Coronary endothelial dysfunction appears to be a manifestation of a systemic process: A report from the Women's Ischemia Syndrome Evaluation - Coronary Vascular Dysfunction (WISE-CVD) study.

<h4>Background</h4>Coronary microvascular dysfunction (CMD) is prevalent in symptomatic women with ischemia but no obstructive coronary artery disease (INOCA). Urine albumin-creatinine ratio (UACR) is a measure of renal microvascular endothelial dysfunction. Both are predictors of advers...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Sawan Jalnapurkar, Sofy Landes, Janet Wei, Puja K Mehta, Chrisandra Shufelt, Margo Minissian, Carl J Pepine, Eileen Handberg, Galen Cook-Wiens, George Sopko, C Noel Bairey Merz
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/da332ccb2f5047b38b3db4e5344d9d53
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:da332ccb2f5047b38b3db4e5344d9d53
record_format	dspace
spelling	oai:doaj.org-article:da332ccb2f5047b38b3db4e5344d9d532021-12-02T20:07:59ZCoronary endothelial dysfunction appears to be a manifestation of a systemic process: A report from the Women's Ischemia Syndrome Evaluation - Coronary Vascular Dysfunction (WISE-CVD) study.1932-620310.1371/journal.pone.0257184https://doaj.org/article/da332ccb2f5047b38b3db4e5344d9d532021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0257184https://doaj.org/toc/1932-6203<h4>Background</h4>Coronary microvascular dysfunction (CMD) is prevalent in symptomatic women with ischemia but no obstructive coronary artery disease (INOCA). Urine albumin-creatinine ratio (UACR) is a measure of renal microvascular endothelial dysfunction. Both are predictors of adverse cardiovascular events. It is unknown if CMD could be a manifestation of a systemic process. We evaluated the relationship between renal microvascular dysfunction and CMD as measured by invasive coronary function testing (CFT).<h4>Methods and results</h4>We measured urine albumin and creatinine to provide UACR in 152 women enrolled in the Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) study (2008-2015) with suspected INOCA who underwent CFT. Invasive CFT measures of endothelial and non-endothelial dependent coronary microvascular function were obtained. Subjects were divided into those with detectable (≥20 mg/g) and undetectable urine albumin (<20 mg/g). The group mean age was 54 ± 11 years, with a moderate cardiac risk factor burden including low diabetes prevalence, and a mean UACR of 12 ± 55 mg/g (range 9.5-322.7 mg/g). Overall, coronary endothelial-dependent variables (change in coronary blood flow and coronary diameter in response to cold pressor testing) had significant inverse correlations with log UACR (r = -0.17, p = 0.05; r = -0.18, p = 0.03, respectively).<h4>Conclusions</h4>Among women with INOCA and relatively low risk factor including diabetes burden, renal microvascular dysfunction, measured by UACR, is related to coronary endothelial-dependent CMD. These results suggest that coronary endothelial-dependent function may be a manifestation of a systemic process. Enhancing efferent arteriolar vasodilatation in both coronary endothelial-dependent function and renal microvascular dysfunction pose potential targets for investigation and treatment.<h4>Clinical trial registration</h4>https://clinicaltrials.gov/ct2/show/NCT00832702.Sawan JalnapurkarSofy LandesJanet WeiPuja K MehtaChrisandra ShufeltMargo MinissianCarl J PepineEileen HandbergGalen Cook-WiensGeorge SopkoC Noel Bairey MerzPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0257184 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sawan Jalnapurkar Sofy Landes Janet Wei Puja K Mehta Chrisandra Shufelt Margo Minissian Carl J Pepine Eileen Handberg Galen Cook-Wiens George Sopko C Noel Bairey Merz Coronary endothelial dysfunction appears to be a manifestation of a systemic process: A report from the Women's Ischemia Syndrome Evaluation - Coronary Vascular Dysfunction (WISE-CVD) study.
description	<h4>Background</h4>Coronary microvascular dysfunction (CMD) is prevalent in symptomatic women with ischemia but no obstructive coronary artery disease (INOCA). Urine albumin-creatinine ratio (UACR) is a measure of renal microvascular endothelial dysfunction. Both are predictors of adverse cardiovascular events. It is unknown if CMD could be a manifestation of a systemic process. We evaluated the relationship between renal microvascular dysfunction and CMD as measured by invasive coronary function testing (CFT).<h4>Methods and results</h4>We measured urine albumin and creatinine to provide UACR in 152 women enrolled in the Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) study (2008-2015) with suspected INOCA who underwent CFT. Invasive CFT measures of endothelial and non-endothelial dependent coronary microvascular function were obtained. Subjects were divided into those with detectable (≥20 mg/g) and undetectable urine albumin (<20 mg/g). The group mean age was 54 ± 11 years, with a moderate cardiac risk factor burden including low diabetes prevalence, and a mean UACR of 12 ± 55 mg/g (range 9.5-322.7 mg/g). Overall, coronary endothelial-dependent variables (change in coronary blood flow and coronary diameter in response to cold pressor testing) had significant inverse correlations with log UACR (r = -0.17, p = 0.05; r = -0.18, p = 0.03, respectively).<h4>Conclusions</h4>Among women with INOCA and relatively low risk factor including diabetes burden, renal microvascular dysfunction, measured by UACR, is related to coronary endothelial-dependent CMD. These results suggest that coronary endothelial-dependent function may be a manifestation of a systemic process. Enhancing efferent arteriolar vasodilatation in both coronary endothelial-dependent function and renal microvascular dysfunction pose potential targets for investigation and treatment.<h4>Clinical trial registration</h4>https://clinicaltrials.gov/ct2/show/NCT00832702.
format	article
author	Sawan Jalnapurkar Sofy Landes Janet Wei Puja K Mehta Chrisandra Shufelt Margo Minissian Carl J Pepine Eileen Handberg Galen Cook-Wiens George Sopko C Noel Bairey Merz
author_facet	Sawan Jalnapurkar Sofy Landes Janet Wei Puja K Mehta Chrisandra Shufelt Margo Minissian Carl J Pepine Eileen Handberg Galen Cook-Wiens George Sopko C Noel Bairey Merz
author_sort	Sawan Jalnapurkar
title	Coronary endothelial dysfunction appears to be a manifestation of a systemic process: A report from the Women's Ischemia Syndrome Evaluation - Coronary Vascular Dysfunction (WISE-CVD) study.
title_short	Coronary endothelial dysfunction appears to be a manifestation of a systemic process: A report from the Women's Ischemia Syndrome Evaluation - Coronary Vascular Dysfunction (WISE-CVD) study.
title_full	Coronary endothelial dysfunction appears to be a manifestation of a systemic process: A report from the Women's Ischemia Syndrome Evaluation - Coronary Vascular Dysfunction (WISE-CVD) study.
title_fullStr	Coronary endothelial dysfunction appears to be a manifestation of a systemic process: A report from the Women's Ischemia Syndrome Evaluation - Coronary Vascular Dysfunction (WISE-CVD) study.
title_full_unstemmed	Coronary endothelial dysfunction appears to be a manifestation of a systemic process: A report from the Women's Ischemia Syndrome Evaluation - Coronary Vascular Dysfunction (WISE-CVD) study.
title_sort	coronary endothelial dysfunction appears to be a manifestation of a systemic process: a report from the women's ischemia syndrome evaluation - coronary vascular dysfunction (wise-cvd) study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/da332ccb2f5047b38b3db4e5344d9d53
work_keys_str_mv	AT sawanjalnapurkar coronaryendothelialdysfunctionappearstobeamanifestationofasystemicprocessareportfromthewomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvdstudy AT sofylandes coronaryendothelialdysfunctionappearstobeamanifestationofasystemicprocessareportfromthewomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvdstudy AT janetwei coronaryendothelialdysfunctionappearstobeamanifestationofasystemicprocessareportfromthewomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvdstudy AT pujakmehta coronaryendothelialdysfunctionappearstobeamanifestationofasystemicprocessareportfromthewomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvdstudy AT chrisandrashufelt coronaryendothelialdysfunctionappearstobeamanifestationofasystemicprocessareportfromthewomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvdstudy AT margominissian coronaryendothelialdysfunctionappearstobeamanifestationofasystemicprocessareportfromthewomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvdstudy AT carljpepine coronaryendothelialdysfunctionappearstobeamanifestationofasystemicprocessareportfromthewomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvdstudy AT eileenhandberg coronaryendothelialdysfunctionappearstobeamanifestationofasystemicprocessareportfromthewomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvdstudy AT galencookwiens coronaryendothelialdysfunctionappearstobeamanifestationofasystemicprocessareportfromthewomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvdstudy AT georgesopko coronaryendothelialdysfunctionappearstobeamanifestationofasystemicprocessareportfromthewomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvdstudy AT cnoelbaireymerz coronaryendothelialdysfunctionappearstobeamanifestationofasystemicprocessareportfromthewomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvdstudy
_version_	1718375269883969536

Coronary endothelial dysfunction appears to be a manifestation of a systemic process: A report from the Women's Ischemia Syndrome Evaluation - Coronary Vascular Dysfunction (WISE-CVD) study.

Ejemplares similares