower (P = 0.039 and P = 0.035, respectively), despite a similar LV ejection fraction and LV mass. PFR was higher in Group 1 and LV RWT was negatively related to PFR (r = -0.296, P = 0.001). Conclusions: In women with suspected INOCA and intermediate CFR, those with lower MPRI had a trend towards more adverse remodelling and impaired diastolic LV function compared with those with higher MPRI. CFR was similar between the two groups. These findings provide evidence that both coronary microvessel vasomotion and structural and functional myocardial remodelling contribute to CMD.",

keywords = "cardiac magnetic resonance, coronary flow reserve, coronary microvascular dysfunction, remodelling, women",

author = "Park, {Seong Mi} and Janet Wei and Galen Cook-Wiens and Nelson, {Michael D.} and Louise Thomson and Daniel Berman and Eileen Handberg and John Petersen and David Anderson and Pepine, {Carl J.} and Merz, {C. Noel Bairey}",

note = "Funding Information: Research reported in this publication was supported by the National Heart, Lung and Blood Institute (NHLBI) under grant numbers N01HV68161, N01HV68162, N01HV68163, N01HV68164, U01HL64829, U01HL64914, U01HL64924, K23HL105787, T32HL69751, R01HL090957, R01HL33610, R01HL56921, and UM1HL087366; the National Institute on Aging (NIA) under grant number R03AG032631; the National Center for Research Resources (NCRR) under grant number M01RR000425; the National Center for Advancing Translational Sciences (NCATS) under grant numbers UL1TR000124, UL1TR000064, and UL1TR001427. This work was also supported by grants from the Gustavus and Louis Pfeiffer Research Foundation, Danville, NJ; The Ladies Hospital Aid Society of Western Pennsylvania, Pittsburgh, PA; The Society for Women{\textquoteright}s Health Research (SWHR), Washington, DC; QMED, Inc., Laurence Harbor, NJ; The Women{\textquoteright}s Guild of Cedars-Sinai, the Edythe L. Broad, the Constance Austin Women{\textquoteright}s Heart Research Fellowships, the Barbra Streisand Publisher Copyright: {\textcopyright} 2019 Published on behalf of the European Society of Cardiology. All rights reserved.",

year = "2019",

month = aug,

day = "1",

doi = "10.1093/ehjci/jez044",

language = "English",

volume = "20",

pages = "875--882",

journal = "European heart journal cardiovascular Imaging",

issn = "2047-2404",

publisher = "Oxford University Press",

number = "8",

}

TY - JOUR

T1 - Left ventricular concentric remodelling and functional impairment in women with ischaemia with no obstructive coronary artery disease and intermediate coronary flow reserve

T2 - A report from the WISE-CVD study

AU - Park, Seong Mi

AU - Wei, Janet

AU - Cook-Wiens, Galen

AU - Nelson, Michael D.

AU - Thomson, Louise

AU - Berman, Daniel

AU - Handberg, Eileen

AU - Petersen, John

AU - Anderson, David

AU - Pepine, Carl J.

AU - Merz, C. Noel Bairey

N1 - Funding Information: Research reported in this publication was supported by the National Heart, Lung and Blood Institute (NHLBI) under grant numbers N01HV68161, N01HV68162, N01HV68163, N01HV68164, U01HL64829, U01HL64914, U01HL64924, K23HL105787, T32HL69751, R01HL090957, R01HL33610, R01HL56921, and UM1HL087366; the National Institute on Aging (NIA) under grant number R03AG032631; the National Center for Research Resources (NCRR) under grant number M01RR000425; the National Center for Advancing Translational Sciences (NCATS) under grant numbers UL1TR000124, UL1TR000064, and UL1TR001427. This work was also supported by grants from the Gustavus and Louis Pfeiffer Research Foundation, Danville, NJ; The Ladies Hospital Aid Society of Western Pennsylvania, Pittsburgh, PA; The Society for Women’s Health Research (SWHR), Washington, DC; QMED, Inc., Laurence Harbor, NJ; The Women’s Guild of Cedars-Sinai, the Edythe L. Broad, the Constance Austin Women’s Heart Research Fellowships, the Barbra Streisand Publisher Copyright: © 2019 Published on behalf of the European Society of Cardiology. All rights reserved.

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Women with evidence of ischaemia but no obstructive coronary artery disease (INOCA) often have coronary microvascular dysfunction (CMD). Although invasively measured coronary flow reserve (CFR) is useful for the diagnosis of CMD, intermediate CFR values are often found of uncertain significance. We investigated myocardial flow reserve and left ventricular (LV) structural and functional remodelling in women with suspected INOCA and intermediate CFR. Methods and results: Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) study participants who had invasively measured intermediate CFR of 2.0≤ CFR ≤3.0 (n = 125) were included for this analysis. LV strain, peak filling rate (PFR) and myocardial perfusion reserve index (MPRI) were obtained by cardiac magnetic resonance imaging. Participants were divided: (i) Group 1 (n = 66) high MPRI ≥ 1.8, and (ii) Group 2 (n = 59) low MPRI < 1.8. The mean age was 54 ± 12 years and CFR was 2.46 ± 0.27. MPRI was significantly different but CFR did not differ between groups. LV relative wall thickness (RWT) trended higher in Group 2 and circumferential peak systolic strain and early diastolic strain rate were lower (P = 0.039 and P = 0.035, respectively), despite a similar LV ejection fraction and LV mass. PFR was higher in Group 1 and LV RWT was negatively related to PFR (r = -0.296, P = 0.001). Conclusions: In women with suspected INOCA and intermediate CFR, those with lower MPRI had a trend towards more adverse remodelling and impaired diastolic LV function compared with those with higher MPRI. CFR was similar between the two groups. These findings provide evidence that both coronary microvessel vasomotion and structural and functional myocardial remodelling contribute to CMD.

AB - Women with evidence of ischaemia but no obstructive coronary artery disease (INOCA) often have coronary microvascular dysfunction (CMD). Although invasively measured coronary flow reserve (CFR) is useful for the diagnosis of CMD, intermediate CFR values are often found of uncertain significance. We investigated myocardial flow reserve and left ventricular (LV) structural and functional remodelling in women with suspected INOCA and intermediate CFR. Methods and results: Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) study participants who had invasively measured intermediate CFR of 2.0≤ CFR ≤3.0 (n = 125) were included for this analysis. LV strain, peak filling rate (PFR) and myocardial perfusion reserve index (MPRI) were obtained by cardiac magnetic resonance imaging. Participants were divided: (i) Group 1 (n = 66) high MPRI ≥ 1.8, and (ii) Group 2 (n = 59) low MPRI < 1.8. The mean age was 54 ± 12 years and CFR was 2.46 ± 0.27. MPRI was significantly different but CFR did not differ between groups. LV relative wall thickness (RWT) trended higher in Group 2 and circumferential peak systolic strain and early diastolic strain rate were lower (P = 0.039 and P = 0.035, respectively), despite a similar LV ejection fraction and LV mass. PFR was higher in Group 1 and LV RWT was negatively related to PFR (r = -0.296, P = 0.001). Conclusions: In women with suspected INOCA and intermediate CFR, those with lower MPRI had a trend towards more adverse remodelling and impaired diastolic LV function compared with those with higher MPRI. CFR was similar between the two groups. These findings provide evidence that both coronary microvessel vasomotion and structural and functional myocardial remodelling contribute to CMD.

KW - cardiac magnetic resonance

KW - coronary flow reserve

KW - coronary microvascular dysfunction

KW - remodelling

KW - women

UR - http://www.scopus.com/inward/record.url?scp=85070119310&partnerID=8YFLogxK

U2 - 10.1093/ehjci/jez044

DO - 10.1093/ehjci/jez044

M3 - Article

C2 - 30904924

AN - SCOPUS:85070119310

SN - 2047-2404

VL - 20

SP - 875

EP - 882

JO - European heart journal cardiovascular Imaging

JF - European heart journal cardiovascular Imaging

IS - 8

M1 - jez044

ER -

Left ventricular concentric remodelling and functional impairment in women with ischaemia with no obstructive coronary artery disease and intermediate coronary flow reserve: A report from the WISE-CVD study

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this